title: Initial Performance of NI-RADS to Predict Residual or Recurrent Head and Neck Squamous Cell Carcinoma.
abstract: OBJECTIVE
  The Head and Neck Imaging Reporting and Data System (NI-RADS) surveillance template for head and neck cancer includes a numeric assessment of suspicion for recurrence (1-4) for the primary site and neck. Category 1 indicates no evidence of recurrence; category 2, low suspicion of recurrence; category 3, high suspicion of recurrence; and category 4, known recurrence. Our purpose was to evaluate the performance of the NI-RADS scoring system to predict local and regional disease recurrence or persistence.
  
  
  METHODS
  This study was classified as a quality-improvement project by the institutional review board. A retrospective database search yielded 500 consecutive cases interpreted using the NI-RADS template. Cases without a numeric score, non-squamous cell carcinoma primary tumors, and primary squamous cell carcinoma outside the head and neck were excluded. The electronic medical record was reviewed to determine the subsequent management, pathology results, and outcome of clinical and radiologic follow-up.
  
  
  RESULTS
  A total of 318 scans and 618 targets (314 primary targets and 304 nodal targets) met the inclusion criteria. Among the 618 targets, 85.4% were scored NI-RADS 1; 9.4% were scored NI-RADS 2; and 5.2% were scored NI-RADS 3. The rates of positive disease were 3.79%, 17.2%, and 59.4% for each NI-RADS category, respectively. Univariate association analysis demonstrated a strong association between the NI-RADS score and ultimate disease recurrence, withP< .001 for primary and regional sites.
  
  
  CONCLUSIONS
  The baseline performance of NI-RADS was good, demonstrating significant discrimination among the categories 1-3 for predicting disease.
authors.affiliation: From the Department of Radiology, Hackensack University Medical Center (D.A.K.), Hackensack, New Jersey.
authors.forename: D A
authors.identifier: http://orcid.org/0000-0002-4255-5843
authors.initials: DA
authors.lastname: Krieger
authors.affiliation: Departments of Radiology and Imaging Sciences (P.A.H., A.H.A., K.L.B., A.S.C.).
authors.forename: P A
authors.identifier: http://orcid.org/0000-0001-8816-4744
authors.initials: PA
authors.lastname: Hudgins
authors.affiliation: Department of Radiology (G.K.N.), New York University School of Medicine, New York, New York.
authors.forename: G K
authors.identifier: http://orcid.org/0000-0002-1144-653X
authors.initials: GK
authors.lastname: Nayak
authors.affiliation: Departments of Radiology and Imaging Sciences (P.A.H., A.H.A., K.L.B., A.S.C.).
authors.forename: K L
authors.identifier: http://orcid.org/0000-0003-3917-4641
authors.initials: KL
authors.lastname: Baugnon
authors.affiliation: Departments of Radiology and Imaging Sciences (P.A.H., A.H.A., K.L.B., A.S.C.).
authors.forename: A S
authors.identifier: http://orcid.org/0000-0001-7498-2543
authors.initials: AS
authors.lastname: Corey
authors.affiliation: Otolaryngology Head and Neck Surgery (M.R.P., J.J.B.), Emory University School of Medicine, Atlanta, Georgia.
authors.forename: M R
authors.identifier: http://orcid.org/0000-0001-6477-9728
authors.initials: MR
authors.lastname: Patel
authors.affiliation: Otolaryngology Head and Neck Surgery (M.R.P., J.J.B.), Emory University School of Medicine, Atlanta, Georgia.|Departments of Radiation Oncology (J.J.B.).|Hematology and Medical Oncology (J.J.B., N.F.S.).
authors.forename: J J
authors.identifier: http://orcid.org/0000-0002-1519-2071
authors.initials: JJ
authors.lastname: Beitler
authors.affiliation: Hematology and Medical Oncology (J.J.B., N.F.S.).
authors.forename: N F
authors.identifier: http://orcid.org/0000-0003-4972-1477
authors.initials: NF
authors.lastname: Saba
authors.affiliation: Biostatistics (Y.L.), Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Y
authors.identifier: http://orcid.org/0000-0001-8926-3058
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Departments of Radiology and Imaging Sciences (P.A.H., A.H.A., K.L.B., A.S.C.) Ashley.aiken@emoryhealthcare.org.
authors.forename: A H
authors.identifier: http://orcid.org/0000-0003-1096-3540
authors.initials: AH
authors.lastname: Aiken
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging*; D059906:Neuroimaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D014057:Tomography, X-Ray Computed / Q000379:methods