Inter- and Intrareader Agreement of NI-RADS in the Interpretation of Surveillance Contrast-Enhanced CT after Treatment of Oral Cavity and Oropharyngeal Squamous Cell Carcinoma.

L.-A Schaafs,C Erxleben,B Hamm,S.M Niehues,S Shnayien,S.-R Ro,H.-C Bauknecht,F.H.J Elsholtz,J Lenk

doi:10.3174/ajnr.a6529

Abstract

The Neck Imaging Reporting and Data System was introduced to assess the probability of recurrence in surveillance imaging after treatment of head and neck cancer. This study investigated inter- and intrareader agreement in interpreting contrast-enhanced CT after treatment of oral cavity and oropharyngeal squamous cell carcinoma. This retrospective study analyzed CT datasets of 101 patients. Four radiologists provided the Neck Imaging Reporting and Data System reports for the primary site and neck (cervical lymph nodes). The Kendall's coefficient of concordance (W), Fleiss κ (κF), the Kendall's rank correlation coefficient (τB), and weighted κ statistics (κw) were calculated to assess inter- and intrareader agreement. Overall, interreader agreement was strong or moderate for both the primary site (W = 0.74, κF = 0.48) and the neck (W = 0.80, κF = 0.50), depending on the statistics applied. Interreader agreement was higher in patients with proved recurrence at the primary site (W = 0.96 versus 0.56, κF = 0.65 versus 0.30) or in the neck (W = 0.78 versus 0.56, κF = 0.41 versus 0.29). Intrareader agreement was moderate to strong or almost perfect at the primary site (range τB = 0.67-0.82, κw = 0.85-0.96) and strong or almost perfect in the neck (range τB = 0.76-0.86, κw = 0.89-0.95). The Neck Imaging Reporting and Data System used for surveillance contrast-enhanced CT after treatment of oral cavity and oropharyngeal squamous cell carcinoma provides acceptable score reproducibility with limitations in patients with posttherapeutic changes but no cancer recurrence.

Highlights

BACKGROUND AND PURPOSEThe Neck Imaging Reporting and Data System was introduced to assess the probability of recurrence in surveillance imaging after treatment of head and neck cancer
Oral cavity squamous cell carcinoma (OCSCC) is the most common malignancy of the head and neck but might soon be overtaken by oropharyngeal squamous cell carcinoma (OPSCC), whose incidence is rapidly rising, mainly because its occurrence is related to the human papillomavirus.[1,2,3]
In the records of our weekly interdisciplinary conferences held between June 2017 and July 2019, we identified 123 consecutive patients for whom contrast-enhanced CT (CECT) studies performed at our department or by an external institution were available, and 101 patients (41 women, 60 men; median age, 64 years) were included in this study

Summary

Methods

This retrospective study analyzed CT datasets of 101 patients. Four radiologists provided the Neck Imaging Reporting and Data System reports for the primary site and neck (cervical lymph nodes). The Kendall's coefficient of concordance (W), Fleiss k (k F), the Kendall's rank correlation coefficient (t B), and weighted k statistics (k w) were calculated to assess inter- and intrareader agreement. This retrospective study was approved by our institutional review board, and written informed consent was obtained from all. Imaging Of the 101 CECT studies included, 72 were performed in our department, and 29, by an external institution. Image quality of the CECT datasets was rated on a 4-point scale (1, excellent; 2, good; 3, acceptable; 4, not acceptable) to ensure that the dataset allows adequate assessment of the primary site, which is often and primarily affected by metal artifacts. A rating of 4 means that the primary site cannot be evaluated for cancer recurrence

Results

Discussion

Conclusion