Implementation of a Novel Surveillance Template for Head and Neck Cancer: Neck Imaging Reporting and Data System (NI-RADS)

The recent ACR Intersociety Committee Summer Conference addressed the need to reengineer the radiology enterprise to adhere to the value equation and be "patient-centric, data-driven, and outcomes-based." The Intersociety Committee advocated for the universal use of report templates and linked management recommendations [ 1 Dodd III, G.D. Allen Jr., B. Birzniek D. et al. Reengineering the radiology enterprise: a summary of the 2014 Intersociety Committee Summer Conference. J Am Coll Radiol. 2015; 12: 228-234 Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar ]. The ACR instituted the BI-RADS® initiative more than 20 years ago to address interobserver variability in mammography reporting [ 2 Burnside E.S. Sickles E.A. Bassett L.W. et al. The ACR BI-RADS experience: learning from history. J Am Coll Radiol. 2009; 6: 851-860 Abstract Full Text Full Text PDF PubMed Scopus (221) Google Scholar ]. The standardization of mammography reports improved comprehension of imaging findings, conveyed the level of suspicion, and guided management recommendations [ 3 Lazarus E. Mainiero M.B. Schepps B. Koelliker S.L. Livingston L.S. BI-RADS lexicon for US and mammography: interobserver variability and positive predictive value. Radiology. 2006; 239: 385-391 Crossref PubMed Scopus (379) Google Scholar ]. Structured reports are also easier for patients to understand, facilitating direct communication between radiologists and patients. Many patients want increased direct input from radiologists because of their greater expertise in imaging interpretation [ 4 Schwartz L.H. Panicek D.M. Berk A.R. Li Y. Hricak H. Improving communication of diagnostic radiology findings through structured reporting. Radiology. 2011; 260: 174-181 Crossref PubMed Scopus (308) Google Scholar ]. Referring physicians are most receptive to direct patient reporting when they have working relationships with radiologists as part of a coordinated health care team [ 5 Safdar N. Shet N. Bulas D. Knight N. Handoffs between radiologists and patients: threat or opportunity?. J Am Coll Radiol. 2011; 8: 853-857 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar ]. Referring physicians may worry that direct patient reporting might result in a loss of control in the patient-physician relationship and also stress the importance of collaboration with radiologists before information disclosure to patients [ 6 Johnson A.J. Frankel R.M. Williams L.S. Glover S. Easterling D. Patient access to radiology reports: what do physicians think?. J Am Coll Radiol. 2010; 7: 281-289 Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar ].