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29-01-2025 | Magnetic Resonance Imaging | Review

Diagnostic accuracy of node-RADS for the detection of lymph node invasion: a systematic review and meta-analysis

Authors: Feng Lu, Yanjun Zhao, Zhongjuan Wang, Ninghan Feng

Published in: European Radiology

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Abstract

Objective

To conduct a meta-analysis assessing the diagnostic performance of the node reporting and data system (Node-RADS) for detecting lymph node (LN) invasion.

Method

We performed a systematic literature search of online scientific publication databases from inception up to July 31, 2024. We used the quality assessment of diagnostic accuracy studies-2 (QUADAS-2) to assess the study quality, and heterogeneity was determined by the Q-test and measured with I2 statistics. We employed the hierarchic summary ROC (HSROC) model to estimate the summary sensitivity and specificity. Subgroup analyses were conducted according to the imaging modality and cutoff values.

Results

A total of 13 studies involving 1341 participants met the inclusion criteria. Pooled summary estimates of sensitivity, specificity, and area under the curve of HSROC were 0.79 (95% CI: 0.66–0.88), 0.86 (95% CI: 0.80–0.90), and 0.90 (95% CI: 0.87–0.92). Subgroup analysis showed that the pooled sensitivity and specificity for CT were 0.74 (95% CI: 0.63–0.83) and 0.84 (95% CI: 0.74–0.91), whereas for MRI were 0.84 (95% CI: 0.59–0.95) and 0.88 (95% CI: 0.81–0.93), respectively.

Conclusion

Node-RADS demonstrates the promising potential for the prediction of LN invasion, with high specificity but moderate sensitivity, particularly with optimal cutoff value ≥ 3. Indirect comparisons showed no significant difference between CT and MRI regarding overall diagnostic accuracy.

Key Points

Question Since the Node-RADS has been proposed, a number of studies have assessed its diagnostic performance for evaluating LN invasion.
Findings Node-RADS demonstrated high specificity but moderate sensitivity, and cutoff3 is the optimal threshold; indirect comparison suggested no significant difference between CT and MRI.
Clinical relevance This study synthesized currently available evidence on studies of utilizing Node-RADS for assessing LNI in patients with various cancers, providing valuable insights for radiologists for utilizing this new risk scoring system in clinical practice.
Appendix
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Literature
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go back to reference Brierley (2016) TNM Classification of Malignant Tumours, 8th edn. Wiley-Blackwell, New York Brierley (2016) TNM Classification of Malignant Tumours, 8th edn. Wiley-Blackwell, New York
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go back to reference Hovels AM, Heesakkers RAM, Adang EM et al (2008) The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis. Clin Radiol 63:387–395 Hovels AM, Heesakkers RAM, Adang EM et al (2008) The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis. Clin Radiol 63:387–395
Metadata
Title
Diagnostic accuracy of node-RADS for the detection of lymph node invasion: a systematic review and meta-analysis
Authors
Feng Lu
Yanjun Zhao
Zhongjuan Wang
Ninghan Feng
Publication date
29-01-2025
Publisher
Springer Berlin Heidelberg
Published in
European Radiology
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-025-11387-6