Node-RADS: a systematic review and meta-analysis of diagnostic performance, category-wise malignancy rates, and inter-observer reliability

作者：Jingyu Zhong, Shiqi Mao, Haoda Chen, Yibin Wang, Qian Yin, Qingqing Cen, Junjie Lu, Jiarui Yang, Y. Hu, Yue Xing, Xian‐Wei Liu, Xiang Ge, Run Jiang, Yang Song, Minda Lu, Jingshen Chu, Huan Zhang, Guangcheng Zhang, Defang Ding, Weiwu Yao · 发表于：European Radiology · 年份：2024 · DOI：10.1007/s00330-024-11160-1 · 被引用次数：34 · 研究领域：Lung Cancer Diagnosis and Treatment、Head and Neck Cancer Studies、Radiomics and Machine Learning in Medical Imaging

OBJECTIVE: To perform a systematic review and meta-analysis to estimate diagnostic performance, category-wise malignancy rates, and inter-observer reliability of Node Reporting and Data System 1.0 (Node-RADS). METHODS: Five electronic databases were systematically searched for primary studies on the use of Node-RADS to report the possibility of cancer involvement of lymph nodes on CT and MRI from January 1, 2021, until April 15, 2024. The study quality was assessed by modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and Quality Appraisal of Diagnostic Reliability (QAREL) tools. The diagnostic accuracy was estimated with bivariate random-effects model, while the pooled category-wise malignancy rates were obtained with random-effects model. RESULTS: Six Node-RADS-CT studies and three Node-RADS-MRI studies covering nine types of cancer were included. The study quality was mainly damaged by inappropriate index test and unknown timing according to QUADAS-2, and unclear blindness during the rating process according to QAREL. The area under hierarchical summary receiver operating characteristic curve (95% conventional interval) was 0.92 (0.89-0.94) for Node-RADS ≥ 3 as positive and 0.91 (0.88-0.93) for Node-RADS ≥ 4 as positive, respectively. The pooled malignancy rates (95% CIs) of Node-RADS 1 to 5 were 4% (0-10%), 31% (9-58%), 55% (34-75%), 89% (73-99%), and 100% (97-100%), respectively. The inter-observer reliability of five studies was interpreted as fair to...