Radiology, Nuclear Medicine and imaging, Pediatrics, Perinatology and Child Health, Medicine, Obstetrics and Gynecology
17
Scopus Publications
Scopus Publications
Feasibility of T2-Weighted MRI Radiomics for Initial Risk Stratification in Pediatric Neuroblastoma Annalisa Tondo, Irene Ferri, Mattia Biavati, Federica Carra, Irene Trambusti, et al. Children, 2026 Purpose: The purpose of this study was to evaluate the feasibility of magnetic resonance imaging (MRI)-based radiomics derived from routine T2-weighted imaging for initial risk stratification in pediatric neuroblastoma (NB) and to explore its potential role as a noninvasive adjunct to established clinical and molecular classification systems. Methods: In this retrospective, single-center pilot study, 45 children with newly diagnosed NB (2015–2024) were analyzed. Primary tumors were manually segmented on baseline axial T2-weighted MRI. A total of 107 Image Biomarker Standardization Initiative (IBSI)-compliant radiomic features were extracted. Supervised machine learning classifiers (Random Forest, XGBoost) and dimensionality reduction approaches (principal component analysis [PCA], linear discriminant analysis [LDA]) combined with K-means clustering were evaluated. Model performance was assessed using stratified cross-validation and an independent test set. Reporting adhered to the Checklist for Evaluation of Radiomics Research (CLEAR). Results: Fifteen patients (33%) were classified as high-risk (HR) and 30 (67%) as non-high-risk (NHR) according to International Neuroblastoma Risk Group (INRG) criteria. The highest classification performance was achieved using LDA followed by K-means clustering, with a test accuracy of 77.8%, sensitivity of 64.7%, and specificity of 85.7%. Radiomic classification agreed with conventional risk stratification in 77.8% of cases. The analysis relied exclusively on T2-weighted imaging, supporting workflow feasibility without requiring contrast administration or advanced MRI sequences. Conclusions: In this single-center pilot study, T2-weighted MRI radiomics demonstrated feasibility for noninvasive initial risk stratification in pediatric NB. Although limited by sample size and the lack of external validation, these findings support further multicenter investigations of radiomics as an adjunctive imaging biomarker during early diagnostic evaluation.
Role of foetal MRI in the evaluation of ischaemic-haemorrhagic lesions of the foetal brain Lucia Manganaro, Silvia Bernardo, Laura La Barbera, Giuseppe Noia, Lucia Masini, et al. Journal of Perinatal Medicine, 2012 Objective: The purpose of this study is to define the role of foetal magnetic resonance imaging (MRI) in evaluating cerebral ischaemic-haemorrhagic lesions and the extension of parenchymal injuries. Study design: From September 2006 to September 2010, 271 foetal MRI have been performed on cases referred to us for ultrasound suspect of brain abnormalities or cytomegalovirus infection and Toxoplasma serum conversion. Foetal MRI was performed with a 1.5-T magnet system without mother sedation. Results: Foetal MRI detected ischaemic-haemorrhagic lesions in 14 of 271 foetuses, consisting of 5% incidence. MRI confirmed the diagnosis in three of 14 cases with ultrasonography (US) suspect of ischaemic-haemorrhagic lesions associated with ventriculomegaly. In one of 14 cases with US findings of cerebellar haemorrhage, MRI confirmed the diagnosis and provided additional information regarding the parenchymal ischaemic injury. In eight of 14 cases with US suspect of ventriculomegaly (3), corpus callosum agenesis (2), hypoplasia of cerebellar vermis (1), holoprosencephaly (1) and spina bifida (1), MRI detected ischaemic and haemorrhagic lesions unidentified at US examination. In two of 14 foetuses with US suspect of intracerebral space-occupying lesion, MRI modified the diagnosis to extra-axial haematoma associated with dural sinus malformation. Results were compared with post-mortem findings or afterbirth imaging follow-up. Conclusions: Foetal MRI is an additional imaging modality in the diagnosis of cerebral ischemic-haemorrhagic lesions, and it is useful in providing further information on the extension of the parenchymal injury and associated abnormalities, thus improving delivery management.
