Diagnostic Value of NODE-RADS in Bladder Cancer Association with Histopathology and Imaging Chracteristics

ESUR 2025 Annual Meeting Stockholm, Stockholm, Sweden, 25 - 28 September 2025, pp.1-5, (Full Text)

Title: Diagnostic Value of NODE-RADS in Bladder Cancer: Association with

Histopathology and Imaging Characteristics

Objectives

To assess the ability of the NODE-RADS scoring system to predict lymph node

metastasis in bladder cancer and to explore its relationship with histopathological

results and radiologic features.

Materials and Methods

This retrospective study included 48 patients with bladder cancer who underwent

cross-sectional imaging before surgery. Lymph nodes were scored according to

NODE-RADS, and histopathological results were reviewed. Associations were

analyzed between NODE-RADS scores and lymph node status, tumor grade,

vascular invasion, nodal size (short and long axes), and morphologic imaging

findings. Chi-square and ANOVA tests were used for statistical analysis.

Results

Among 48 patients, 11 (22.9%) had histopathologically proven nodal metastases.

None of the patients with NODE-RADS scores of 1 (n=13) or 2 (n=12) had

metastases. One patient with a score of 3 (n=12) had a positive node. All patients

with scores of 4 (n=6) and 5 (n=5) had metastatic involvement.

Using a threshold of ≥3, NODE-RADS achieved a sensitivity of 100% and a

specificity of 88.9%. Higher scores were significantly linked with increased nodal

dimensions (p < 0.001), irregular contours, necrosis, and spherical shape (p < 0.05).

No significant correlation was found with tumor grade, vascular invasion, or sex.

Conclusions

NODE-RADS is a reliable and practical tool for predicting nodal metastasis in bladder

cancer. It may enhance radiological staging and support treatment decisions when

used routinely in preoperative evaluation.