NI-RADS
Neck Imaging Reporting and Data System
NI-RADS is the ACR's system for surveillance imaging after treatment for head and neck cancer — the setting where post-surgical and post-radiation change constantly mimics recurrence. It pairs a standardized lexicon with numeric levels of suspicion, each tied to a management recommendation, so the “worrying-looking but treated” neck gets read consistently instead of case by case. The original 2018 paradigm covered CT and FDG-PET/CT; the 2025 update adds descriptors and management guidance specific to MRI, for the cancers best followed with that modality. Its aim is to catch submucosal recurrence early enough for salvage surgery while damping down false alarms.
Version history & what changed
- MRI edition2025Current
Adds descriptors and management guidance specific to MRI, extending standardized post-treatment surveillance to the head-and-neck cancers best followed with that modality.
- CT & FDG-PET/CT edition2018
The original paradigm: a standardized surveillance lexicon with numeric levels of suspicion tied to management, for CT and FDG-PET/CT after treatment of head and neck cancer.
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Resources & links
- officialACR NI-RADS official page
RadPigeon is an independent radiology news digest and is not affiliated with or endorsed by American College of Radiology (ACR). “NI-RADS” is a trademark of its owner and is named here only to refer to the system. Always consult the official source for the exact, current criteria.