NI-RADS to Predict Residual or Recurrent Head and Neck Squamous Cell Carcinoma

American College of Radiology NI-RADS is a surveillance imaging template used to predict residual or recurrent tumor in the setting of head and neck cancer. The lexicon and imaging template provides a framework to standardize the interpretations and communications with referring physicians and provides linked management recommendations, which add value in patient care. Studies have shown reasonable interreader agreement and excellent discriminatory power among the different NI-RADS categories. This article reviews the literature associated with NI-RADS and serves as a practical guide for radiologists interested in using the NI-RADS surveillance template at their institution, highlighting frequently encountered pearls and pitfalls.