基于MRI的Node-RADS评分系统在膀胱癌淋巴结转移中的诊断价值
Performance of MRI-based Node-RADS scoring system for the assessment of lymph node metastasis in bladder cancer patients
柏荣杰 1杨潇 1蔡令凯 1王成浩 1吴启开 1庄俊涛 1曹强 1李鹏超 1孙雪莹 2吕强1
作者信息
- 1. 南京医科大学第一附属医院(江苏省人民医院)泌尿外科(南京,210029)
- 2. 南京医科大学第一附属医院(江苏省人民医院)放射科
- 折叠
摘要
目的:探讨基于MRI的Node-RADS评分系统在评估膀胱癌淋巴结转移(lymph node metastasis,LNM)中的适用性.方法:回顾性分析2019年1月—2024年2月于南京医科大学第一附属医院术前行MRI检查并行根治性膀胱切除术联合盆腔淋巴结清扫的223例患者的围术期临床病理及影像学资料,接受新辅助治疗的患者被排除在外,由2位医生对患者图像按照Node-RADS的评分标准进行独立评分.采用受试者工作特征(receiver operating characteristic,ROC)曲线评估Node-RADS评分系统对膀胱癌LNM的诊断效能并计算不同临界值的灵敏度、特异度、阳性预测值和阴性预测值(≥1,≥2,≥3,≥4,≥5).结果:2位评分者的Node-RADS评分一致性良好(Kappa值=0.842,P＜0.01).Node-RADS评分评估LNM的ROC曲线下面积为0.841(95％置信区间:0.786～0.886).根据ROC曲线分析,以Node-RADS≥4分为阈值,其约登指数为0.552,预测淋巴结转移的灵敏度为62.75％,特异度为92.44％,阳性预测值71.11％,阴性预测值89.33％.结论:以核磁共振为基础的Node-RADS在不同评分者之间具有较高的一致性,并且能有效地预测膀胱癌的LNM.
Abstract
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.
关键词
膀胱癌/淋巴结转移/Node-RADS评分Key words
bladder cancer/lymph node metastasis/Node-RADS score引用本文复制引用
出版年
2024
NETL
NSTL
万方数据