Clinical utility of Neck Imaging Reporting and Data System in post-treatment surveillance of head and neck cancer: A case series

Abstract: The Neck Imaging Reporting and Data System (NI-RADS) provides a standardized framework for surveillance imaging in head-and-neck squamous cell carcinoma (HNSCC) following treatment. It aims to enhance communication between radiologists and clinicians, reduce interreader variability, and guide timely and appropriate clinical interventions. The present case series evaluates the clinical applicability of NI-RADS categorization in a tertiary care center of North India. Five cases of HNSCC with varying primary sites, treatment modalities, and surveillance outcomes were retrospectively reviewed. Each case was analyzed in the context of its NI-RADS categorization and correlated with subsequent clinical decisions, biopsy outcomes, and disease progression. NI-RADS scoring clarified ambiguous imaging findings, minimized unnecessary interventions, enabled early detection of recurrences, and reinforced clinical judgment. NI-RADS enhanced the consistency and clarity in posttreatment HNSCC imaging. It also improved clinical decision-making and communication; its effectiveness is maximized when integrated with clinical judgment, histopathology, and patient-specific risk factors.