Skip to main content
Top

09-06-2024 | Osteomyelitis | Scientific Article

Diagnostic performance and inter-reader reliability of bone reporting and data system (Bone-RADS) on computed tomography

Authors: Chankue Park, Arash Azhideh, Atefe Pooyan, Ehsan Alipour, Sara Haseli, Ishan Satwah, Majid Chalian

Published in: Skeletal Radiology

Login to get access

Abstract

Objective

To evaluate the diagnostic performance and inter-reader reliability of the Bone Reporting and Data System (Bone-RADS) for solitary bone lesions on CT.

Materials and methods

This retrospective analysis included 179 patients (mean age, 56 ± 18 years; 94 men) who underwent bone biopsies between March 2005 and September 2021. Patients with solitary bone lesions on CT and sufficient histopathology results were included. Two radiologists categorized the bone lesions using the Bone-RADS (1, benign; 4, malignant). The diagnostic performance of the Bone-RADS was calculated using histopathology results as a standard reference. Inter-reader reliability was calculated.

Results

Bone lesions were categorized into two groups: 103 lucent (pathology: 34 benign, 12 intermediate, 54 malignant, and 3 osteomyelitis) and 76 sclerotic/mixed (pathology: 46 benign, 2 intermediate, 26 malignant, and 2 osteomyelitis) lesions. The Bone-RADS for lucent lesions had sensitivities of 95% and 82%, specificities of 11% and 11%, and accuracies of 57% and 50% for readers 1 and 2, respectively. The Bone-RADS for sclerotic/mixed lesions had sensitivities of 75% and 68%, specificities of 27% and 27%, and accuracies of 45% and 42% for readers 1 and 2, respectively. Inter-reader reliability was moderate to very good (κ = 0.744, overall; 0.565, lucent lesions; and 0.851, sclerotic/mixed lesions).

Conclusion

Bone-RADS has a high sensitivity for evaluating malignancy in lucent bone lesions and good inter-reader reliability. However, it has poor specificity and accuracy for both lucent and sclerotic/mixed lesions. A possible explanation is that proposed algorithms heavily depend on clinical features such as pain and history of malignancy.
Literature
1.
go back to reference Rajiah P, Ilaslan H, Sundaram M. Imaging of primary malignant bone tumors (nonhematological). Radiol Clin. 2011;49(6):1135–61.CrossRef Rajiah P, Ilaslan H, Sundaram M. Imaging of primary malignant bone tumors (nonhematological). Radiol Clin. 2011;49(6):1135–61.CrossRef
2.
go back to reference Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. Ca Cancer J Clin. 2021;71(1):7–33.CrossRefPubMed Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. Ca Cancer J Clin. 2021;71(1):7–33.CrossRefPubMed
3.
go back to reference Islami F, Miller KD, Siegel RL, et al. National and state estimates of lost earnings from cancer deaths in the United States. JAMA Oncol. 2019;5(9):e191460–e191460.CrossRefPubMedPubMedCentral Islami F, Miller KD, Siegel RL, et al. National and state estimates of lost earnings from cancer deaths in the United States. JAMA Oncol. 2019;5(9):e191460–e191460.CrossRefPubMedPubMedCentral
4.
go back to reference Redondo A, Bagué S, Bernabeu D, et al. Malignant bone tumors (other than Ewing’s): clinical practice guidelines for diagnosis, treatment and follow-up by Spanish Group for Research on Sarcomas (GEIS). Cancer Chemother Pharmacol. 2017;80:1113–31.CrossRefPubMedPubMedCentral Redondo A, Bagué S, Bernabeu D, et al. Malignant bone tumors (other than Ewing’s): clinical practice guidelines for diagnosis, treatment and follow-up by Spanish Group for Research on Sarcomas (GEIS). Cancer Chemother Pharmacol. 2017;80:1113–31.CrossRefPubMedPubMedCentral
5.
go back to reference Costelloe CM, Madewell JE. Radiography in the initial diagnosis of primary bone tumors. AJR Am J Roentgenol. 2013;200(1):3–7.CrossRefPubMed Costelloe CM, Madewell JE. Radiography in the initial diagnosis of primary bone tumors. AJR Am J Roentgenol. 2013;200(1):3–7.CrossRefPubMed
6.
go back to reference Hoffman RJ, Stanborough RO, Garner HW. Diagnostic imaging approach to solitary bone lesions. Semin Roentgenol. 2022;57(3):241–51.CrossRefPubMed Hoffman RJ, Stanborough RO, Garner HW. Diagnostic imaging approach to solitary bone lesions. Semin Roentgenol. 2022;57(3):241–51.CrossRefPubMed
7.
go back to reference Miller TT. Bone tumors and tumorlike conditions: analysis with conventional radiography. Radiology. 2008;246(3):662–74.CrossRefPubMed Miller TT. Bone tumors and tumorlike conditions: analysis with conventional radiography. Radiology. 2008;246(3):662–74.CrossRefPubMed
8.
go back to reference Priolo F, Cerase A. The current role of radiography in the assessment of skeletal tumors and tumor-like lesions. Eur J Radiol. 1998;27:S77–85.CrossRefPubMed Priolo F, Cerase A. The current role of radiography in the assessment of skeletal tumors and tumor-like lesions. Eur J Radiol. 1998;27:S77–85.CrossRefPubMed
9.
go back to reference Do BH, Langlotz C, Beaulieu CF. Bone tumor diagnosis using a naïve Bayesian model of demographic and radiographic features. J Digit Imaging. 2017;30:640–7.CrossRefPubMedPubMedCentral Do BH, Langlotz C, Beaulieu CF. Bone tumor diagnosis using a naïve Bayesian model of demographic and radiographic features. J Digit Imaging. 2017;30:640–7.CrossRefPubMedPubMedCentral
10.
go back to reference Mehta K, McBee MP, Mihal DC, England EB. Radiographic analysis of bone tumors: a systematic approach. Semin Roentgenol. 2017;52(4):194–208.CrossRefPubMed Mehta K, McBee MP, Mihal DC, England EB. Radiographic analysis of bone tumors: a systematic approach. Semin Roentgenol. 2017;52(4):194–208.CrossRefPubMed
11.
go back to reference Burnside ES, Sickles EA, Bassett LW. The ACR BI-RADS® experience: learning from history. J Am Coll of Radiol. 2009;6(12):851–60.CrossRef Burnside ES, Sickles EA, Bassett LW. The ACR BI-RADS® experience: learning from history. J Am Coll of Radiol. 2009;6(12):851–60.CrossRef
12.
go back to reference An JY, Unsdorfer KM, Weinreb JC. BI-RADS, C-RADS, CAD-RADS, LI-RADS, Lung-RADS, NI-RADS, O-RADS, PI-RADS, TI-RADS: Reporting and data systems. Radiographics. 2019;39(5):1435–6.CrossRefPubMed An JY, Unsdorfer KM, Weinreb JC. BI-RADS, C-RADS, CAD-RADS, LI-RADS, Lung-RADS, NI-RADS, O-RADS, PI-RADS, TI-RADS: Reporting and data systems. Radiographics. 2019;39(5):1435–6.CrossRefPubMed
13.
go back to reference Ribeiro GJ, Gillet R, Blum A, Teixeira PAG. Imaging report and data system (RADS) for bone tumors: where do we stand and future directions. Skeletal Radiol. 2023;52(2):151–6.CrossRefPubMed Ribeiro GJ, Gillet R, Blum A, Teixeira PAG. Imaging report and data system (RADS) for bone tumors: where do we stand and future directions. Skeletal Radiol. 2023;52(2):151–6.CrossRefPubMed
14.
go back to reference Ribeiro GJ, Gillet R, Hossu G, Trinh J-M, et al. Solitary bone tumor imaging reporting and data system (BTI-RADS): Initial assessment of a systematic imaging evaluation and comprehensive reporting method. Eur Radiol. 2021;31(10):7637–52. Ribeiro GJ, Gillet R, Hossu G, Trinh J-M, et al. Solitary bone tumor imaging reporting and data system (BTI-RADS): Initial assessment of a systematic imaging evaluation and comprehensive reporting method. Eur Radiol. 2021;31(10):7637–52.
15.
go back to reference Chhabra A, Gupta A, Thakur U, Pezeshk P, Dettori N, Callan A, et al. Osseous tumor reporting and data system—Multireader validation study. J Comput Assist Tomogr. 2021;45(4):571–85.CrossRefPubMed Chhabra A, Gupta A, Thakur U, Pezeshk P, Dettori N, Callan A, et al. Osseous tumor reporting and data system—Multireader validation study. J Comput Assist Tomogr. 2021;45(4):571–85.CrossRefPubMed
16.
go back to reference Chang CY, Garner HW, Ahlawat S, et al. Society of Skeletal Radiology–white paper. Guidelines for the diagnostic management of incidental solitary bone lesions on CT and MRI in adults: bone reporting and data system (Bone-RADS). Skeletal Radiol. 2022;51(9):1743–64.CrossRefPubMedPubMedCentral Chang CY, Garner HW, Ahlawat S, et al. Society of Skeletal Radiology–white paper. Guidelines for the diagnostic management of incidental solitary bone lesions on CT and MRI in adults: bone reporting and data system (Bone-RADS). Skeletal Radiol. 2022;51(9):1743–64.CrossRefPubMedPubMedCentral
17.
go back to reference Board WCoTE. WHO classification of tumours: soft tissue and bone tumours: International Agency for Research on Cancer; 2020. Board WCoTE. WHO classification of tumours: soft tissue and bone tumours: International Agency for Research on Cancer; 2020. 
18.
go back to reference Choi JH, Ro JY. The 2020 WHO classification of tumors of bone: an updated review. Adv Anat Pathol. 2021;28(3):119–38.CrossRefPubMed Choi JH, Ro JY. The 2020 WHO classification of tumors of bone: an updated review. Adv Anat Pathol. 2021;28(3):119–38.CrossRefPubMed
19.
20.
go back to reference Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMed Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMed
21.
go back to reference Chai JW, Hong SH, Choi J-Y. Radiologic diagnosis of osteoid osteoma: from simple to challenging findings. Radiographics. 2010;30(3):737–49.CrossRefPubMed Chai JW, Hong SH, Choi J-Y. Radiologic diagnosis of osteoid osteoma: from simple to challenging findings. Radiographics. 2010;30(3):737–49.CrossRefPubMed
22.
go back to reference Kaim AH, Hügli R, Bonél HM. Chondroblastoma and clear cell chondrosarcoma: radiological and MRI characteristics with histopathological correlation. Skeletal Radiol. 2002;31:88–95.CrossRefPubMed Kaim AH, Hügli R, Bonél HM. Chondroblastoma and clear cell chondrosarcoma: radiological and MRI characteristics with histopathological correlation. Skeletal Radiol. 2002;31:88–95.CrossRefPubMed
23.
24.
go back to reference Rigopoulou A, Saifuddin A. Intraosseous hemangioma of the appendicular skeleton: imaging features of 15 cases, and a review of the literature. Skeletal Radiol. 2012;41:1525–36.CrossRefPubMed Rigopoulou A, Saifuddin A. Intraosseous hemangioma of the appendicular skeleton: imaging features of 15 cases, and a review of the literature. Skeletal Radiol. 2012;41:1525–36.CrossRefPubMed
25.
go back to reference Murphey MD, Walker EA, Wilson AJ. From the archives of the AFIP: imaging of primary chondrosarcoma: radiologic-pathologic correlation. Radiographics. 2003;23(5):1245–78.CrossRefPubMed Murphey MD, Walker EA, Wilson AJ. From the archives of the AFIP: imaging of primary chondrosarcoma: radiologic-pathologic correlation. Radiographics. 2003;23(5):1245–78.CrossRefPubMed
Metadata
Title
Diagnostic performance and inter-reader reliability of bone reporting and data system (Bone-RADS) on computed tomography
Authors
Chankue Park
Arash Azhideh
Atefe Pooyan
Ehsan Alipour
Sara Haseli
Ishan Satwah
Majid Chalian
Publication date
09-06-2024
Publisher
Springer Berlin Heidelberg
Keyword
Osteomyelitis
Published in
Skeletal Radiology
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-024-04721-4