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Robotic Pancreatoduodenectomy for Pancreatic Head Cancer: a Case Report of a Standardized Technique
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Predictive Value of First Posttreatment Imaging Using Standardized Reporting in Head and Neck Cancer.

Derek Hsu1, Falgun H Chokshi2,3, Patricia A Hudgins2

  • 1Emory University School of Medicine, Atlanta, Georgia, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|July 24, 2019
PubMed
Summary

The Neck Imaging Reporting and Data System (NI-RADS) accurately predicts treatment failure in head and neck squamous cell carcinoma (HNSCC) patients. Higher NI-RADS scores on post-treatment PET/CECT scans indicate a significantly increased risk of recurrence.

Keywords:
PETradiologysquamous cell carcinoma

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Area of Science:

  • Oncology
  • Radiology
  • Medical Imaging

Background:

  • Head and neck squamous cell carcinoma (HNSCC) surveillance requires accurate post-treatment assessment.
  • The Neck Imaging Reporting and Data System (NI-RADS) offers a standardized template for interpreting imaging findings.
  • Evaluating the accuracy of NI-RADS in predicting treatment failure is crucial for patient management.

Purpose of the Study:

  • To analyze the accuracy of the NI-RADS system in the initial post-treatment assessment of HNSCC.
  • To determine the correlation between NI-RADS categories and treatment failure rates.

Main Methods:

  • Retrospective cohort study involving 199 HNSCC patients.
  • Analysis of first post-treatment fluorodeoxyglucose positron emission tomography/contrast-enhanced computed tomography (PET/CECT) using NI-RADS.
  • Follow-up for treatment failure defined by biopsy or RECIST criteria, analyzed with Cox proportional hazards models.

Main Results:

  • Treatment failure rates increased with higher NI-RADS categories (4.3% for category 1, 9.1% for category 2, 42.1% for category 3).
  • A strong association was found between NI-RADS categories and treatment failure at primary and neck sites (HR 2.60 and 5.22, respectively; P < .001).
  • No statistically significant association was observed between NI-RADS category and treatment failure in surgically treated patients at the primary site (HR 0.88; P = .82).

Conclusions:

  • The NI-RADS category on baseline post-treatment PET/CECT is a strong predictor of treatment failure in HNSCC.
  • This standardized system aids in risk stratification and surveillance planning for HNSCC patients.
  • Further subgroup analysis is needed to clarify the role of NI-RADS in specific treatment modalities.