#MyRadGirlfriend No. 96: The spooky bill

Oct 24, 2019

2019 10 24 20 46 4554 2019 10 25 My Rad Girlfriend 96 The Spooky Bill Thumbnail

Radiology cartoon

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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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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