TY  - JOUR
A1  - Loch, Florian N.
A1  - Beyer, Katharina
A1  - Kreis, Martin E.
A1  - Kamphues, Carsten
A1  - Rayya, Wael
A1  - Schineis, Christian
A1  - Jahn, Janosch
A1  - Tronser, Moritz
A1  - Elsholtz, Fabian H. J.
A1  - Hamm, Bernd
A1  - Reiter, Rolf
T1  - Diagnostic performance of Node Reporting and Data System (Node-RADS) for regional lymph node staging of gastric cancer by CT
T2  - European Radiology
N2  - Objectives Diagnostic performance of imaging for regional lymph node assessment in gastric cancer is still limited, and there is a lack of consensus on radiological evaluation. At the same time, there is an increasing demand for structured reporting using Reporting and Data Systems (RADS) to standardize oncological imaging. We aimed at investigating the diagnostic performance of Node-RADS compared to the use of various individual criteria for assessing regional lymph nodes in gastric cancer using histopathology as reference. Methods In this retrospective single-center study, consecutive 91 patients (median age, 66 years, range 33–91 years, 54 men) with CT scans and histologically proven gastric adenocarcinoma were assessed using Node-RADS assigning scores from 1 to 5 for the likelihood of regional lymph node metastases. Additionally, different Node-RADS criteria as well as subcategories of altered border contour (lobulated, spiculated, indistinct) were assessed individually. Sensitivity, specificity, and Youden’s index were calculated for Node-RADS scores, and all criteria investigated. Interreader agreement was calculated using Cohen’s kappa. Results Among all criteria, best performance was found for Node-RADS scores ≥ 3 and ≥ 4 with a sensitivity/specificity/Youden’s index of 56.8%/90.7%/0.48 and 48.6%/98.1%/0.47, respectively, both with substantial interreader agreement ( κ = 0.73 and 0.67, p < 0.01). Among individual criteria, the best performance was found for short-axis diameter of 10 mm with sensitivity/specificity/Youden’s index of 56.8%/87.0%/0.44 ( κ = 0.65, p < 0.01). Conclusion This study shows that structured reporting of combined size and configuration criteria of regional lymph nodes in gastric cancer slightly improves overall diagnostic performance compared to individual criteria including short-axis diameter alone. The results show an increase in specificity and unchanged sensitivity. Clinical relevance statement The results of this study suggest that Node-RADS may be a suitable tool for structured reporting of regional lymph nodes in gastric cancer. Key Points • Assessment of lymph nodes in gastric cancer is still limited, and there is a lack of consensus on radiological evaluation. • Node-RADS in gastric cancer improves overall diagnostic performance compared to individual criteria including short-axis diameter. • Node-RADS may be a suitable tool for structured reporting of regional lymph nodes in gastric cancer.
Y1  - 2024
UR  - https://opus.bibliothek.uni-augsburg.de/opus4/frontdoor/index/index/docId/123726
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:384-opus4-1237261
SN  - 1432-1084
VL  - 34
IS  - 5
SP  - 3183
EP  - 3193
PB  - Springer Science and Business Media LLC
ER  -