• Bardia Hajikarimloo, Salem M Tos, AlvaniMohammadamin SabbaghMSStudent Research Committee Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Mohammad Ali Rafiei, Diba Akbarzadeh, Mohammad ShahirEftekhar, Mohammadhosein Akhlaghpasand, and Mohammad Amin Habibi.
• Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA.
• World Neurosurg. 2024 Oct 29.

BackgroundThe Ki-67 index is a histopathological marker that has been reported to be a crucial factor in the biological behavior and prognosis of meningiomas. Several studies have developed artificial intelligence (AI) models to predict the Ki-67 based on radiomics. In this study, we aimed to perform a systematic review and meta-analysis of AI models that predicted the Ki-67 index in meningioma.MethodsLiterature records were retrieved on April 27th, 2024, using the relevant key terms without filters in PubMed, Embase, Scopus, and Web of Science. Records were screened according to the eligibility criteria, and the data from included studies were extracted. The quality assessment was performed using the QUADAS-2 tool. The meta-analysis, sensitivity analysis, and meta-regression were conducted using R software.ResultsOur study included six studies. The mean Ki-67 ranged from 2.7 ± 2.97 to 4.8 ± 40.3. Of six studies, five utilized an ML method. The most used AI method was the least absolute shrinkage and selection operator (LASSO). The AUC and ACC ranged from 0.83 to 0.99 and 0.81 to 0.95, respectively. AI models demonstrated a pooled sensitivity of 87.5% (95% CI: 75.2%, 94.2%), a specificity of 86.9% (95% CI: 75.8%, 93.4%), and a diagnostic odds ratio (DOR) of 40.02 (95% CI: 13.5, 156.4). The summary receiver operating characteristic SROC curve indicated an AUC of 0.931 for the prediction of Ki-67 index status in intracranial meningiomas.ConclusionAI models have demonstrated promising performance for predicting the Ki-67 index in meningiomas and can optimize the treatment strategy.Copyright © 2024 Elsevier Inc. All rights reserved.

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