Diagnostic and Prognostic Value of MRI-based Node-RADS for Regional Lymph Node Metastasis in Renal Cell Carcinoma

Motivation: The prognostic property of regional lymph node metastasis (RLNM) has been widely recognized, but the diagnostic workup has stagnated for renal cell carcinoma (RCC). Goal(s): This study aimed to assess the diagnostic performance of MRI-based Node Reporting and Data System (Node-RADS) for RLNM and to explore its prognostic impact on patients with RCC. Approach: A single-center retrospective comparative study. Results: MRI-based Node-RADS presented better diagnostic performance for RLNM than the size criteria and previous clinical models (AUC, 0.91 vs 0.79–0.85; all P<.05), and exhibited a substantial prognostic value for RCCs regarding progress-free survival and overall survival (both P<.001). Impact: Node-RADS, a concept that combines size, texture, margin, and shape, is a promising approach for lymph node metastasis in RCCs, which may contribute to improving clinical node staging and guiding clinical decision making.