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Abstract
Background:
Bone tumors are a heterogeneous group of lesions with a wide range of biological behavior, from benign to highly aggressive malignant tumors. It is important to differentiate these tumors for appropriate management and prognosis. Magnetic resonance imaging (MRI) is useful in differentiating these tumors because of its high soft tissue resolution, as well as its ability to evaluate marrow and soft tissue involvement; however, diagnostic overlap occurs in these tumors.
Objective:
To determine the diagnostic accuracy of magnetic resonance imaging in differentiating benign from malignant bone tumors, using histopathology as the gold standard.
Methods:
This study was a cross-sectional diagnostic accuracy study conducted in the Department of Radiology, Mardan Medical Complex, Pakistan, from Nov 2024 to April 2025. A total of 136 patients with suspected bone tumors were included in the study. MRI was used as the index test, and histopathological examination was used as the reference standard for diagnosis. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were used as performance measures for diagnosis.
Results:
MRI demonstrated a sensitivity of 91.36% and specificity of 87.27% in differentiating malignant from benign bone tumors, with an overall diagnostic accuracy of 89.70%. Malignant lesions were more frequently associated with larger size, ill-defined margins, cortical destruction, periosteal reaction, and soft tissue involvement, whereas benign lesions typically exhibited well-defined margins and less aggressive imaging features.
Conclusion:
MRI is a reliable and effective diagnostic tool for the differentiation of benign and malignant bone tumors, and it plays a vital role in the early diagnosis and treatment of these conditions, although histopathological examination of the tumor tissue is necessary for the definitive diagnosis of the tumor