Machine Learning-Driven radiomics on 18 F-FDG PET for glioma diagnosis: a systematic review and meta-analysis.
Authors
Affiliations (15)
Affiliations (15)
- Department of Radiation Oncology, Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
- Qazvin University of Medical Sciences, Qazvin, Iran.
- Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Mazandaran University of Medical Sciences, Sari, Iran.
- Department of medicine, Mashhad university of medical sciences, Mashhad, Iran.
- School of Medicine, Zanjan University of Medical Science, Zanjan, Iran.
- Shiraz University of Medical Sciences, Shiraz, Iran.
- Musculoskeletal Imaging Research Center (MIRC), Tehran University of Medical Sciences, Tehran, Iran.
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehrani, Iran.
- Neurosurgery Department, Kerman University of Medical Sciences, Kerman, Iran. [email protected].
- Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
- Department of Radiology, University of Washington, Seattle, WA, USA.
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehrani, Iran. [email protected].
- College of medicine, university of Arizona, 1501 N Campbell Ave, Tucson, AZ, 85724, USA. [email protected].
Abstract
Machine learning (ML) applied to radiomics has revolutionized neuro-oncological imaging, yet the diagnostic performance of ML models based specifically on ^18F-FDG PET features in glioma remains poorly characterized. To systematically evaluate and quantitatively synthesize the diagnostic accuracy of ML models trained on ^18F-FDG PET radiomics for glioma classification. We conducted a PRISMA-compliant systematic review and meta-analysis registered on OSF ( https://doi.org/10.17605/OSF.IO/XJG6P ). PubMed, Scopus, and Web of Science were searched up to January 2025. Studies were included if they applied ML algorithms to ^18F-FDG PET radiomic features for glioma classification and reported at least one performance metric. Data extraction included demographics, imaging protocols, feature types, ML models, and validation design. Meta-analysis was performed using random-effects models with pooled estimates of accuracy, sensitivity, specificity, AUC, F1 score, and precision. Heterogeneity was explored via meta-regression and Galbraith plots. Twelve studies comprising 2,321 patients were included. Pooled diagnostic metrics were: accuracy 92.6% (95% CI: 91.3-93.9%), AUC 0.95 (95% CI: 0.94-0.95), sensitivity 85.4%, specificity 89.7%, F1 score 0.78, and precision 0.90. Heterogeneity was high across all domains (I² >75%). Meta-regression identified ML model type and validation strategy as partial moderators. Models using CNNs or PET/MRI integration achieved superior performance. ML models based on ^18F-FDG PET radiomics demonstrate strong and balanced diagnostic performance for glioma classification. However, methodological heterogeneity underscores the need for standardized pipelines, external validation, and transparent reporting before clinical integration.