A radiomics model for preoperative prediction of brain invasion in meningioma non-invasively based on MRI: A multicentre study

Background: Prediction of brain invasion pre-operatively rather than postoperatively would contribute to the selection of surgical techniques, predicting meningioma grading and prognosis. Here, we aimed to predict the risk of brain invasion in meningioma pre-operatively using a nomogram by incorporating radiomic and clinical features. Methods: In this case-control study, 1728 patients from Beijing Tiantan Hospital (training cohort: n = 1070) and Lanzhou University Second Hospital (external validation cohort: n = 658) were diagnosed with meningiomas by histopathology. Radiomic features were extracted from the T1-weighted post-contrast and T2-weighted magnetic resonance imaging. The least absolute shrinkage and selection operator was used to select the most informative features of different modalities. The support vector machine algorithm was used to predict the risk of brain invasion. Furthermore, a nomogram was constructed by incorporating radiomics signature and clinical risk factors, and decision curve analysis was used to validate the clinical usefulness of the nomogram. Findings: Sixteen features were significantly correlated with brain invasion. The clinicoradiomic model derived from the fusing MRI sequences and sex resulted in the best discrimination ability for risk prediction of brain invasion, with areas under the curves (AUCs) of 0.857 (95% CI, 0.831-0.887) and 0.819 (95% CI, 0.775-0.863) and sensitivities of 72.8% and 90.1% in the training and validation cohorts, respectively. Interpretation: Our clinicoradiomic model showed good performance and high sensitivity for risk prediction of brain invasion in meningioma, and can be applied in patients with meningiomas. (c) 2020 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license. (http://creativecommons.org/licenses/by-nc-nd/4.0/)