Dual-energy CT NI-RADS criteria may enhance post-treatment head and neck cancer surveillance

A dual-energy CT-based Neck Imaging Reporting and Data System (NI-RADS) using normalized iodine concentration (cutoff 2.769) showed 86.7% sensitivity and 80.0% specificity for detecting residual/recurrent head and neck squamous cell carcinoma, potentially improving upon conventi…

• In 47 patients with post-treatment HNSCC, normalized iodine concentration ratio had the highest AUC for distinguishing benign from malignant findings (cutoff 2.769, sensitivity 86.7%, specificity 80.0%).
• The DECT NI-RADS system (upgrading category 2 lesions exceeding the cutoff) may improve both diagnostic performance and interreader agreement versus conventional CECT NI-RADS.
• This retrospective, single-center study is preliminary and requires prospective validation.

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