Noninvasive Determination of and 1p19q Status of Lower-grade Gliomas Using MRI Radiomics: A Systematic Review.

Background: Determination of () status and, if -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 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 and/or 1p19q status from MR imaging radiomic features.

Data Analysis: For each article, the classification of 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 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 and 1p19q status in lower-grade gliomas but requires translational research for clinical uptake.