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Interrater Reliability of NI-RADS on Posttreatment PET/Contrast-enhanced CT Scans in Head and Neck Squamous Cell
Derek Hsu1, Tanya J Rath1, Barton F Branstetter1
1From the Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Room BG03, Atlanta, GA 30322 (D.H., A.H.A.); Department of Neuroradiology, Mayo Clinic, Phoenix, Ariz (T.J.R.); Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (B.F.B.); Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah (Y.A., R.H.W.); Department of Neuroradiology, Weill Cornell Imaging at New York-Presbyterian, New York, NY (C.D.P.); Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass (A.F.J.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (K.M.K.); Department of Radiology, University of Vermont Medical Center, Burlington, Vt (M.P.B.); Radiology Imaging Associates, Englewood, Colo (S.M.P.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.H.K.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Ga (P.A.R.); and Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Ga (B.R.).
Abstract:
Purpose To evaluate the interrater reliability among radiologists examining posttreatment head and neck squamous cell carcinoma (HNSCC) fluorodeoxyglucose PET/contrast-enhanced CT (CECT) scans using Neck Imaging Reporting and Data System (NI-RADS). Materials and Methods In this retrospective study, images in 80 patients with HNSCC who underwent posttreatment surveillance PET/CECT and immediate prior comparison CECT or PET/CECT (from June 2014 to July 2016) were uploaded to the American College of Radiology's cloud-based website, Cortex. Eight radiologists from seven institutions with variable NI-RADS experience independently evaluated each case and assigned an appropriate prose description and NI-RADS category for the primary site and the neck site. Five of these individuals were experienced readers (> 5 years of experience), and three were novices (< 5 years of experience). In total, 640 lexicon-based and NI-RADS categories were assigned to lesions among the 80 included patients by the eight radiologists. Light generalization of Cohen κ for interrater reliability was performed. Results Of the 80 included patients (mean age, 63 years ± 10 [standard deviation]), there were 58 men (73%); 60 patients had stage IV HNSCC (75%), and the most common tumor location was oropharynx (n = 32; 40%). Light κ for lexicon was 0.30 (95% CI: 0.23, 0.36) at the primary site and 0.31 (95% CI: 0.24, 0.37) at the neck site. Light κ for NI-RADS category was 0.55 (95% CI: 0.46, 0.63) at the primary site and 0.60 (95% CI: 0.48, 0.69) at the neck site. Percent agreement between lexicon and correlative NI-RADS category was 84.4% (540 of 640) at the primary site and 92.6% (593 of 640) at the neck site. There was no significant difference in interobserver agreement among the experienced versus novice raters. Conclusion Moderate agreement was achieved among eight radiologists using NI-RADS at posttreatment HNSCC surveillance imaging. Keywords: CT, PET/CT, Head/Neck, Neck, Neoplasms-Primary, Observer Performance Supplemental material is available for this article. © RSNA, 2021.
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