Evaluation of Computed Tomography for Lymph Node Staging in XXXX Prior to Radical Cystectomy.

@entity1 @entity5 @entity1600 @entity2286 @entity150
OBJECTIVES: To retrospectively evaluate the value of CT for @entity1600 ( @entity1600 ) staging in @entity150 . METHODS: Two uroradiologists reviewed CT scans of 231 @entity1 who underwent radical cystectomy and pelvic lymphadenectomy according to a predefined 12-field template. A 5-step model was used to grade the radiological likelihood of a @entity1600 to represent malignant spread based on size, configuration and structure as well as regional clustering. Statistical analyses were performed both on @entity1 - and field-based levels. RESULTS: @entity1600 metastases were found in 59 of 231 @entity1 (25.5%). On a @entity1 -based level, sensitivity, specificity, positive predictive value ( @entity2286 ), negative predictive value (NPV) and accuracy were 52.6, 93.6, 73.2, 85.6 and 83.4%, respectively. Using the field-based approach, a total of 1,649 anatomical fields were evaluable, of which 114 fields showed @entity5 (6.9%). On a field basis, sensitivity, specificity, @entity2286 , NPV and accuracy were 30.2, 98, 51.5, 94.5 and 93.3%, respectively. Concerning local staging (pT category), the overall accuracy was 78%; overstaging occurred in 6% and understaging in 16%. CONCLUSIONS: In line with prior studies, the sensitivity of CT imaging for the detection of @entity1600 metastases was low, while high values for specificity were achieved. This was further underlined by analyzing standardized anatomical fields. Concerning local staging, postoperative changes after TURB-T rarely led to overstaging.
