Optimizing MRI Detection of Recurrence in Head and Neck Cancer: The Clinical Impact of NI-RADS Post-Treatment

Abstract

Background: Head and neck squamous cell carcinoma (HNSCC) are associated with high recurrence rates, necessitating effective post-treatment surveillance to improve patient outcomes.Objectives: This study evaluates the role of Neck Imaging Reporting and Data System (NI-RADS) Scores in predicting disease recurrence in patients with HNSCC.Patients and methods: This retrospective cohort study included patients diagnosed with HNSCC. Demographic, clinical, and treatment-related data were collected, with MRI findings and NI-RADS scores used to assess recurrence. MRI findings such as T1- and T2-weighted imaging and diffusion-weighted imaging (DWI) and contrast study were analyzed for their role in detecting residual or recurrent disease.Results: The study involved 120 patients with treated head and neck cancer, with an average age of 59 years, predominantly male (80.8%). The most common primary tumor sites were the larynx, oral cavity, and hypopharynx. Tumor stages ranged from I-IV, with 30% at stage II and 55% being moderate grade. NI-RADS scores showed 41.7% classified as NI-RADS 1 and 30.8% as higher-risk NI-RADS 3. Treatment included chemotherapy, surgery, and combinations, with 31.7% receiving both chemotherapy and radiotherapy. And MRI findings correlated with NI-RADS classifications, showing higher recurrence rates for higher NI-RADS categories, especially NI-RADS 2b, 3, and 4, with statistically significant differences (p < 0.001).Conclusion: Higher NI-RADS scores were associated with higher recurrence rates, particularly in primary sites and lymph nodes. NI-RADS MRI serves as a reliable tool for risk stratification and decision-making in post-treatment surveillance.