Three-Phase Parathyroid 4-Dimensional Computed Tomography Initial Experience

Abstract

Multiphase multidetector contrast-enhanced parathyroid CT (4-dimensional computed tomography [4D-CT]) is an emerging tool for evaluating patients with primary hyperparathyroidism. Our goal was to describe the initial performance of 2 inexperienced readers in interpretation of 4D-CT. Twenty-three subjects who received 4D-CT and successful surgical exploration were studied (14 initial and 9 repeat explorations; 15 single-gland disease and 8 multigland disease) A staff neuroradiologist prospectively interpreted all studies, and a neuroradiology fellow retrospectively interpreted all studies; their results were compared with the surgical findings for each side of the neck separately. The prospective readings were 78% accurate overall, 97% accurate in the subset of single-gland disease cases, and 89% accurate in re-exploration cases. There was 91% concordance in interpretation between observers, with κ of 0.83. Initial results after implementation of 4D-CT show high accuracy of interpretation for inexperienced observers, comparable to published data, and high interobserver agreement.