Parillo Marco, Vaccarino Federica, Vertulli Daniele, Cea Laura, Mallio Carlo Augusto, Beomonte Zobel Bruno, Quattrocchi Carlo Cosimo
Radiology, Multizonal Unit of Rovereto and Arco, APSS Provincia Autonoma Di Trento, Trento, Italy.
Research Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
Acta Radiol. 2025 Jul;66(7):687-694. doi: 10.1177/02841851251322887. Epub 2025 Jul 15.
BackgroundNode Reporting and Data System 1.0 (Node-RADS) classifies the risk of cancer metastases in lymph nodes at any anatomical site, using computed tomography (CT) and/or magnetic resonance imaging (MRI). This new RADS needs clinical validation through agreement studies.PurposeTo evaluate the inter-reader reliability of Node-RADS between radiologists with different levels of experience, focusing on rectal cancer CT and MRI.Material and MethodsWe designed a single-center observational retrospective study to identify staging CT or MRI of newly diagnosed individuals with rectal cancer. Four readers (two residents in radiology and two radiologists) scored each mesorectal node with Node-RADS on a per-lymph node basis. Fleiss' κ was calculated to assess the level of agreement both for the score and for each individual category of the Node-RADS. A subgroup analysis was performed on a per-patient basis to evaluate the correlation between the Node-RADS assigned by the most experienced reader and the histopathological diagnosis of node involvement.ResultsA total of 20 patients were included in the study The number of Node-RADS scored per reader was 242, corresponding to 968 values to be compared for agreement assessment. Fleiss' κ for Node-RADS score among all readers was 0.65 (substantial agreement). Analysis of the individual categories of the Node-RADS demonstrated a good agreement between all readers (κ > 0.61). A moderate positive correlation was documented between the Node-RADS and the likelihood of nodes being metastatic on histology.ConclusionThe Node-RADS score exhibited good inter-reader reliability between experienced radiologists and those still in training.
背景节点报告与数据系统1.0（Node-RADS）使用计算机断层扫描（CT）和/或磁共振成像（MRI）对任何解剖部位淋巴结的癌症转移风险进行分类。这种新的RADS需要通过一致性研究进行临床验证。
目的
评估不同经验水平的放射科医生之间Node-RADS的阅片者间可靠性，重点关注直肠癌的CT和MRI。
材料与方法
我们设计了一项单中心观察性回顾性研究，以确定新诊断的直肠癌患者的分期CT或MRI。四名阅片者（两名放射科住院医师和两名放射科医生）基于每个淋巴结，使用Node-RADS对每个直肠系膜淋巴结进行评分。计算Fleiss'κ以评估评分以及Node-RADS各个类别之间的一致性水平。基于每位患者进行亚组分析，以评估经验最丰富的阅片者给出的Node-RADS与淋巴结受累的组织病理学诊断之间的相关性。
结果
本研究共纳入20例患者。每位阅片者的Node-RADS评分数量为242，对应968个待比较的一致性评估值。所有阅片者之间Node-RADS评分的Fleiss'κ为0.65（高度一致性）。对Node-RADS各个类别的分析表明，所有阅片者之间具有良好的一致性（κ>0.61）。Node-RADS与组织学上淋巴结转移可能性之间存在中度正相关。
结论
在经验丰富的放射科医生和仍在培训的医生之间，Node-RADS评分表现出良好的阅片者间可靠性。
