Current Status and Challenges of Imaging‐Based Diagnosis of Lymph Node Metastasis in Colon Cancer: The Lymph Node Committee of the Japanese Society for Cancer of the Colon and Rectum
4 affiliations
- 1Department of Surgery, Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan
- 2Department of Surgery, Saitama Medical Center Jichi Medical University Saitama Japan
- 3Department of Colorectal Surgery National Cancer Center Hospital Tokyo Japan
- 4Department of Surgery National Defense Medical College Tokorozawa Saitama Japan
Abstract
Background: Accurate pre‐treatment evaluation of lymph node metastasis (LNM) in colon cancer is important for determining an optimal treatment strategy. This diagnosis is mainly performed using the size of lymph nodes visualized on CT, although morphological diagnosis is also used.
Results: Meta‐analyses of CT for diagnosis of LNM in colon cancer indicate unsatisfactory results, with pooled sensitivities of 71% and 74%, and pooled specificities of 67% and 54%. Our recent report also showed only moderate diagnostic performance, with pooled sensitivity of 66.7%, pooled specificity of 72.4%, and an AUC of the HSROC of 0.741. This is because strict positive criteria based on the size and morphology of visualized lymph nodes are difficult to establish, and currently there are limitations to determining treatment strategies based on imaging diagnosis. Diagnostic accuracy can be improved by setting individualized diagnostic criteria according to the purpose, considering underlying clinicopathological factors, and combining multiple metastasis‐related factors. New diagnostic methods such as dual‐energy CT and radiomics have also been explored. Unlike traditional diagnoses based on imaging findings, these methods quantify and evaluate parameters, and radiomics, in particular, allows detailed evaluation by quantifying high‐dimensional features that are not visible.
Conclusion: Further studies are required to improve diagnostic capabilities that will enable optimal treatment strategies for LNM in colon cancer.
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BibTeX
@article{ogawa2026current,
title = {{Current Status and Challenges of Imaging‐Based Diagnosis of Lymph Node Metastasis in Colon Cancer: The Lymph Node Committee of the Japanese Society for Cancer of the Colon and Rectum}},
author = {Shimpei Ogawa and Yuji Takayama and Yasuyuki Takamizawa and Yukihide Kanemitsu and Hideki Ueno},
journal = {Annals of Gastroenterological Surgery},
year = {2026},
month = jul,
doi = {10.1002/ags3.70250},
url = {https://doi.org/10.1002/ags3.70250},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Current Status and Challenges of Imaging‐Based Diagnosis of Lymph Node Metastasis in Colon Cancer: The Lymph Node Committee of the Japanese Society for Cancer of the Colon and Rectum
AU - Shimpei Ogawa
AU - Yuji Takayama
AU - Yasuyuki Takamizawa
AU - Yukihide Kanemitsu
AU - Hideki Ueno
PY - 2026
DA - 2026/07/16
JO - Annals of Gastroenterological Surgery
DO - 10.1002/ags3.70250
UR - https://doi.org/10.1002/ags3.70250
AB - Background: Accurate pre‐treatment evaluation of lymph node metastasis (LNM) in colon cancer is important for determining an optimal treatment strategy. This diagnosis is mainly performed using the size of lymph nodes visualized on CT, although morphological diagnosis is also used. Results: Meta‐analyses of CT for diagnosis of LNM in colon cancer indicate unsatisfactory results, with pooled sensitivities of 71% and 74%, and pooled specificities of 67% and 54%. Our recent report also showed only moderate diagnostic performance, with pooled sensitivity of 66.7%, pooled specificity of 72.4%, and an AUC of the HSROC of 0.741. This is because strict positive criteria based on the size and morphology of visualized lymph nodes are difficult to establish, and currently there are limitations to determining treatment strategies based on imaging diagnosis. Diagnostic accuracy can be improved by setting individualized diagnostic criteria according to the purpose, considering underlying clinicopathological factors, and combining multiple metastasis‐related factors. New diagnostic methods such as dual‐energy CT and radiomics have also been explored. Unlike traditional diagnoses based on imaging findings, these methods quantify and evaluate parameters, and radiomics, in particular, allows detailed evaluation by quantifying high‐dimensional features that are not visible. Conclusion: Further studies are required to improve diagnostic capabilities that will enable optimal treatment strategies for LNM in colon cancer.
SN - 2475-0328
ER -