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Purpose <p>To assess the agreement of Neck Imaging Reporting and Data System (NI-RADS) using magnetic resonance imaging (MRI) among readers with different experience in the evaluation of oropharyngeal squamous cell carcinoma (OPSCC) patients.</p> Material and methods <p>We conducted an observational retrospective study and collected post-treatment follow-up MRIs in patients treated for OPSCC. Each scan was scored according to NI-RADS by 1 general radiologist, 2 radiology residents, and 2 seasoned radiologists. Percentage of agreement (POA) and kappa values (κ) were calculated for the assignment of NI-RADS and its individual MRI features (lymph node, primary tumor size, primary site signal on T2-weighted, contrast-enhanced and diffusion-weighted images). Inter-reader agreement was calculated for all post-treatment MRIs and separately for the first post-treatment MRI (using pre-treatment MRI as reference) and subsequent follow-ups.</p> Results <p>Ninety-one patients were included (a total of 218 MRIs per rater). The agreement among all readers for NI-RADS (κ = 0.53, POA = 89%) and for each individual MRI feature (κ = 0.42–0.52, POA = 84–93%) assessment was moderate. Lower reliability emerged between the expert radiologist and the radiologists not specialized in head and neck imaging in the first follow-up MRI scan for both primary site contrast enhancement (κ =&#xa0;0.38-0.41,&#xa0;POA = 72%-88%) and lymph node (κ = 0.25-0.36, POA = 77%-90%) assessment.</p> Conclusion <p>MRI NI-RADS showed moderate inter-rater agreement in OPSCC patients, with greater interpretative challenges in the evaluation of the first post-treatment MRI. Regular application of the NI-RADS in clinical settings may help enhance consistency and reliability in imaging evaluations.</p>

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Inter-rater reliability of MRI Neck Imaging Reporting and Data System (NI-RADS) in the follow-up of oropharyngeal squamous cell carcinoma

  • 期刊论文

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  • 发表日期：

    2026年3月30日

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  • Andrea Falzone,
  • Marco Parillo,
  • Marinella Neri,
  • Alessandro Marinetti,
  • Matteo Zanini,
  • Francesco Sella,
  • Carlo Cosimo Quattrocchi

摘要

Purpose

To assess the agreement of Neck Imaging Reporting and Data System (NI-RADS) using magnetic resonance imaging (MRI) among readers with different experience in the evaluation of oropharyngeal squamous cell carcinoma (OPSCC) patients.

Material and methods

We conducted an observational retrospective study and collected post-treatment follow-up MRIs in patients treated for OPSCC. Each scan was scored according to NI-RADS by 1 general radiologist, 2 radiology residents, and 2 seasoned radiologists. Percentage of agreement (POA) and kappa values (κ) were calculated for the assignment of NI-RADS and its individual MRI features (lymph node, primary tumor size, primary site signal on T2-weighted, contrast-enhanced and diffusion-weighted images). Inter-reader agreement was calculated for all post-treatment MRIs and separately for the first post-treatment MRI (using pre-treatment MRI as reference) and subsequent follow-ups.

Results

Ninety-one patients were included (a total of 218 MRIs per rater). The agreement among all readers for NI-RADS (κ = 0.53, POA = 89%) and for each individual MRI feature (κ = 0.42–0.52, POA = 84–93%) assessment was moderate. Lower reliability emerged between the expert radiologist and the radiologists not specialized in head and neck imaging in the first follow-up MRI scan for both primary site contrast enhancement (κ = 0.38-0.41, POA = 72%-88%) and lymph node (κ = 0.25-0.36, POA = 77%-90%) assessment.

Conclusion

MRI NI-RADS showed moderate inter-rater agreement in OPSCC patients, with greater interpretative challenges in the evaluation of the first post-treatment MRI. Regular application of the NI-RADS in clinical settings may help enhance consistency and reliability in imaging evaluations.