MRI-based Node-RADS effectively improves staging of head and neck cancer
An MRI-based Node-RADS scoring system shows great promise for assessing metastatic lymph nodes in patients with head and neck squamous cell carcinoma (HNSCC).
New work published in the European Journal of Radiology details the accuracy of the system and highlights several imaging characteristics closely correlated with metastases. Experts involved in the research believe that its use could offer providers valuable preoperative insight and help guide them in surgical decisions.
Accurately identifying the signs of metastatic disease is crucial for improving outcomes, the authors note.
“Precise staging of lymph node metastasis is essential to enhance locoregional control of the disease, improve patient survival outcomes and to determine the appropriate therapeutic approach, which may include surgery, radiation, chemotherapy, or a combination of them,” Sara Greco, with the Interdisciplinary Department of Medicine at the University of Bari in Italy, and colleagues explain. “While the need for a highly accurate imaging method for assessment of lymph nodes is paramount, such need is not adequately met by currently available diagnostic imaging methods.”
For their work, researchers retrospectively applied the system to the preoperative MRIs of 42 HNSCC patients who also undergone node dissection. Two radiologists assessed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy of the system, with scores of 4 and 5 considered positive. Histological analyses were used for confirmation.
The system performed well, achieving a sensitivity of 61.54 %, specificity of 89.69 %, PPV of 76.19 %, NPV of 89.69 % and an overall accuracy of 87.29 %. In terms of imaging characteristics indicative of metastatic involvement, necrosis, border irregularity, and shape were significantly correlated with positive histopathological results, suggesting they should be strongly considered for the system’s criteria.
“These results support the utility of Node-RADS as an effective tool for identifying metastatic LNs in head and neck squamous cell carcinoma patients,” the group suggests. “This aligns with previous studies in other cancers, where advanced imaging systems like Node-RADS showed high sensitivity and specificity in detecting metastatic lymphadenopathy, thus supporting its potential for accurate staging and treatment planning in HNSCC.”
Although the team’s findings are positive, they acknowledge that more work and refinement are needed before reliable deployment in HNSCC diagnostics.
Learn more about the study here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.