Preoperative CT-based node-RADS scoring for risk stratification in pancreatic head cancer: diagnostic accuracy and survival implications
European Journal of Radiology, cilt.201, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 201
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.ejrad.2026.112895
- Dergi Adı: European Journal of Radiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO)
- Anahtar Kelimeler: Pancreatic cancer, Lymph node metastasis, Node-RADS, Survival
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose To evaluate the diagnostic performance and prognostic value of the Node Reporting and Data System (Node-RADS) for predicting lymph node metastasis and survival outcomes in patients with pancreatic head adenocarcinoma. Methods This retrospective single-center study included patients with pancreatic head adenocarcinoma undergoing surgical resection. Preoperative contrast-enhanced CT images were evaluated using the Node-RADS classification. Diagnostic performance for lymph node metastasis was assessed by ROC analysis, and associations with overall and disease-free survival were analyzed using Kaplan–Meier and Cox regression methods. Results Node-RADS scoring demonstrated moderate discriminatory ability for detecting lymph node metastasis, with an area under the curve of 0.686, sensitivity of 75.0%, and specificity of 62.2%. The negative predictive value (76.7%) was notably higher than the positive predictive value (60.0%). In multivariate analysis, Node-RADS ≥ 3 emerged as an independent predictor of overall survival (hazard ratio: 2.59, p = 0.023), maintaining significance after adjustment for tumor grade, lymphovascular invasion, and pathologic nodal status. Conclusion Node-RADS demonstrates moderate diagnostic accuracy for detecting lymph node metastasis in pancreatic head adenocarcinoma but provides independent prognostic information for overall survival beyond conventional clinicopathological factors. Systematic Node-RADS scoring may enhance preoperative risk stratification and facilitate personalized treatment planning in pancreatic cancer patients.