E1965. NI-RADS: Overview of a Neck Mass Classification System
  1. Jared Vearrier; University of Cincinnati Medical Center
  2. Jennifer Joyce; University of Cincinnati Medical Center
Head and neck anatomy is complex and often can be a source of anxiety for interpreting radiologists. Identifying head and neck cancer extent and cancer recurrence presents a unique challenge for radiologists as imaging findings can be subtle allowing for variation in interpretation. Differentiating post-treatment changes from cancer recurrence requires training, experience, and guidelines. As a response to these challenges, a new system was created to standardize imaging interpretation and post-treatment surveillance. The system is called the neck imaging reporting and data system (NI-RADS). NI-RADS is a powerful tool that provides image-based risk stratification of complex post-treatment changes for head and neck cancer. There are five categories, from zero to four, with each indicating defined treatment and surveillance guidance based on characteristic imaging findings and associated risk rate of cancer recurrence. NI-RADS provides standardized terminology to communicate level of suspicion reducing inter-interpreter variation and subjectivity in imaging reports.

Educational Goals / Teaching Points
Review the neck imaging reporting and data system (NI-RADS). Demonstrate the benefits of a standardized imaging reporting system to facilitate and guide treatment of head and neck cancer. Illustrate exemplary cases of each NI-RAD category with CT imaging. Teach about the interdisciplinary approach to head and neck cancer treatment.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Contrast enhanced computed tomography (CECT). Head and neck anatomy. Head and neck cancer.

Accurate and conclusive imaging interpretation is essential for optimal treatment of patients with head and neck cancer. NI-RADS is a system for imaging interpretation that provides standardization with regards to surveillance and treatment. Implementing NI-RADS is a step towards improved patient care by increasing detection of cancer recurrence and reducing unnecessary and costly treatments.