A New Classification and Stratification System for Solitary Bone Tumor: Osseous Tumor Radiological and Interpretation and Management System

Motivation: Accurate diagnosis of bone tumors is challenging due to histological diversity and imaging heterogeneity, requiring collaboration among pathologists, radiologists, and multidisciplinary teams. Goal(s): To propose OT-RIMS, a system that categorizes bone tumors by severity and informs patient management. Approach: A retrospective study (2015-2022) of 341 patients with solitary bone tumors, using radiographs, CT, and MRI. Three radiologists assessed images independently, categorized lesions with OT-RIMS, and reached consensus. Results: OT-RIMS showed high sensitivity (92.2-96.1%) and specificity (89.5-93.3%) for malignant tumors, with excellent inter-reader agreement (Kendall's W=0.924). OT-RIMS provides reproducible, standardized tumor risk stratification and management guidance. Impact: OT-RIMS provides a standardized, reproducible framework for bone tumor risk stratification, improving diagnostic accuracy and management. This system reduces variability, enhances clinical decision-making, and opens new research avenues for integrating imaging with molecular data in tumor classification.