AUTHOR=Noori Mirtaheri Parsia , Akhbari Matin , Najafi Farnaz , Mehrabi Hoda , Babapour Ali , Rahimian Zahra , Rigi Amirhossein , Rahbarbaghbani Saeid , Mobaraki Hesam , Masoumi Sanaz , Nouri Danial , Mirzohreh Seyedeh-Tarlan , Sadat Rafiei Seyyed Kiarash , Asadi Anar Mahsa , Golkar Zahra , Asadollah Salmanpour Yasaman , Vesali Mahmoud Ali , Gholami Chahkand Mohammad Sadra , Khodaei Maryam 

TITLE=Performance of deep learning models for automatic histopathological grading of meningiomas: a systematic review and meta-analysis

JOURNAL=Frontiers in Neurology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1536751

DOI=10.3389/fneur.2025.1536751

ISSN=1664-2295

ABSTRACT=BackgroundAccurate preoperative grading of meningiomas is crucial for selecting the most suitable treatment strategies and predicting patient outcomes. Traditional MRI-based assessments are often insufficient to distinguish between low- and high-grade meningiomas reliably. Deep learning (DL) models have emerged as promising tools for automated histopathological grading using imaging data. This systematic review and meta-analysis aimed to comprehensively evaluate the diagnostic performance of deep learning (DL) models for meningioma grading.MethodsThis study was conducted in accordance with the PRISMA-DTA guidelines and was prospectively registered on the Open Science Framework. A systematic search of PubMed, Scopus, and Web of Science was performed up to March 2025. Studies using DL models to classify meningiomas based on imaging data were included. A random-effects meta-analysis was used to pool sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC). A bivariate random-effects model was used to fit the summary receiver operating characteristic (SROC) curve. Study quality was assessed using the Newcastle-Ottawa Scale, and publication bias was evaluated using Egger's test.ResultsTwenty-seven studies involving 13,130 patients were included. The pooled sensitivity was 92.31% (95% CI: 92.1–92.52%), specificity 95.3% (95% CI: 95.11–95.48%), and accuracy 97.97% (95% CI: 97.35–97.98%), with an AUC of 0.97 (95% CI: 0.96–0.98). The bivariate SROC curve demonstrated excellent diagnostic performance, characterized by a relatively narrow 95% confidence interval despite moderate to high heterogeneity (I2 = 79.7%, p < 0.001).ConclusionDL models demonstrate high diagnostic accuracy for automatic meningioma grading and could serve as valuable clinical decision-support tools.Systematic review registrationDOI: 10.17605/OSF.IO/RXEBM