Predictive value of neck imaging reporting and data system (NIRADS) in CECT/CEMRI of laryngeal and oral cavity squamous cell carcinoma

Abstract

Background: The neck imaging reporting and data system (NI-RADS) is a structured reporting algorithm linked with further patient management recommendations. This study was conducted to assess the overall and time point predictive value of the NI-RADS in laryngeal and oral cavity squamous cell carcinoma (SCC) using contrast-enhanced magnetic resonance imaging (CEMRI) and contrast-enhanced computed tomography (CECT). Results: The rate of tumor recurrence was statistically different among the NI-RADS 1-3 categories with recurrence trend for higher NI-RADS scores. The overall negative predictive value (NPV) of the NI-RADS 1 and 2 were 94.3%, 74.3% respectively, and the positive predictive value (PPV) of the NI-RADS 3 was 80.8%. The overall recurrence rate of NI-RADS 3 was higher in oral cavity SCC (87.5%) compared to the laryngeal SCC (70%). The PPV of overall NI-RADS 3 in the follow-up scans (77.8%) was higher than in the first scan (70.6%). The odd ratio of tumor recurrence in NI-RADS 3 primary lesion was 19.6. Conclusion: The predictive value of NI-RADS was significantly different among its categories. Increasing NI-RADS score is associated with increased recurrence among the treated laryngeal and oral cavity SCC. The morphological and enhancement lexicon features equally assign the NI-RADS 3 score.