Predicting molecular subtypes of pediatric medulloblastoma using MRI-based artificial intelligence: A systematic review and meta-analysis.

BACKGROUND

This meta-analysis aims to assess the diagnostic performance of artificial intelligence (AI) based on magnetic resonance imaging (MRI) in detecting molecular subtypes of pediatric medulloblastoma (MB) in children.

METHODS

A thorough review of the literature was performed using PubMed, Embase, and Web of Science to locate pertinent studies released prior to October 2024. Selected studies focused on the diagnostic performance of AI based on MRI in detecting molecular subtypes of pediatric MB. A bivariate random-effects model was used to calculate pooled sensitivity and specificity, both with 95% confidence intervals (CI). Study heterogeneity was assessed using I statistics.

RESULTS

Among the 540 studies determined, eight studies (involving 1195 patients) were included. For the wingless (WNT), the combined sensitivity, specificity, and receiver operating characteristic curve (AUC) based on MRI were 0.73 (95% CI: 0.61-0.83, I = 19%), 0.94 (95% CI: 0.79-0.99, I = 93%), and 0.80 (95% CI: 0.77-0.83), respectively. For the sonic hedgehog (SHH), the combined sensitivity, specificity, and AUC were 0.64 (95% CI: 0.51-0.75, I = 69%), 0.84 (95% CI: 0.80-0.88, I = 54%), and 0.85 (95% CI: 0.81-0.88), respectively. For Group 3 (G3), the combined sensitivity, specificity, and AUC were 0.89 (95% CI: 0.52-0.98, I = 82%), 0.70 (95% CI: 0.62-0.77, I = 44%), and 0.88 (95% CI: 0.84-0.90), respectively. For Group 4 (G4), the combined sensitivity, specificity, and AUC were 0.77 (95% CI: 0.64-0.87, I = 54%), 0.91 (95% CI: 0.68-0.98, I = 80%), and 0.86 (95% CI: 0.83-0.89), respectively.

CONCLUSIONS

MRI-based artificial intelligence shows high diagnostic performance in detecting molecular subtypes of pediatric MB. However, all included studies employed retrospective designs, which may introduce potential biases. More researches using external validation datasets are needed to confirm the results and assess their clinical applicability.