Maggialetti Nicola, Greco Chiara Noemi, Lucarelli Nicola Maria, Morelli Chiara, Cianci Valentina, Sasso Sara, Rubini Dino, Scardapane Arnaldo, Stabile Ianora Amato Antonio
Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy.
Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138, Naples, Italy.
Radiol Med. 2023 Nov;128(11):1287-1295. doi: 10.1007/s11547-023-01703-9. Epub 2023 Sep 14.
The study focuses on the evaluation of the new Node Reporting and Data System 1.0 (Node-rads) scoring accuracy in the assessment of metastatic lymph nodes (LN) in patients with colon carcinoma.
From April 2021 to May 2022, retrospective chart reviews were performed on 67 preoperative CT (Computed Tomography) of patients undergoing excisional surgery for colon cancer at the Polyclinic of Bari, Italy. Primary endpoints were to assess lymph node size and configuration to express the likelihood of a metastatic site adopting the Node-rads score system, whose categories of risk are defined from 1 (very low) to 5 (very high). The nodal postsurgical histological evaluation was the gold standard. The relationship between Node-rads score, LN size, configuration criteria (texture, border and shape) and the presence of histological metastases was statistically evaluated.
All surgical specimens examined had correlation with Node-rads score. They were significantly more likely to present nodes micrometastasis those patients with (a) spherical LN shape (82.8%), (b) with lymph node necrosis (100%), (c) irregular borders (87%) and (d) the LN short axis more than 10 mm (61.9%).
Our experience highlights how the Node-rads system proposes an intuitive and effective definition of criteria to standardize the lymph node radiological reports in colon cancer disease. Further studies are needed to streamline the classification of the nodal and peripheral LN in all the oncological imaging.
本研究聚焦于评估新型淋巴结报告与数据系统1.0（Node-rads）在评估结肠癌患者转移性淋巴结（LN）方面的评分准确性。
2021年4月至2022年5月，对意大利巴里综合医院接受结肠癌切除手术的67例患者的术前CT（计算机断层扫描）进行回顾性病历审查。主要终点是评估淋巴结大小和形态，以采用Node-rads评分系统来表达转移部位的可能性，该系统的风险类别从1（极低）到5（极高）进行定义。淋巴结术后组织学评估为金标准。对Node-rads评分、LN大小、形态标准（质地、边界和形状）与组织学转移的存在之间的关系进行统计学评估。
所有检查的手术标本均与Node-rads评分相关。那些具有（a）球形LN形态（82.8%）、（b）伴有淋巴结坏死（100%）、（c）边界不规则（87%）以及（d）LN短轴大于10毫米（61.9%）的患者出现淋巴结微转移的可能性显著更高。
我们的经验凸显了Node-rads系统如何提出直观且有效的标准定义，以规范结肠癌疾病中淋巴结的放射学报告。需要进一步研究以简化所有肿瘤影像学中淋巴结及周围LN的分类。
