Performance of MRI-based Node-RADS scoring system for the assessment of lymph node metastasis in bladder cancer patients
Objective:To explore the applicability of MRI-based Node-RADS scoring system in the evaluation of lymph node metastasis(LNM)of bladder cancer(BCa).Methods:We retrospectively reviewed and collected clinical and MRI data of the BCa patients treated with radical cystectomy and pelvic lymph node dissection in First Affiliated Hospital of Nanjing Medical University from January 2019 to February 2024.Patients receiving neoadju-vant chemotherapy were excluded.Two doctors reviewed and scored each patient separately according to Node-RADS.The sensitivity,specificity,positive predictive value and negative predictive value(≥1,≥2,≥3,≥4,≥5)of the Node-RADS scoring system for LNM were evaluated by receiver operating characteristic(ROC)curve.Results:Interobserver agreement of Node-RADS score between the two doctors was good(Kappa=0.842,P＜0.01).The area under the ROC curve for the Node-RADS score assessing LNM was 0.841(95％confidence interval:0.786-0.886).According to the ROC analysis,the best cutoff-point was 4 for the detection of LNM.The Youden index was 0.552,and the sensitivity,specificity,positive predictive value,and negative predictive value were 62.75％,92.44％,71.11％,and 89.33％,respectively.Conclusion:MRI-based Node-RADS exhibi-ted a high agreement between different doctors,and can effectively predict the LNM of bladder cancer.
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