CT-based Node-RADS for standardized evaluation of lymph node metastasis in rectal cancer and its clinicopathological correlates.

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

European Journal of Radiology Pub Date : 2026-10-15 DOI:10.1016/j.ejrad.2026.113306

Xiaoyi Xiao, Fei Jiang, You Chen, Meiyan Qu, Liang Yang, Taifu Gu, Lianggeng Gong, Jia Qiu

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引用次数: 0

Abstract

Background: Lymph node metastasis identification has important clinical implications for treatment decision-making in rectal cancer (RC). To evaluate the diagnostic performance of the CT-based Node Reporting and Data System 1.0 (Node-RADS) for lymph node metastasis risk in treatment-naive RC patients, and to investigate the correlation between the Node-RADS score and clinicopathological factors.

Methods: A single-center retrospective study was performed to RC patients (Aug 2020-Dec 2025) who underwent radical resection surgery and preoperative contrast-enhanced CT examination. Lymph node status was assessed using Node-RADS score ranging from 1 to 5. Sensitivity, specificity, and Youden's index were calculated for different Node-RADS cut-off values. The overall diagnostic performance was evaluated using receiver operating characteristic curves and the area under the curve (AUC). The associations between Node-RADS score and clinicopathological parameters were analyzed.

Results: A total of 459 RC patients were evaluated, including 174 pN + and 285 pN-. Node-RADS scores ≥ 3 and ≥ 4 have the satisfactory diagnostic performance, with sensitivity/ specificity/Youden's index of 87.36 %/58.25 %/0.46 for Node-RADS scores ≥ 3 by Reader 1, 89.08 %/54.04 %/0.43 for Node-RADS scores ≥ 3 by Reader 2, 74.14 %/78.95 %/0.53 for Node-RADS scores ≥ 4 by Reader 1, and 72.99 %/75.44 %/0.48 for Node-RADS scores ≥ 4 by Reader 2, respectively. The AUC of Node-RADS scores were 0.831(95 %CI:0.793-0.864) and 0.806(95 %CI:0.767-0.841) by Reader 1 and Reader 2, respectively. Node-RADS score correlated with pathological T stage, N stage, and lymphovascular invasion. The inter-reader agreement for Node-RADS score were substantial, with weighted kappa values of 0.650.

Conclusions: The CT-based Node-RADS demonstrates stability and satisfactory diagnostic performance for identifying patients with lymph node metastasis in treatment-naive RC.

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基于ct的node - rads对直肠癌淋巴结转移及其临床病理相关性的标准化评价。

背景：淋巴结转移的识别对直肠癌的治疗决策具有重要的临床意义。目的评价基于ct的淋巴结报告与数据系统1.0 （Node- rads）对初治RC患者淋巴结转移风险的诊断价值，并探讨Node- rads评分与临床病理因素的相关性。方法：对2020年8月- 2025年12月行根治性手术及术前CT增强检查的RC患者进行单中心回顾性研究。采用node - rads评分1 - 5评估淋巴结状态。计算不同Node-RADS临界值的敏感性、特异性和约登指数。使用受试者工作特征曲线和曲线下面积（AUC）评估总体诊断性能。分析Node-RADS评分与临床病理参数的关系。结果：共评估了459例RC患者，其中174例pN + ，285例pN-。Node-RADS分数 ≥ 3和 ≥ 4有令人满意的诊断性能,敏感性和特异性/ Youden指数87.36 % / 58.25 % / 0.46 Node-RADS分数 ≥ 3由读者1,89.08 % / 54.04 % / 0.43 Node-RADS分数 ≥ 3由读者2,74.14 % / 78.95 % / 0.53 Node-RADS分数 ≥ 4由读者1,和72.99 % / 75.44 % / 0.48 Node-RADS分数 ≥ 4由读者2,分别。Reader 1和Reader 2的Node-RADS评分AUC分别为0.831（95 %CI:0.793-0.864）和0.806（95 %CI:0.767-0.841）。Node-RADS评分与病理性T分期、N分期及淋巴血管浸润相关。Node-RADS评分的读者间一致性很高，加权kappa值为0.650。结论：基于ct的node - rads在鉴别未接受治疗的RC患者淋巴结转移方面具有稳定性和令人满意的诊断性能。

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.