To evaluate the diagnostic value of magnetic resonance imaging (MRI) radiomics in distinguishing high-grade meningiomas (HGM) from low-grade meningiomas (LGM). A systematic search was conducted in PubMed, EMbase, Web of Science, and The Cochrane Library databases up to December 31, 2023. Two researchers independently screened studies, extracted data, and assessed risk of bias and quality of included studies as well. Meta-analysis was performed using Stata 14 software to calculate pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC). A total of 21 studies with 2253 patients were included (607 HGM, 1646 LGM). Meta-analysis showed an overall SEN of 0.82 (95% CI 0.74–0.88) and SPE of 0.85 (95% CI 0.81–0.89). The PLR and NLR were 5.64 (95% CI 4.17–7.64) and 0.21 (95% CI 0.14–0.31), respectively, with a pooled DOR of 26.66 (95% CI 14.42–49.27) and an AUC of 0.91 (95% CI 0.88–0.93), indicating high diagnostic accuracy. Although additional research is required to validate suitable techniques, MRI radiomics shows strong potential as an accurate tool for meningioma grading. Standardizing radiomics application could enhance diagnostic precision and clinical decision-making for meningioma grading in the future.
Trial Registration: CRD42024500086.