Evidence map›Paper›PMID 41792574›Full record

ArticleEuropean radiology2026

Comparative analysis of RADS classification systems for solitary bone lesions: malignancy risk stratification performance and clinical utility.

Arash Azhideh, Sara Haseli, Chankue Park, Hyeyun Lee, Hyun Su Kim, Peyman Mirghaderi, Majid Chalian

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Arash Azhideh *Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA, USA.
Sara Haseli *Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA, USA.
Chankue ParkDepartment of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA, USA. chankue.park@gmail.com.ORCID http://orcid.org/0000-0003-2937-114X
Hyeyun LeeDepartment of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
Hyun Su KimDepartment of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA, USA.
Peyman MirghaderiDepartment of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA, USA.
Majid ChalianDepartment of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare the malignancy risk stratification performance and inter-reader reliability of four Reporting and Data System (RADS) algorithms for solitary bone lesions: CT Bone-RADS, MRI Bone-RADS, Osseous Tumor (OT)-RADS, and Bone Tumor Imaging (BTI)-RADS. MATERIALS AND

methodsThis retrospective analysis included patients with solitary bone lesions who underwent both CT and MRI between March 2005 and September 2021. Three radiologists independently categorized each lesion using CT Bone-RADS (1-4), MRI Bone-RADS (1-4), OT-RADS (2-5), and BTI-RADS (1-4). Categories were dichotomized into high- versus low-risk for malignancy. Diagnostic performance metrics and area under the receiver operating characteristic curve (AUC) were calculated for each reader as well as for a consensus interpretation generated using a majority-vote method. The reference standard was either histopathologic confirmation or imaging surveillance. Inter-reader reliability was assessed using Gwet's AC1 statistic.

resultsA total of 207 patients (mean age, 49 ± 18 years; 111 men and 96 women) were included. Consensus malignancy risk stratification performance (AUC; sensitivity/specificity/positive predictive value/negative predictive value/accuracy, %) was as follows: CT Bone-RADS (0.52; 95/9/43/73/44), MRI Bone-RADS (0.60; 98/12/44/88/47), OT-RADS (0.91; 93/71/69/94/80), and BTI-RADS (0.89; 98/39/53/96/63). Inter-reader reliability (AC1) was excellent for CT Bone-RADS (0.978), MRI Bone-RADS (0.931), and BTI-RADS (0.822), and moderate for OT-RADS (0.585).

conclusionAmong the evaluated bone tumor-RADS, OT-RADS demonstrated the most balanced diagnostic performance with moderate inter-reader reliability. CT Bone-RADS, MRI Bone-RADS, and BTI-RADS showed excellent inter-reader reliability. KEY POINTS: Question Evaluation of solitary bone lesions is important but often challenging. This study compared four bone tumor-RADS algorithms to determine which provides the best malignancy risk stratification. Findings Among the four RADS algorithms, OT-RADS demonstrated the most balanced overall diagnostic performance in consensus analysis, while CT Bone-RADS, MRI Bone-RADS, and BTI-RADS showed excellent inter-reader reliability. Clinical relevance Knowledge of each RADS system's performance characteristics helps clinicians apply these algorithms appropriately to optimize the assessment of solitary bone lesions.

Indexed as

Bone NeoplasmsMagnetic Resonance ImagingTomography, X-Ray ComputedAdultAgedAlgorithmsFemaleHumansMaleMiddle AgedObserver VariationReproducibility of ResultsRetrospective StudiesRisk AssessmentSensitivity and SpecificityBone neoplasmsDiagnostic accuracyDiagnostic imagingReproducibility of resultsSensitivity and specificity

Identifiers

PMID41792574

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.