Radiomics on sagittal T2 MRI distinguishes ependymomas but not pilocytic astrocytomas in children with spinal cord tumors

Radiomics on sagittal T2 MRI differentiated pediatric ependymomas from other intramedullary spinal tumors in forty patients: balanced accuracy 0.834 (95% CI 0.723-0.955), AUC 0.838, sensitivity 0.909, specificity 0.759. Pilocytic astrocytomas could not be differentiated.

• Random forest with LASSO selected an average of four radiomic features from sagittal T2-weighted images and achieved balanced accuracy 0.834, AUC 0.838, sensitivity 0.909, specificity 0.759, PPV 0.588, NPV 0.957, MCC 0.603 for ependymoma classification.
• Radiomic features for pilocytic astrocytomas showed inadequate effect size (Cohen's d 0.356), and ML models performed suboptimally, so no differentiation was possible.

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