Diagnostic performance of CT-based node-RADS for detecting metastatic lymph nodes in melanoma and comparison with short-axis and roundness index.

Publication date: Sep 01, 2026

To evaluate the diagnostic performance of the CT-based Node-RADS score for assessing metastatic lymph node involvement in patients with cutaneous melanoma and to compare it with short axis and roundness index. This retrospective study included patients with histologically confirmed melanoma who underwent contrast-enhanced CT before sentinel lymph node biopsy. A control cohort of trauma patients free from any condition potentially affecting lymph nodes was included to represent physiological lymph nodes and to address class imbalance. Lymph nodes were independently assessed by two radiologists and re-evaluated after one month; inter- and intra-observer agreement were evaluated using Cohen’s kappa. Diagnostic performance was assessed using ROC curve analysis, and AUCs were compared with the DeLong test. A total of 123 lymph nodes were analyzed, of which 55 (45%) were metastatic. Inter- and intra-observer agreement was excellent (_705 = 0. 84-0. 97 and 0. 85-0. 98, respectively). All imaging features differed significantly between metastatic and non-metastatic lymph nodes (p

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