Evaluation of the Bone Reporting and Data System (Bone-RADS) on computed tomography in children with solitary bone lesions
Pediatric Radiology, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Publication Date: 2026
- Doi Number: 10.1007/s00247-026-06681-4
- Journal Name: Pediatric Radiology
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Aerospace Database, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Technology Collection (ProQuest)
- Keywords: Bone tumors, Bone-RADS, Children, Computed tomography
- Open Archive Collection: AVESIS Open Access Collection
- Bursa Uludag University Affiliated: Yes
Abstract
Background: The Bone Reporting and Data System (Bone-RADS) has been developed to facilitate and provide a common language for the management of bone tumors in adults. No bone reporting system has been developed to evaluate solitary bone lesions in children. Objective: This study aims to evaluate the interrater agreement and diagnostic performance of Bone-RADS in children with solitary bone lesions on computed tomography (CT). Materials and methods: From January 2014 to January 2026, patients <18 years old with bone lesions and a CT available in our picture archiving and communication system (PACS) were identified for eligibility. Five raters evaluated the CT images after a senior radiologist’s informative lecture on Bone-RADS. The final diagnosis, accepted as the reference standard, was determined by a multidisciplinary team based on biopsy or at least 2 years of follow-up. Interrater agreement was assessed. A binary Bone-RADS categorization was also used for diagnostic performance evaluation. Results: Seventy-four patients (22 females) with a mean age of 12.5±3.4 (range, 3-17) years old were enrolled in the study. The interrater agreement among all raters was almost perfect for both Bone-RADS and the binary Bone-RADS classification (P<0.001). Except for one non-advanced rater, all individual agreements with the reference standard were substantial in Bone-RADS (P<0.001). Binary Bone-RADS classification showed high accuracy, ranging from 81.1% to 90.5% across all raters. Conclusion: Bone-RADS on CT showed high interrater agreement and diagnostic performance in children with solitary bone lesions. Bone-RADS on CT may be used in children to manage solitary bone lesions.