Bone Reporting and Data System on MRI (Bone-RADS-MRI): a validation study by four readers on 275 cases from three...

Area of Science:

• Radiology
• Oncology
• Orthopedics

Background:

• Incidental solitary bone lesions require accurate characterization to guide management.
• Standardized reporting systems improve diagnostic consistency and patient care.

Purpose of the Study:

• To assess the reproducibility and diagnostic effectiveness of the Bone Reporting and Data System on MRI (Bone-RADS-MRI) for incidental solitary bone lesions in adults.

Main Methods:

• Retrospective analysis of 275 MRI cases with confirmed bone lesions.
• Categorization of lesions using the Bone-RADS algorithm by musculoskeletal and non-musculoskeletal radiologists.
• Evaluation of inter-reader agreement and diagnostic performance against histopathology or clinical follow-up.

Main Results:

• Moderate inter-reader agreement was observed between radiologists of similar and different specialties (weighted kappa 0.572 and 0.520).
• Bone-RADS-MRI demonstrated high sensitivity (88.5%–94.5%) but lower specificity (55.5%–74.5%) in identifying lesions requiring treatment.
• Diagnostic accuracy ranged from 76.4% to 82.9%.

Conclusions:

• Bone-RADS-MRI is effective in identifying adult bone lesions that warrant further investigation or treatment.
• The system shows moderate reliability among readers with varying experience and specialties.
• Further clinical validation is recommended to enhance inter-reader agreement and refine diagnostic performance, particularly specificity.