Performance of CT-based Node-RADS for assessing cervical regional lymph node metastasis in papillary thyroid carcinoma

IF 3.9 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2026-02-01 Epub Date: 2025-12-01 DOI:10.1016/j.ejrad.2025.112593

Ying Xiang , Dandan Huang , Yuelang Zhang , Xiaohui Li , Le Liu , Kang Zhu , Ying He , Haiqiao Sun , Tuo He , Xuan Su , Jiamin Kang , Weiguo Xu , Xiaoyong Ren

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引用次数: 0

Abstract

Objectives

The Node Reporting and Data System (Node-RADS) score system was recently proposed to better characterize lymph node metastasis (LNM). The study aimed to explore the diagnostic performance of Node-RADS score system for predicting LNM on CECT (contrast-enhanced CT) scans in patients with papillary thyroid carcinoma (PTC).

Methods

In total, 191 PTC patients (61 males and 130 females, average age: 45.37 ± 13.22 years), who underwent preoperative CECT, US examinations and lymph nodes (LNs) dissection, were retrospectively analyzed through Node-RADS CECT score system. Moreover, the area under the curve (AUC), sensitivity, specificity, and Youden’s index were calculated for Node-RADS CECT score and individual criteria.

Results

Overall, 191 patients with a total of 300 LNs (204 metastatic and 96 benign) were assessed. At the LNs level, best performance was found for Node-RADS CECT score ≥ 2 and ≥ 4 of central LNs and lateral LNs (AUC: 0.772 and 0.756), respectively. Node-RADS CECT score was shown to be an independent predictor of LNM (odds ratio [OR] = 2.41, p < 0.05). Among all criteria, combined with Node-RADS CECT score and US achieved the best diagnostic efficiency in evaluation of LNM, with AUCs of 0.846 in central group and 0.872 in lateral group (Delong test: p < 0.05).

Conclusions

The Node-RADS CECT score system provides a standardized LNM assessment. Combined Node-RADS CECT score and US would lead to an enhancement in predictive accuracy. Whereas, the rates of LNM ranged from 15.32% to 35.48% at the node level for score 1 and 2, which should be validated in the future research.

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基于ct的淋巴结- rads评估甲状腺乳头状癌颈部区域淋巴结转移的价值。

目的：最近提出了淋巴结报告和数据系统（Node- rads）评分系统，以更好地表征淋巴结转移（LNM）。本研究旨在探讨Node-RADS评分系统对甲状腺乳头状癌（PTC）患者CECT（对比增强CT） LNM的诊断价值。方法：采用Node-RADS CECT评分系统对191例术前行CECT、US检查及淋巴结清扫的PTC患者（男61例，女130例，平均年龄45.37±13.22岁）进行回顾性分析。此外，计算Node-RADS CECT评分和个体标准的曲线下面积（AUC）、敏感性、特异性和约登指数。结果：总共评估了191例患者共300例LNs（204例转移性，96例良性）。在LNs水平上，Node-RADS CECT评分≥2和≥4的中央LNs和侧LNs表现最佳（AUC分别为0.772和0.756）。Node-RADS CECT评分被证明是LNM的独立预测因子（优势比[OR] = 2.41, p）。结论：Node-RADS CECT评分系统提供了标准化的LNM评估。结合Node-RADS CECT评分和US可提高预测准确性。而在1分和2分的节点水平上，LNM的检出率在15.32% ~ 35.48%之间，有待于进一步的研究验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.