Diagnostic Accuracy of Machine Learning-Based Radiomics in Grading Gliomas: Systematic Review and Meta-Analysis

PURPOSE: This study aimed to estimate the diagnostic accuracy of machine learning- (ML-) based radiomics in differentiating high-grade gliomas (HGG) from low-grade gliomas (LGG) and to identify potential covariates that could affect the diagnostic accuracy of ML-based radiomic analysis in classifying gliomas. METHOD: A primary literature search of the PubMed database was conducted to find all related literatures in English between January 1, 2009, and May 1, 2020, with combining synonyms for “machine learning,” “glioma,” and “radiomics.” Five retrospective designed original articles including LGG and HGG subjects were chosen. Pooled sensitivity, specificity, their 95% confidence interval, area under curve (AUC), and hierarchical summary receiver-operating characteristic (HSROC) models were obtained. RESULT: The pooled sensitivity when diagnosing HGG was higher (96% (95% CI: 0.93, 0.98)) than the specificity when diagnosing LGG (90% (95% CI 0.85, 0.93)). Heterogeneity was observed in both sensitivity and specificity. Metaregression confirmed the heterogeneity in sample sizes (p=0.05), imaging sequence types (p=0.02), and data sources (p=0.01), but not for the inclusion of the testing set (p=0.19), feature extraction number (p=0.36), and selection of feature number (p=0.18). The results of subgroup analysis indicate that sample sizes of more than 100 and feature selection numbers less than the total sample size positively affected the diagnostic performance in differentiating HGG from LGG. CONCLUSION: This study demonstrates the excellent diagnostic performance of ML-based radiomics in differentiating HGG from LGG.