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Six readers with different levels of expertise in pelvic MRI (2 dedicated pelvic radiologists, 2 residents in their fourth year of training, and 2 residents in their second year of training) independently evaluated preoperative CTs and MRIs and assigned Node-RADS scores. Inter-observer agreement and inter-method agreement were calculated. Node-RADS was compared with post-surgical pathology data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At surgery, pelvic nodal metastases were detected in 12.5% of the patients. Interobserver agreement in nodal status assessment using Node-RADS varied from \u03ba\u2009=\u20090.783 to \u03ba\u2009=\u20090.426 using MRI, and from \u03ba\u2009=\u20090.936 to \u03ba\u2009=\u20090.295 using CT, with worse results among less experienced readers. MRI and CT were concordant in the N definition in 94\u201398% of the cases. Using MRI, the most experienced readers showed 63% sensitivity and 100% specificity in the detection of nodal metastases, compared to 44% sensitivity and 96% specificity for poorly experienced readers. Using CT, the most experienced readers showed 50% sensitivity and 100% specificity; the less experienced readers showed 43% sensitivity and 94% specificity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Node-RADS is a reproducible and accurate tool for locoregional nodal staging of EC, but only for readers with specific experience in pelvic imaging. MRI outperforms CT in nodal assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Preoperative assessment of nodal metastases by EC is difficult, but it may help in tailoring the best surgical approach for each patient<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Node-RADS is a reliable tool for assessing the presence of pelvic nodal metastases by EC, both on CT and MRI, among experienced readers<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>The use of Node-RADS among experienced readers enables detection of nodal metastases with good sensitivity and excellent specificity; MRI should be preferred over CT due to its higher sensitivity<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-025-11923-4","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T17:51:44Z","timestamp":1755712304000},"page":"989-997","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Node-RADS for preoperative locoregional nodal staging of endometrial cancer: reproducibility and accuracy assessment using CT and MRI"],"prefix":"10.1007","volume":"36","author":[{"given":"Matteo","family":"Bonatti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Valletta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Corato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Proner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurjan","family":"Hoxha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Odoferdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Steinkasserer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta Valerieva","family":"Ninkova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9926-760X","authenticated-orcid":false,"given":"Giacomo","family":"Avesani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Vingiani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Manganaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"11923_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. 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