An MRI-based deep transfer learning radiomics nomogram for predicting meningioma grade.

The aim of this study was to establish a nomogram based on clinical, radiomics, and deep transfer learning (DTL) features to predict meningioma grade. Three hundred forty meningiomas from one hospital composed the training set, and 102 meningiomas from another hospital composed the test set. The enhanced T1 WI images were used for analysis. The clinical, radiomics and DTL features were selected to construct the model. Radiomics and DTL scores were calculated. The deep transfer learning radiomics (DTLR) nomogram was developed on the basis of selected clinical features, radiomics scores and DTL scores. Receiver operating characteristic (ROC) curves and decision curve analysis (DCA) curves were drawn. The clinical features of sex, shape, indistinct margin and peritumoral edema were selected and used to construct the clinical model. Thirty-two radiomics features and 28 DTL features were selected for model construction. The clinical model had an AUC of 0.788. (95% CI: 0.6996-0.8756), with an accuracy of 0.745, a sensitivity of 0.941, and a specificity of 0.549 in the test set. The DTLR nomogram had the highest AUC of 0.866 (95% CI: 0.7984-0.9340), with an accuracy of 0.804, a sensitivity of 0.745, and a specificity of 0.863 in the test set. Compared with the other models, the DTLR nomogram had the greatest net benefit according to the DCA. There was a significant difference between the DTLR nomogram and the clinical model, no significant difference between the rest models in DeLong test.The DTLR nomogram has superior predictive value in DCA and could be a valuable method in clinical decision-making. Given the results of DeLong test, only the radiomics model is sufficient and there is no need to add DTL features. As a new attempt, the DTLR nomogram needs to be improved in the future study.