Abstract
BACKGROUND: Determination of isocitrate dehydrogenase (IDH) status and, if IDH-mutant, assessing 1p19q codeletion are an important component of diagnosis of World Health Organization grades II/III or lower-grade gliomas. This has led to research into noninvasively correlating imaging features (“radiomics”) with genetic status.
PURPOSE: Our aim was to perform a diagnostic test accuracy systematic review for classifying IDH and 1p19q status using MR imaging radiomics, to provide future directions for integration into clinical radiology.
DATA SOURCES: Ovid (MEDLINE), Scopus, and the Web of Science were searched in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Diagnostic Test Accuracy guidelines.
STUDY SELECTION: Fourteen journal articles were selected that included 1655 lower-grade gliomas classified by their IDH and/or 1p19q status from MR imaging radiomic features.
DATA ANALYSIS: For each article, the classification of IDH and/or 1p19q status using MR imaging radiomics was evaluated using the area under curve or descriptive statistics. Quality assessment was performed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool and the radiomics quality score.
DATA SYNTHESIS: The best classifier of IDH status was with conventional radiomics in combination with convolutional neural network–derived features (area under the curve = 0.95, 94.4% sensitivity, 86.7% specificity). Optimal classification of 1p19q status occurred with texture-based radiomics (area under the curve = 0.96, 90% sensitivity, 89% specificity).
LIMITATIONS: A meta-analysis showed high heterogeneity due to the uniqueness of radiomic pipelines.
CONCLUSIONS: Radiogenomics is a potential alternative to standard invasive biopsy techniques for determination of IDH and 1p19q status in lower-grade gliomas but requires translational research for clinical uptake.
ABBREVIATIONS:
- AI
- artificial intelligence
- AUC
- area under the curve
- CNN
- convolutional neural network
- IDH
- isocitrate dehydrogenase
- IDH-mut
- IDH-mutant
- LGG
- lower-grade gliomas
- ML
- machine learning
- PRISMA-DTA
- Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Diagnostic Test Accuracy
- QUADAS-2
- Quality Assessment of Diagnostic Accuracy Studies 2
- RQS
- radiomics quality score
- SVM
- support vector machine
- VASARI
- Visually Accessible Rembrandt Images
- WHO
- World Health Organization
- © 2021 by American Journal of Neuroradiology
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