{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T07:29:19Z","timestamp":1774510159312,"version":"3.50.1"},"reference-count":18,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["PE 1711\/2\u20131"],"award-info":[{"award-number":["PE 1711\/2\u20131"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["PE 1711-2-2"],"award-info":[{"award-number":["PE 1711-2-2"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["BA 6438\/4\u20131"],"award-info":[{"award-number":["BA 6438\/4\u20131"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Accurate and reproducible lymph node (LN) measurement is essential for oncologic staging and therapy monitoring but is subject to inter-reader variability. This study evaluated the accuracy and reproducibility of a fully automated artificial intelligence (AI)-based LN measurement workflow in contrast-enhanced chest CT, using multi-reader manual measurements as reference. Methods: Sixty thoracic LNs from seven patients were independently measured by 13 radiologists in two reading rounds. The median of all measurements served as the ground truth (GT). Automated short- and long-axis diameters were derived from fully automated 3D CNN-based segmentations. Agreement between AI and manual measurements was assessed using Friedman testing, intraclass correlation coefficients (ICCs), and concordance correlation coefficients (CCCs). Measurement stability was evaluated across repeated runs on different hardware systems. Results: A total of 2280 manual measurements were analyzed. Manual assessment showed significant inter-reader variability (p &lt; 0.01), while intra-reader agreement was high. No significant differences were observed between AI-based measurements and the GT (all p &gt; 0.01). Agreement was good, with CCC values of 0.86 (SAD) and 0.79 (LAD). AI-based measurements were numerically stable across hardware configurations. Conclusions: Fully automated AI-based LN measurements in chest CT scans provide strong agreement with multi-reader consensus and high numerical stability. Automated measurement may support more standardized and reproducible oncologic imaging assessment.<\/jats:p>","DOI":"10.3390\/diagnostics16070967","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T13:57:34Z","timestamp":1774447054000},"page":"967","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fully Automated AI-Based Lymph Node Measurements in Chest CT: Accuracy and Reproducibility Compared with Multi-Reader Assessment"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3694-0235","authenticated-orcid":false,"given":"Andra-Iza","family":"Iuga","sequence":"first","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6747-6578","authenticated-orcid":false,"given":"Heike","family":"Carolus","sequence":"additional","affiliation":[{"name":"Philips GmbH Innovative Technologies, 22335 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liliana Lourenco","family":"Caldeira","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5021-6895","authenticated-orcid":false,"given":"Jonathan","family":"Kottlors","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3980-931X","authenticated-orcid":false,"given":"Miriam","family":"Rinneburger","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6536-3898","authenticated-orcid":false,"given":"Mathilda","family":"Weisthoff","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Fervers","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Rauen","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Fichter","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Goertz","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pia","family":"Niederau","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"},{"name":"Institute of Neuroradiology, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Siedek","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carola","family":"Heneweer","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten","family":"Gietzen","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lenhard","family":"Pennig","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anja","family":"Dobrostal","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"},{"name":"Department of Radiology, Hospital of the Augustinians, 50678 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3761-0350","authenticated-orcid":false,"given":"Fabian","family":"Laqua","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Woznicki","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Maintz","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, 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