NIRADS SURVEILLANCE REPORT TEMPLATE



INDICATION: [ ]
Subsite & HPV status: [ ]
Surgery & Chemoradiation: [ ]

TECHNIQUE:  
 
COMPARISON: [<None.>]
 
FINDINGS:  
[<No evidence of recurrent disease is demonstrated at the primary site. >]
 
[<No pathologically enlarged, necrotic, or otherwise abnormal lymph nodes. >]
 
Expected post-treatment changes are noted including [<supraglottic mucosal edema and thickening of the skin and subcutaneous soft tissues.>] 
 
There are no findings to suggest a second primary in the imaged aerodigestive tract.
 
Evaluation of the visualized portions of brain, orbits, spine and lungs show no aggressive lesions suspicious for metastatic involvement.
 
 IMPRESSION:
Primary: [1}. [<Expected post-treatment changes in the neck without evidence of recurrent disease in the primary site >]
 
Neck: [1}, [<No evidence of abnormal lymph nodes.>]