Related Experiment Video For Colonic neoplasms
Updated: Aug 6, 2026
Comparison of Predictive Performance of Three Lymph Node Staging Systems in Colorectal Signet Ring Cell Carcinoma Based on Machine Learning Model
Published on: April 18, 2025
Assessment of inter-reader agreement and diagnostic performance of Node-RADS in colon cancer
Hui Wang1, Bailing Dai1, Na Feng2
1Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, China.
Objectives:
To assess the inter-reader agreement and diagnostic performance of Node-reporting and data system (Node-RADS) in the evaluation of colon cancer among radiologists with varied experience levels.
Materials And Methods:
A total of 247 patients with colon cancer were included in this retrospective study. Lymph node evaluations were performed by six radiologists with diverse experience levels (three junior and three senior readers) using Node-RADS. Inter-reader agreement for Node-RADS classification and specific imaging features was assessed using the kappa statistic and compared between junior and senior readers. The diagnostic performance of Node-RADS was evaluated at a cutoff of 3 and 4 score.
Results:
Lymph node metastasis was observed in 47.8% of patients. The overall inter-reader agreement was substantial for Node-RADS classification (k = 0.69), almost perfect for size (k = 0.83), moderate for texture and border (k = 0.41-0.45), and fair for shape (k = 0.37). Senior readers demonstrated higher inter-reader agreement in both Node-RADS and specific features than junior readers. Senior readers achieved higher AUC (0.79-0.80) than junior readers (0.72-0.78). At a cutoff of 3, sensitivity, specificity, and accuracy across all readers were 52.5-70.3%, 84.5-93.0%, and 69.2-79.8%, respectively. The corresponding values were 33.9-44.9%, 92.3-98.4%, and 64.4-72.5%, respectively, at a cutoff of 4. Senior readers showed significantly higher pooled sensitivity and accuracy, with comparable specificity compared to junior readers at both Node-RADS cutoffs.
Conclusion:
The Node-RADS demonstrates high agreement between observers. Senior readers showed higher inter-reader agreement and diagnostic performance than junior readers. Node-RADS exhibits high specificity but relatively low sensitivity for detecting lymph node metastasis in colon cancer.
Critical Relevance Statement:
This study demonstrated good inter-observer agreement for Node-reporting and data system (Node-RADS) in colon cancer across readers of varying experience, supporting its clinical reliability. However, its limited sensitivity for predicting lymph node metastasis highlights the need for further improvement.
Key Points:
Assessing inter-observer agreement among different readers for Node-RADS assignment is critical before its clinical application. Substantial inter-observer agreement for Node-RADS was observed across readers of varying experience levels.
Related Concept Videos
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
01:30Radiological Investigation I: X-ray and CT
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and solid...
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...