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Validity of Magnetic Resonance Imaging in the evaluation of bone tumours using surgical and pathological findings as reference standard Authors Dr Safi Salim, Dr Suma Job, Dr Josey Verghese, Dr Harikumaran Nair GS Department of Radiodiagnosis, Government T.D. Medical College, Alappuzha, Kerala, India Corresponding Author Dr Suma Job Email: sumajob@yahoo.com Abstract Introduction: Conventional teaching identifies that the ultimate responsibility for definitive diagnosis of bone tumour resides with the pathologist. But the radiologist has the added advantage of viewing the lesion in a bigger canvas using the different imaging modalities. Despite newer imaging techniques, radiograph is the preliminary and single most important imaging investigation. MR imaging helps to confirm the diagnosis, determine the focal extent and local staging of the tumour for its effective treatment and follow up. However false positive diagnosis may lead to over staging of tumour and result in unnecessarily radical surgical procedures. This study is meant to assess the sensitivity, specificity, positive predictive value and negative predictive value of MRI findings in bone tumours using surgical and pathological findings as reference standard. Methodology: The study was a descriptive study with diagnostic test evaluation. The study population included all patients clinically suspected of bone tumour referred for MRI evaluation from orthopaedics department to Department of Radiodiagnosis, Govt. T.D. Medical College, Alappuzha. MRI findings were evaluated to look for marrow, soft tissue, joint, neurovascular bundle, and cortical involvement. The obtained data from MRI findings were compared with surgical and pathological findings by statistical analysis. Results: MRI shows high sensitivity of 100% in detection of marrow, soft tissue, joint and neurovascular bundle involvement and 97.4% in the detection of cortical involvement and specificity of 87.5%, 70.6%, 95%, 98.2% and 100% respectively in detection of marrow, soft tissue, joint, neurovascular bundle and cortical involvement; in comparison with surgical and pathological findings. Conclusion: MR imaging is highly sensitive and specific in assessing the extent of involvement of bone tumour and thus aids in its treatment.