Accuracy of Radiomics in Predicting IDH Mutation Status in Diffuse Gliomas: A Bivariate Meta-Analysis

Purpose: To perform a systematic review and meta-analysis assessing the predictive accuracy of radiomics in the noninvasive determination of isocitrate dehydrogenase (IDH) status in grade-4 and lower-grade diffuse gliomas. Materials and Methods: A systematic search was performed in the PubMed, Scopus, Embase, Web of Science and Cochrane library databases for relevant articles published between January 1, 2010 and July 7, 2021. Pooled sensitivity and specificity across studies was estimated. Risk of bias was evaluated using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2), and methodology was evaluated using the radiomics quality score (RQS). Additional subgroup analyses were performed according to tumor grade, RQS, and number of sequences used (PROSPERO ID: CRD42021268958). Results: Twenty-six studies that included a total of 3,280 patients were included for analysis. The pooled sensitivity and specificity of radiomics for the detection of IDH mutation were 79% (95%CI: 76%–83%) and 80% (95%CI: 76%–83%), respectively. Low RQS scores were found overall for the included works. Subgroup analyses showed lower false positive rates in very low RQS studies (RQS < 6) (meta-regression z = −1.9, P = .02) compared with adequate RQS studies. No substantial differences were found in pooled sensitivity/specificity for the pure grade-4 gliomas group compared with the all-grade gliomas group (81%/86% versus 79%/79% respectively) and for studies using single versus multiple sequences (80%/77% versus 79%/82% respectively). Conclusion: The pooled data showed that radiomics achieved good accuracy performance in distinguishing IDH mutation status in patients with grade-4 and lower-grade diffuse gliomas. Overall methodological quality (RQS) is low and introduces potential bias.