Department of Radiology, Campus Benjamin Franklin, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany.
Department of Neuroradiology, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin and Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
Eur Radiol. 2021 Aug;31(8):6295-6304. doi: 10.1007/s00330-021-07693-4. Epub 2021 Feb 3.
To assess inter- and intrareader agreement of the Neck Imaging Reporting and Data System (NI-RADS) used in contrast-enhanced magnetic resonance imaging (MRI) including analysis of diffusion-weighted imaging (DWI), which is currently not part of the NI-RADS criteria.
This retrospective study included anonymized surveillance contrast-enhanced MRI datasets of 104 patients treated for different head and neck cancers. Three radiologists experienced in head and neck imaging reported findings for the primary site and the neck using NI-RADS criteria in a first step and evaluated DWI sequences for the primary site in a second step. Thirty randomly selected imaging datasets were again presented to the readers. Kappa statistics and observed agreement (A) were calculated.
Interreader agreement across all MRI datasets was moderate (κ = 0.53) for NI-RADS categories assigned to the primary site, substantial for NI-RADS categories of the neck (κ = 0.67), and almost perfect for DWI of the primary site (κ = 0.83). Interreader agreement for the primary site was particularly low in cases of cancer recurrence (κ = 0.35) and when categories 2a, 2b, and 3 were combined (κ = 0.30). Intrareader agreement was considerably lower for NI-RADS categories of the primary site (range A = 53.3-70.0%) than for NI-RADS categories of the neck (range A = 83.3-90.0%) and DWI of the primary site (range A = 93.3-100.0%).
Interreader agreement of NI-RADS for reporting contrast-enhanced MRI findings is acceptable for the neck but limited for the primary site. Here, DWI has the potential to serve as a reliable additional criterion.
• NI-RADS was originally designed for contrast-enhanced computed tomography with or without positron emission tomography but can also be used for contrast-enhanced magnetic resonance imaging alone. • Overall interreader agreement was acceptable for NI-RADS categories assigned to the neck but should be improved for the primary site, where it was inferior to DWI; similar tendencies were found for intrareader agreement. • DWI is currently no criterion of NI-RADS, but has shown potential to improve its reliability, especially for categories 2a, 2b, and 3 of the primary site.
评估对比增强磁共振成像（MRI）中使用的颈部成像报告和数据系统（NI-RADS）的读者间和读者内一致性，包括目前不属于 NI-RADS 标准的弥散加权成像（DWI）的分析。
这项回顾性研究纳入了 104 例因不同头颈部癌症接受治疗的患者的匿名监测对比增强 MRI 数据集。三位在头颈部成像方面经验丰富的放射科医生首先使用 NI-RADS 标准对头颈部原发灶和颈部进行报告，然后在第二步对头颈部原发灶的 DWI 序列进行评估。然后再次向读者呈现 30 个随机选择的成像数据集。计算了kappa 统计量和观察一致性（A）。
所有 MRI 数据集的读者间一致性在原发灶的 NI-RADS 分类中为中度（κ=0.53），在颈部的 NI-RADS 分类中为显著（κ=0.67），在原发灶的 DWI 中为几乎完美（κ=0.83）。在癌症复发的情况下（κ=0.35）以及当 2a、2b 和 3 类合并时（κ=0.30），原发灶的读者间一致性特别低。原发灶的 NI-RADS 分类的读者内一致性明显低于颈部的 NI-RADS 分类（范围 A=53.3%-70.0%）和原发灶的 DWI（范围 A=93.3%-100.0%）。
用于报告对比增强 MRI 结果的 NI-RADS 的读者间一致性对于颈部是可接受的，但对于原发灶是有限的。在这里，DWI 有可能作为一种可靠的附加标准。
NI-RADS 最初是为增强 CT 设计的，包括或不包括正电子发射断层扫描，但也可以单独用于增强 MRI。
颈部的 NI-RADS 分类的总体读者间一致性是可以接受的，但需要改进原发灶的一致性，其一致性低于 DWI；读者内一致性也存在类似的趋势。
DWI 目前不属于 NI-RADS 的标准，但已显示出提高其可靠性的潜力，特别是对于原发灶的 2a、2b 和 3 类。
