影像学对胃癌区​​域淋巴结评估的诊断性能仍然有限，并且放射学评估缺乏共识。与此同时，对使用报告和数据系统 (RADS) 标准化肿瘤成像的结构化报告的需求不断增加。我们旨在调查 Node-RADS 的诊断性能，与使用组织病理学作为参考的各种个体标准评估胃癌区域淋巴结的诊断性能进行比较。在这项回顾性单中心研究中，连续 91 名患者（中位年龄 66 岁，年龄范围为 33-91 岁，54 名男性），通过 CT 扫描和组织学证实的胃腺癌，使用 Node-RADS 进行评估，为区域淋巴结转移的可能性评分从 1 到 5。此外，还单独评估了不同的 Node-RADS 标准以及边界轮廓改变的子类别（分叶状、针状、不明显）。计算 Node-RADS 评分的敏感性、特异性和 Youden 指数，并研究所有标准。使用 Cohen's kappa 计算读者间一致性。在所有标准中，Node-RADS 评分 ≥ 3 和 ≥ 4 表现最佳，敏感性/特异性/Youden 指数分别为 56.8%/90.7%/0.48 和 48.6%/98.1%/0.47 ，分别具有显着的读者间一致性（κ = 0.73 和 0.67，p < 0.01）。在各个标准中，短轴直径 10 mm 的性能最佳，敏感性/特异性/约登指数为 56.8%/87.0%/0.44 (κ = 0.65，p < 0.01)。这项研究表明，组合的结构化报告与仅包括短轴直径的个体标准相比，胃癌区域淋巴结的大小和配置标准略微提高了整体诊断性能。结果显示特异性有所提高，而敏感性没有变化。本研究的结果表明，Node-RADS 可能是胃癌区域淋巴结结构化报告的合适工具。• 胃癌淋巴结的评估仍然有限，并且放射学评估缺乏共识。 • 与包括短轴直径在内的个体标准相比，胃癌的淋巴结-RADS 提高了整体诊断性能。 • Node-RADS 可能是结构化报告胃癌区域淋巴结的合适工具。© 2023。作者。

Diagnostic performance of imaging for regional lymph node assessment in gastric cancer is still limited, and there is a lack of consensus on radiological evaluation. At the same time, there is an increasing demand for structured reporting using Reporting and Data Systems (RADS) to standardize oncological imaging. We aimed at investigating the diagnostic performance of Node-RADS compared to the use of various individual criteria for assessing regional lymph nodes in gastric cancer using histopathology as reference.In this retrospective single-center study, consecutive 91 patients (median age, 66 years, range 33-91 years, 54 men) with CT scans and histologically proven gastric adenocarcinoma were assessed using Node-RADS assigning scores from 1 to 5 for the likelihood of regional lymph node metastases. Additionally, different Node-RADS criteria as well as subcategories of altered border contour (lobulated, spiculated, indistinct) were assessed individually. Sensitivity, specificity, and Youden's index were calculated for Node-RADS scores, and all criteria investigated. Interreader agreement was calculated using Cohen's kappa.Among all criteria, best performance was found for Node-RADS scores ≥ 3 and ≥ 4 with a sensitivity/specificity/Youden's index of 56.8%/90.7%/0.48 and 48.6%/98.1%/0.47, respectively, both with substantial interreader agreement (κ = 0.73 and 0.67, p < 0.01). Among individual criteria, the best performance was found for short-axis diameter of 10 mm with sensitivity/specificity/Youden's index of 56.8%/87.0%/0.44 (κ = 0.65, p < 0.01).This study shows that structured reporting of combined size and configuration criteria of regional lymph nodes in gastric cancer slightly improves overall diagnostic performance compared to individual criteria including short-axis diameter alone. The results show an increase in specificity and unchanged sensitivity.The results of this study suggest that Node-RADS may be a suitable tool for structured reporting of regional lymph nodes in gastric cancer.• Assessment of lymph nodes in gastric cancer is still limited, and there is a lack of consensus on radiological evaluation. • Node-RADS in gastric cancer improves overall diagnostic performance compared to individual criteria including short-axis diameter. • Node-RADS may be a suitable tool for structured reporting of regional lymph nodes in gastric cancer.© 2023. The Author(s).