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Open Access 08-07-2024 | Colon Cancer | Hollow Organ GI

Diagnostic accuracy and reliability of CT-based Node-RADS for colon cancer

Authors: Jakob Leonhardi, Matthias Mehdorn, Sigmar Stelzner, Uwe Scheuermann, Anne-Kathrin Höhn, Daniel Seehofer, Benedikt Schnarkowski, Timm Denecke, Hans-Jonas Meyer

Published in: Abdominal Radiology

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Abstract

Objective

The Node-RADS classification was recently published as a classification system to better characterize lymph nodes in oncological imaging. The present analysis investigated the diagnostic benefit of the Node-RADS classification of staging computed tomography (CT) images to categorize and stage lymph nodes in patients with colon cancer.

Materials and methods

All patients were surgically resected and the lymph nodes were histopathological analyzed. All investigated lymph nodes were scored in accordance to the Node-RADS classification by two experienced radiologists. Interreader variability was assessed with Cohen’s kappa analysis, discrimination analysis was performed with Mann-Whitney-U test and diagnostic accuracy was assessed with receiver-operating characteristics (ROC) curve analysis.

Results

Overall, 108 patients (n = 49 females, 45.3%) with a mean age of 70.08 ± 14.34 years were included. In discrimination analysis, the total Node-RADS score showed statistically significant differences between N- and N + stage (for reader 1: mean 1.89 ± 1.09 score for N- versus 2.93 ± 1.62 score for N+, for reader 2: 1.33 ± 0.48 score for N- versus 3.65 ± 0.94 score for N+, p = 0.001, respectively). ROC curve analysis for lymph node discrimination showed an area under the curve of 0.68. A threshold value of 2 resulted in a sensitivity of 0.62 and a specificity of 0.71.

Conclusion

Node-RADS score derived from staging CT shows only limited diagnostic accuracy to correctly predict nodal positivity in colon cancer. The interreader variability seems to be high and should question the clinical translation for this tumour entity.
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Metadata
Title
Diagnostic accuracy and reliability of CT-based Node-RADS for colon cancer
Authors
Jakob Leonhardi
Matthias Mehdorn
Sigmar Stelzner
Uwe Scheuermann
Anne-Kathrin Höhn
Daniel Seehofer
Benedikt Schnarkowski
Timm Denecke
Hans-Jonas Meyer
Publication date
08-07-2024
Publisher
Springer US
Published in
Abdominal Radiology
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-024-04485-4
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