This calculator will generate two different NI-RADS scores for neck lymph nodes and the primary site. If the scores don't match, consider the higher one for the final recommendation.
This calculator does not include the "X- modifier":
If the primary tumor is unknown, then the authors suggest designating “P-unknown primary”; if the primary cannot be assessed (dental artifact, motion, other technical reasons, or outside FOV), then the authors suggest “P-x
Head and neck cancer surveillance MR examinations are often tailored to a specific area of concern (e.g. skull base for perineural tumor spread), in which case the entire neck may not be imaged. If the neck cannot be assessed, then the authors suggest "N-x."
- Aiken, A. H., Rath, T. J., Anzai, Y., Branstetter, B. F., Hoang, J. K., Wiggins, R. H., Juliano, A. F., Glastonbury, C., Phillips, C. D., Brown, R., & Hudgins, P. A. (2018). ACR Neck Imaging Reporting and Data Systems (NI-RADS): A White Paper of the ACR NI-RADS Committee. Journal of the American College of Radiology : JACR, 15(8), 1097–1108. https://doi.org/10.1016/j.jacr.2018.05.006
- Aiken AH, Hudgins PA. Neck Imaging Reporting and Data System. Magn Reson Imaging Clin N Am. 2018;26(1):51-62. doi:10.1016/j.mric.2017.08.004