{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:17:07Z","timestamp":1788308227500,"version":"build-2803163510"},"reference-count":47,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Spinal meningiomas (SMs) are common primary spinal tumors for which surgery is considered the first-line treatment when safe and feasible. The ability to extrapolate the tumor grade from preoperative imaging may significantly inform early patient expectation-setting regarding recurrence. Building on radiomics studies in cranial meningiomas, the authors aimed to construct a benchmark radiomics model to preoperatively identify the histological grade of SMs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Institutional surgical records from May 2012 to November 2025 were queried for pathology-confirmed meningiomas below the foramen magnum, with preoperative contrast-enhanced imaging available for segmentation. SMs were classified as low-grade (WHO grade 1) and high-grade (WHO grade 2 tumors and grade 1 tumors with atypia). Tumors were manually segmented, and features were extracted using the PyRadiomics software package. An ensemble model of k-nearest neighbors, random forest, and support vector machine classifiers was trained using nested cross-validation on a subset of 10 features to differentiate tumor grades. Clinical data for the cohort were also extracted, and disease control in an adjunctive clinical series was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Seventy-four patients were included in radiomics analysis, with an area under the receiver operating characteristic curve of 0.879 and a mean F1 score of 0.748. The model\u2019s top 5 features were all texture features that differed significantly (p &lt; 0.05) across low- and high-grade SMs. These included measures of tumor textural and contrast-enhancement heterogeneity, with overlap with features reported in radiomics models for histological grading of intracranial meningiomas. Fifty-five patients with a median radiographic follow-up of 22.2 (range 1.9\u201386.4) months remained for clinical analysis after exclusion of patients with less than 1 month of follow-up and syndromic meningiomas. Four recurrences occurred at a median of 20.8 (range 1.8\u201341.8) months. High-grade tumor pathology did not significantly impact progression-free survival (p = 0.682, log-rank test; Cox regression high vs low grade hazard ratio [HR] 0.62, 95% CI 0.06\u20136.11, p = 0.685). Subtotal resection was associated with poorer progression-free survival than gross-total resection (p = 0.004, log-rank test; Cox regression subtotal vs gross-total resection HR 10.62, 95% CI 1.46\u201377.05, p = 0.019). These findings remain contextualized within a relatively limited follow-up window and small recurrence event count, suggesting a need to characterize the interplay between tumor grade and extent of resection as drivers of local disease control in SMs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>A preoperative radiomics model can stratify high-grade SMs using open-source tools applied to single-institution data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.6.focus2635","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:01:16Z","timestamp":1787702476000},"page":"E8","source":"Crossref","is-referenced-by-count":0,"title":["Spinal meningiomas: histopathological grading using a benchmark radiomics model with notes on disease control"],"prefix":"10.3171","volume":"61","author":[{"given":"Adhith","family":"Palla","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, NYU Langone Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas K.","family":"Goff","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NYU Langone Health, New York, New York;"},{"name":"Department of Neurological Surgery, University of Texas at Austin Dell Medical School, Austin, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blake","family":"Perdikis","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NYU Langone Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hammad A.","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NYU Langone Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarra","family":"Belakhoua","sequence":"additional","affiliation":[{"name":"Department of Neuropathology, NYU Langone Health, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A.","family":"Grin","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NYU Langone Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aly","family":"Valliani","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NYU Langone Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshni","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, NYU Langone Health, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan T.","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, NYU Langone Health, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Ricardo","family":"McFaline-Figueroa","sequence":"additional","affiliation":[{"name":"Department of Neuro-Oncology, Perlmutter Cancer Center at NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darryl","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NYU Langone Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Frempong-Boadu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NYU Langone Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric K.","family":"Oermann","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NYU Langone Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilya","family":"Laufer","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, NYU Langone Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"J Neurooncol","first-page":"173","article-title":"Descriptive epidemiology of primary spinal cord tumors","volume":"87","author":"Schellinger KA","year":"2008","unstructured":"Schellinger KA, Propp JM, Villano JL, McCarthy BJ. 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