Predictive value of radiomics for intracranial aneurysm rupture: a systematic review and meta-analysis

To systematically review the literature on radiomics for predicting intracranial aneurysm rupture and conduct a meta-analysis to obtain evidence confirming the value of radiomics in this prediction. A systematic literature search was conducted in PubMed, Web of Science, Embase, and The Cochrane Library databases up to March 2024. The QUADAS-2 tool was used to assess study quality. Stata 15.0 and Review Manager 5.4.1 were used for statistical analysis. Outcomes included combined sensitivity (Sen), specificity (Spe), positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR), and their 95% confidence intervals (CI), as well as pre-test and post-test probabilities. The SROC curve was plotted, and the area under the curve (AUC) was calculated. Publication bias and small-study effects were assessed using the Deeks' funnel plot. The 9 included studies reported 4,284 patients, with 1,411 patients with intracranial aneurysm rupture (prevalence 32.9%). The overall performance of radiomics for predicting intracranial aneurysm rupture showed a combined Sen of 0.78 (95% CI: 0.74-0.82), Spe of 0.74 (95% CI: 0.70-0.78), +LR of 3.0 (95% CI: 2.7-3.4), -LR of 0.29 (95% CI: 0.25-0.35), DOR of 10 (95% CI: 9-12), and AUC of 0.83 (95% CI: 0.79-0.86). Significant heterogeneity was observed in both Sen (I = 90.93, 95% CI: 89.00-92.87%) and Spe (I = 94.28, 95% CI: 93.21-95.34%). Radiomics can improve the diagnostic efficacy of intracranial aneurysm rupture. More large-sample, prospective, multicenter clinical studies are needed to further evaluate its predictive value. https://www.crd.york.ac.uk/PROSPERO/.