Frumer M, Konen O, Rootman MS, et al. - This study was undertaken to investigate the associations of the modified Bosniak categories assigned by radiologists to histological results and inter-rater reliability, focusing on intermediate-risk lesions. Researchers retrospectively obtained data of pediatric patients who had undergone surgery for intermediate-risk complex renal cyst at a tertiary medical center in 2006-2019. Seven children, each with 1 complex cyst that was rated as intermediate-risk on the pathological study was included in the cohort. A disconcerting underestimation of intermediate-risk was caused by the implementation of the modified Bosniak classification in children. A low inter-rater consistency for the categories intended to guide decisions regarding surgery or conservative management was observed. The data imply that clinicians should be cautious iapplying the modified Bosniak system for children.