Evidence mapPaperPMID 40836021Full record

ArticleEuropean radiology2026

Node-RADS for preoperative locoregional nodal staging of endometrial cancer: reproducibility and accuracy assessment using CT and MRI.

Matteo Bonatti, Riccardo Valletta, Valentina Corato, Bernardo Proner, Laurjan Hoxha, Luca Odoferdi, Martin Steinkasserer, Roberta Valerieva Ninkova, Giacomo Avesani, Vincenzo Vingiani and 1 more

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Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Matteo BonattiDepartment of Radiology, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), Bolzano, Italy.
Riccardo VallettaDepartment of Radiology, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), Bolzano, Italy.
Valentina CoratoDepartment of Radiology, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), Bolzano, Italy.
Bernardo PronerDepartment of Radiology, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), Bolzano, Italy.
Laurjan HoxhaDepartment of Radiology, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), Bolzano, Italy.
Luca OdoferdiDepartment of Radiology, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), Bolzano, Italy.
Martin SteinkassererDepartment of Gynecology and Obstetrics, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), Bolzano, Italy.
Roberta Valerieva NinkovaDepartment of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy.
Giacomo AvesaniDepartment of Imaging and Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy. giacomo.avesani@policlinicogemelli.it.ORCID http://orcid.org/0000-0001-9926-760X
Vincenzo VingianiDepartment of Radiology, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), Bolzano, Italy.
Lucia ManganaroDepartment of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo assess the reproducibility and diagnostic accuracy of the Node Reporting and Data System 1.0 (Node-RADS) for detecting pelvic nodal metastases by endometrial cancer (EC) using CT and MRI, among readers with different levels of expertise. MATERIALS AND

methodsThis IRB-approved, single-center retrospective study included 128 patients with EC who underwent preoperative MRI at our Institution (Jan 2020-Dec 2023). Six readers with different levels of expertise in pelvic MRI (2 dedicated pelvic radiologists, 2 residents in their fourth year of training, and 2 residents in their second year of training) independently evaluated preoperative CTs and MRIs and assigned Node-RADS scores. Inter-observer agreement and inter-method agreement were calculated. Node-RADS was compared with post-surgical pathology data.

resultsAt surgery, pelvic nodal metastases were detected in 12.5% of the patients. Interobserver agreement in nodal status assessment using Node-RADS varied from κ = 0.783 to κ = 0.426 using MRI, and from κ = 0.936 to κ = 0.295 using CT, with worse results among less experienced readers. MRI and CT were concordant in the N definition in 94-98% of the cases. Using MRI, the most experienced readers showed 63% sensitivity and 100% specificity in the detection of nodal metastases, compared to 44% sensitivity and 96% specificity for poorly experienced readers. Using CT, the most experienced readers showed 50% sensitivity and 100% specificity; the less experienced readers showed 43% sensitivity and 94% specificity.

conclusionsNode-RADS is a reproducible and accurate tool for locoregional nodal staging of EC, but only for readers with specific experience in pelvic imaging. MRI outperforms CT in nodal assessment. KEY POINTS: Question Preoperative assessment of nodal metastases by EC is difficult, but it may help in tailoring the best surgical approach for each patient. Findings Node-RADS is a reliable tool for assessing the presence of pelvic nodal metastases by EC, both on CT and MRI, among experienced readers. Clinical relevance The use of Node-RADS among experienced readers enables detection of nodal metastases with good sensitivity and excellent specificity; MRI should be preferred over CT due to its higher sensitivity.

Indexed as

Endometrial NeoplasmsLymphatic MetastasisLymph NodesMagnetic Resonance ImagingTomography, X-Ray ComputedAdultAgedAged, 80 and overFemaleHumansMiddle AgedNeoplasm StagingObserver VariationPelvisPreoperative CareReproducibility of ResultsCancer stagingEndometrial neoplasmsLymph nodesMagnetic resonance imagingMultidetector computed tomography

Identifiers

PMID40836021
PMCPMC12953289

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.