CT-based radiomics for predicting stone-free rate after ESWL: a systematic review and meta-analysis.

purposeTo evaluate the prognostic significance of computed tomography (CT)-based radiomic features of urinary stones in predicting stone-free rate (SFR) after extracorporeal shockwave lithotripsy (ESWL) and laser lithotripsy.

methodsA systematic literature search of several databases using Boolean operators was performed according to PRISMA guideline and registered in PROSPERO (CRD420250650566). Studies using CT-based radiomics to predict SFR after ESWL or laser lithotripsy and reporting area under the receiver operating characteristic curve (AUC) with 95% confidence intervals (CI) were included. CLAIM and PROBAST checklists were used to assess transparency and and and risk of bias, respectively. A random-effects meta-analysis was performed to pool AUC estimates and assess heterogeneity.

resultsSeven studies were selected and analyzed, of which five described radiomic prediction for ESWL and were analyzed in the meta-analysis. The pooled AUC for radiomics-based models predicting SFR after ESWL was 0.883 (95% CI: 0.840-0.927), with low heterogeneity (I

conclusionAdding CT-based radiomic features of stones to other clinical and radiologic parameters can predict SFR after ESWL with an AUC of > 0.85. However, the results are based on a small number of studies mostly with a high risk of bias, so follow-up studies performed according to the tenets of using radiomic analysis are needed.