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Diagnostic performance of Node Reporting and Data System (Node-RADS) for regional lymph node staging of gastric cancer by CT

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Bibliographic Details
Title: Diagnostic performance of Node Reporting and Data System (Node-RADS) for regional lymph node staging of gastric cancer by CT
Authors: Florian N. Loch, Katharina Beyer, Martin E. Kreis, Carsten Kamphues, Wael Rayya, Christian Schineis, Janosch Jahn, Moritz Tronser, Fabian H. J. Elsholtz, Bernd Hamm, Rolf Reiter
Source: Eur Radiol
Publisher Information: Springer Science and Business Media LLC, 2023.
Publication Year: 2023
Subject Terms: Male, Adult, Aged, 80 and over, Gastrointestinal, Lymph Nodes/pathology [MeSH], Aged, 80 and over [MeSH], Aged [MeSH], Stomach Neoplasms/pathology [MeSH], Radiology Information Systems [MeSH], Tomography, X-Ray Computed/methods [MeSH], Sensitivity and Specificity [MeSH], Male [MeSH], Adenocarcinoma/pathology [MeSH], Adenocarcinoma/diagnostic imaging [MeSH], Lymph nodes, Gastric cancer, Female [MeSH], Computed tomography, Adult [MeSH], Humans [MeSH], Retrospective Studies [MeSH], Middle Aged [MeSH], Lymph Nodes/diagnostic imaging [MeSH], Lymphatic Metastasis/diagnostic imaging [MeSH], Gastrectomy, Lymphatic Metastasis/pathology [MeSH], Neoplasm Staging/methods [MeSH], Stomach Neoplasms/diagnostic imaging [MeSH], Lymphadenectomy, Middle Aged, Adenocarcinoma, Sensitivity and Specificity, 3. Good health, Radiology Information Systems, Stomach Neoplasms, Lymphatic Metastasis, Humans, Female, Lymph Nodes, Tomography, X-Ray Computed, Aged, Retrospective Studies, Neoplasm Staging
Description: 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 κ = 0.65, p 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.
Document Type: Article
Other literature type
Language: English
ISSN: 1432-1084
DOI: 10.1007/s00330-023-10352-5
Access URL: https://pubmed.ncbi.nlm.nih.gov/37921924
https://repository.publisso.de/resource/frl:6497825
Rights: CC BY
Accession Number: edsair.doi.dedup.....69b59a44176024ca3de19ece20c9ce5d
Database: OpenAIRE
Description
Abstract: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 κ = 0.65, p 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.
ISSN:14321084
DOI:10.1007/s00330-023-10352-5