Prospective Multicenter Study on the Predictive Role of Node-RADS Score in Patients With Prostate Cancer Who…

Cohort studyEuropean urology focus· Aug 2026

Prospective Multicenter Study on the Predictive Role of Node-RADS Score in Patients With Prostate Cancer Who Are Candidates for Radical Prostatectomy: Comparative Analysis with Validated Nomograms and PET/CT Scan.

Alessandro Sciarra, Paolo Casale, Giulio Bevilacqua … Valeria Panebianco

Oncologic ImagingCohort studyDiagnosisQ1IF 4.2

High Node-RADS score linked to much higher odds of positive pelvic lymph nodes

Prospective Multicenter Study on the Predictive Role of Node-RADS Score in Patients With Prostate Cancer Who Are Candidates for Radical Prostatectomy: Comparative Analysis with Validated Nomograms and PET/CT Scan.

Alessandro Sciarra … Valeria Panebianco

European urology focus · Aug 2026

Background

This is the first prospective study analyzing the predictive value of preoperative Node-Reporting And Data System (RADS) determination at imaging for pelvic lymph node (pelvic lymph node) involvement in cases of prostate cancer (prostate cancer) considered for radical prostatectomy (radical prostatectomy) with extended pelvic lymph node dissection (ePLND).

Methods

A total of 267 patients with a histological diagnosis of prostate cancer undergoing radical prostatectomy with an ePLND were prospectively examined.

n = 267 patients

Results

high node-RADS score raised odds of positive pelvic nodes over 12-fold

AOR 16.98 (95% CI 4.29 to 67.17)

null 1

4.29

67.17

CI excludes the null - significant

More results

Node-RADS exceeded PSMA-PET/CT in overall accuracy (area under the curve [AUC] 0.637 vs 0.526), whereas the Briganti 2019 nomogram achieved the highest AUC (0.711).

Combining Node-RADS and Briganti 2019 improved performance further (AUC 0.719).

More results

Node-RADS showed high specificity (0.993) and positive predictive value (0.506), useful to confirm nodal involvement, whereas Briganti 2019 demonstrated high sensitivity (0.952) and excellent NPV (0.960), useful to exclude nodal disease.

PET/CT exhibited limited sensitivity and anatomical correspondence.

“

Conclusion

Node-RADS, especially when combined with the Briganti 2019 nomogram, showed promising performance as a structured radiologic tool for preoperative nodal staging in this selected ePLND-eligible cohort.

Prospective Multicenter Study on the Predictive Role of Node-RADS Score in Patients With Prostate Cancer Who Are Candidates for Radical Prostatectomy: Comparative Analysis with Validated Nomograms and PET/CT Scan.

Prospective Multicenter Study on the Predictive Role of Node-RADS Score in Patients With Prostate Cancer Who Are Candidates for Radical Prostatectomy: Comparative Analysis with Validated Nomograms and PET/CT Scan.

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