RSNA 2014

Dec 1, 2014

Dr. Michael Toepker (left) from Vienna, Austria, stands with his colleagues for a photo with the popular 100th anniversary sign at RSNA 2014.

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Representative MRI scans for which the independently assigned imaging-derived extranodal extension (iENE) grades differed among the readers. (A) Axial and sagittal images in a 56-year-old male patient with nasopharyngeal carcinoma and cervical nodal metastases. Readers 1 and 3 interpreted the finding as a metastatic lymph node invading the left sternocleidomastoid muscle (arrow) and assessed an iENE grade of 3, whereas reader 2 assigned a grade of 2. After joint review, the radiologists reached a consensus on the absence of definite sternocleidomastoid muscle invasion, and the final iENE grade was 2. (B) Axial and sagittal images in a 52-year-old male patient with nasopharyngeal carcinoma and cervical nodal metastases. Reader 1 interpreted the findings as a single enlarged metastatic lymph node and assessed an iENE grade of 1, whereas readers 2 and 3 interpreted them as two coalescent metastatic lymph nodes (arrows) and assessed a grade of 2. After joint review, the radiologists reached a consensus on the coalescence of the two metastatic lymph nodes, and the final iENE grade was 2.

Image-based grading system estimates nasopharyngeal carcinoma severity

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Free webinar for radiology leaders

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Image-based grading system estimates nasopharyngeal carcinoma severity

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The four-tier grading system showed excellent reliability and good prognostic value for patients with nasopharyngeal carcinoma.

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Representative MRI scans for which the independently assigned imaging-derived extranodal extension (iENE) grades differed among the readers. (A) Axial and sagittal images in a 56-year-old male patient with nasopharyngeal carcinoma and cervical nodal metastases. Readers 1 and 3 interpreted the finding as a metastatic lymph node invading the left sternocleidomastoid muscle (arrow) and assessed an iENE grade of 3, whereas reader 2 assigned a grade of 2. After joint review, the radiologists reached a consensus on the absence of definite sternocleidomastoid muscle invasion, and the final iENE grade was 2. (B) Axial and sagittal images in a 52-year-old male patient with nasopharyngeal carcinoma and cervical nodal metastases. Reader 1 interpreted the findings as a single enlarged metastatic lymph node and assessed an iENE grade of 1, whereas readers 2 and 3 interpreted them as two coalescent metastatic lymph nodes (arrows) and assessed a grade of 2. After joint review, the radiologists reached a consensus on the coalescence of the two metastatic lymph nodes, and the final iENE grade was 2.

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