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The early identification of aggressive phenotypes is hence essential to improving outcomes. Here, we investigated the potential of shape-based radiomics features and surface regularity (SR) as non-invasive biomarkers of atypical (grade\u00a02) and anaplastic (grade\u00a03) meningiomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective single-center study, we assessed individuals with treatment-naive meningiomas in a\u00a0comprehensive analysis of MR imaging with histopathological grading and quantification of mitotic activity. Radiomics (sphericity, elongation, flatness) and SR measures were calculated on segmented contrast-enhancing tumor components and tested for association with WHO grade (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u200962 grade\u00a01,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u200971 grade\u00a02, and\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u200919 grade\u00a03) and proliferation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All tumor grades were significantly different in characteristics of sphericity and SR with decreasing values at higher tumor grades as an expression of a\u00a0more irregular shape. Additionally, radiomics features of tumor elongation and flatness discriminated grade\u00a03\u00a0cases from grade\u00a01 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.0008 and\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.0003) and grade\u00a02 meningiomas (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.0008 and\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.0013). Mitotic activity exhibited a\u00a0significant negative correlation with the four imaging markers assessed (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Shape-based radiomics features of sphericity and SR can serve as preoperative grading biomarkers of meningiomas in routine contrast-enhanced T1w MRI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00062-025-01560-1","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T12:15:46Z","timestamp":1758111346000},"page":"169-176","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Non-invasive Prediction of Meningioma Tumor Grade by Quantification of Shape-based Radiomics Features and Surface Regularity"],"prefix":"10.1007","volume":"36","author":[{"given":"Martin","family":"Diebold","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo","family":"Demerath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Reisert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Erny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Braun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till-Karsten","family":"Hauser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Grauvogel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Hohenhaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Urbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Rau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2507-9160","authenticated-orcid":false,"given":"Urs","family":"W\u00fcrtemberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"1560_CR1","doi-asserted-by":"publisher","first-page":"iv1","DOI":"10.1093\/neuonc\/noaa200","volume":"22","author":"QT Ostrom","year":"2020","unstructured":"Ostrom\u00a0QT, Patil\u00a0N, Cioffi\u00a0G, et\u00a0al. 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