Objectives <p>To evaluate the diagnostic performance of the Node Reporting and Data System (Node-RADS) and its enhanced versions for central (CLNM) and lateral lymph node metastases (LLNM) in papillary thyroid cancer (PTC).</p> Materials and methods <p>This retrospective study enrolled 227 patients with histologically confirmed PTC who underwent preoperative thyroid-dedicated contrast-enhanced CT. The original Node-RADS scores were assigned to lymph nodes in cervical levels II–VI, and the results were compared with histopathology. A Hyper‑Enhancement Node‑RADS (HE‑Node‑RADS) model by assigning a hyper‑enhancement feature was further developed. Multivariate logistic regression was used to identify independent predictors of CLNM and construct a Nomogram‑Augmented Node‑RADS (NA‑Node‑RADS). The diagnostic performance of different thresholds of Node-RADS and the modified models was assessed and compared.</p> Results <p>Node-RADS demonstrated moderate to good diagnostic performance for both CLNM (threshold &gt; 1, AUC = 0.741) and LLNM (threshold &gt; 2, AUC = 0.801). Interobserver agreements were excellent (<i>κ</i> = 0.838 for CLNM and <i>κ</i> = 0.827 for LLNM). At threshold &gt; 2, HE-Node-RADS (AUC = 0.883) was significantly superior to Node-RADS for LLNM (<i>p</i> = 0.004). NA-Node-RADS (predicted probability &gt; 47.1%), incorporating age, sex, primary tumor size, and core node features (texture, border, shape), showed superior predictive power for CLNM (AUC = 0.879) compared to Node-RADS (0.795) and HE-Node-RADS (0.807), with good calibration and superior net benefit on decision curve analysis.</p> Conclusion <p>CT‑based Node‑RADS offered robust LNM assessment in PTC. The addition of hyper-enhancement improves Node-RADS performance for LLNM, and the proposed nomogram based on Node-RADS further refines CLNM risk estimation.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>How about the Node-RADS for lymph node metastasis (LNM) assessment in papillary thyroid cancer (PTC), and can it be improved?</i></p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>Node-RADS demonstrates moderate to good diagnostic efficacy. Hyper‑enhancement Node‑RADS and Nomogram‑Augmented Node‑RADS are significantly superior for lateral and central LNM, respectively.</i></p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>Node‑RADS is useful for preoperative assessment of LNM in PTC, but thresholds vary by neck compartment. Integrating hyper-enhancement enhances lateral Node-RADS performance, while incorporating clinical factors improves central Node-RADS and may facilitate individualized clinical decision-making.</i></p> Graphical Abstract <p></p>