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5 mm3. Interreader agreement was excellent (Cohen's Kappa = 0.866-1). Importantly, 30.6%/31.6%/32.2% (reader 1/reader 2/ reader 3) of foramina were assigned grades that did not appear in the original Lee grading system (grades B and D). The readers found no foramen that could not be described accurately with the updated grading system. Thus, an updated 6-point grading system for lumbar foraminal stenosis is reproducible and comprehensively describes lumbar foraminal stenosis as seen on high-resolution MRI.This study was aimed to evaluat