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Application of neck imaging reporting and data systems in MRI diagnosis of early exclusive mucosal local recurrent nasopharyngeal carcinoma
WANG Zeyan  WU Leidi  ZHONG Zhu  WANG Xingrui  XIAO Xuehong  WANG Zhilong 

Cite this article as: WANG Z Y, WU L D, ZHONG Z, et al. Application of neck imaging reporting and data systems in MRI diagnosis of early exclusive mucosal local recurrent nasopharyngeal carcinoma[J]. Chin J Magn Reson Imaging, 2024, 15(3): 170-176. DOI:10.12015/issn.1674-8034.2024.03.027.


[Abstract] Objective To evaluate the diagnostic value of the neck imaging reporting and data systems (NI-RADS) MRI in exclusive mucosal local recurrent nasopharyngeal carcinoma (EMLRNPC) and mucosal posttreatment changes (MPTC), and attempted to propose adding qualitative diffusion-weighted imaging (DWI) criteria for the focal mucosal abnormality in NI-RADS MRI lexicon.Materials and Methods From February 2015 to February 2023, totally 21 cases of EMLRNPC and 29 cases of MPTC confirmed by pathology or imaging follow-up were retrospectively enrolled. Two radiologists independently evaluated the MRI findings and assigned a NI-RADS MRI category in the first step, then reevaluated with the adding qualitative DWI criteria and assigned a modified NI-RADS MRI category in the second step. All images were reevaluated by the senior radiologist in the same steps after three months. Inter- and intra-reader agreements were assessed with Cohen's Kappa test. Receiver operating characteristic curves were generated to assess the diagnostic values of the two NI-RADS categories between EMLRNPC and MPTC. Area under the curve (AUC) was compared by DeLong's test.Results Inter- and intra-reader agreements were 0.69 and 0.88 for NI-RADS MRI categories, and 0.83 and 0.96 for modified NI-RADS MRI categories. In differential diagnosis of EMLRNPC and MPTC, the AUC, sensitivity, specificity of NI-RADS MRI were 0.845 [95% confidence interval (CI): 0.715-0.932], 100.0% (95% CI: 83.9%-100.0%), 69.0% (95% CI: 49.2%-84.7%), and of modified NI-RADS MRI were 0.966 (95% CI: 0.871-0.997), 100.0% (95% CI: 83.9%-100.0%), 93.1% (95% CI: 77.2%-99.2%), respectively. There was statistical difference between the AUCs of two categories (Z=2.985, P=0.003).Conclusions For both NI-RADS MRI and modified NI-RADS MRI which adding the qualitative DWI criteria, the differential diagnostic value of EMLRNPC and MPTC are great, while the consistency and diagnostic performance are stronger for the modified NI-RADS MRI.
[Keywords] nasopharyngeal carcinoma；local recurrence；magnetic resonance imaging；neck imaging reporting and data systems；diffusion-weighted imaging

WANG Zeyan   WU Leidi   ZHONG Zhu   WANG Xingrui   XIAO Xuehong   WANG Zhilong*  

Department of Radiology, Zhongshan City People's Hospital, Zhongshan 528403, China

Corresponding author: WANG Z L, E-mail: wangzhilonger@sina.com

Conflicts of interest   None.

Received  2023-08-04
Accepted  2024-02-26
DOI: 10.12015/issn.1674-8034.2024.03.027
Cite this article as: WANG Z Y, WU L D, ZHONG Z, et al. Application of neck imaging reporting and data systems in MRI diagnosis of early exclusive mucosal local recurrent nasopharyngeal carcinoma[J]. Chin J Magn Reson Imaging, 2024, 15(3): 170-176. DOI:10.12015/issn.1674-8034.2024.03.027.

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