NIRADS-based case assessment of post-treatment head and neck cancer and its clinical correlation: A validation study

Abstract

Introduction: The neck imaging reporting and data system (NIRADS) lexicon is aimed at surveillance of head and neck cancer during post-treatment follow-up using either a CECT or PET-CT scan. These recommendations standardize management, reduce interobserver variability, and standardizes scientific communication. Objectives: The primary aim of this study was to validate the correlation between the NI-RADS category and disease status on clinical follow-up and histopathological analysis. The other objective was to assess the status of primary as well as nodal site at least 8 to 12 weeks after definitive treatment on first post-treatment imaging as per NI-RADS. Materials and Methods: We did a retrospective review of maintained a database of patients treated with curative intent radiotherapy or chemoradiotherapy. The diagnostic accuracy of NIRADS was compared with the clinical follow-up and histopathological findings. Data was recorded using the NIRADS lexicon and analyzed using SPSS 25. Result: In our study, 37 cases were followed with CECT, whereas 111 were followed with PET-CT. We observed no significant difference between CECT and PET-CT for predicting recurrence in any of the NIRADS category. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of NIRADS to predict recurrence for the primary site is 61.54%, 75.21%, 34.8%, 90.1%, and 72.79%, respectively, whereas for the neck, it is 69.54%, 75.41%, 37.5%, 92%, and 74.32%. Conclusion: NIRADS score is strongly associated with positive disease in as Neck as well as primary. Increased use of NIRADS will lead to a uniform reporting system and improved patient outcome.