Observational studyLa Radiologia medica2026
Inter-rater reliability of MRI Neck Imaging Reporting and Data System (NI-RADS) in the follow-up of oropharyngeal squamous cell carcinoma.
Observational study in La Radiologia medica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
purposeTo 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
methodsWe 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.
resultsNinety-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.
conclusionMRI 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.
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