Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
Department of Biomedical Informatics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
J Am Coll Radiol. 2018 Aug;15(8):1097-1108. doi: 10.1016/j.jacr.2018.05.006. Epub 2018 Jul 6.
Imaging surveillance after treatment for head and neck cancer is challenging because of complicated resection and reconstruction surgery, in addition to posttreatment changes from radiation and chemotherapy. The posttreatment neck is often a source of anxiety for diagnostic radiologists, leading to suboptimal reporting and no standardized guidance for next management steps. Nevertheless, imaging is critical for detecting submucosal recurrences in a timely manner, so that patients remain candidates for salvage surgery. In 2016, the ACR convened the Neck Imaging Reporting and Data Systems (NI-RADS) Committee with the goals to (1) provide recommendations for surveillance imaging; (2) produce a lexicon to distinguish between benign posttreatment change and residual or recurrent tumor in the posttreatment neck; and (3) propose a NI-RADS template for reporting on the basis of this lexicon with defined levels of suspicion and management recommendations. In this article, the authors present the ACR NI-RADS Committee's recommendations, which provide guidance regarding the management of patients after treatment for head and neck cancer.
头颈部癌症治疗后的影像学监测具有挑战性，这不仅是因为手术切除和重建复杂，还因为放疗和化疗后的治疗改变。治疗后的颈部常常是诊断放射科医生焦虑的根源，导致报告不充分，也没有针对下一步管理步骤的标准化指南。然而，影像学对于及时检测黏膜下复发至关重要，以便患者仍然有机会接受挽救性手术。2016 年，ACR 召集了颈部成像报告和数据系统（NI-RADS）委员会，目标是：（1）为监测成像提供建议；（2）制定术语表，以区分治疗后颈部的良性治疗后改变与残留或复发性肿瘤；（3）根据该术语表提出 NI-RADS 报告模板，其中包括可疑程度和管理建议的定义级别。在本文中，作者介绍了 ACR NI-RADS 委员会的建议，为头颈部癌症治疗后的患者管理提供了指导。
