Role of Radiomics to Predict Malignant Transformation of Sinonasal Inverted Papilloma: A Systematic Review

Sinonasal inverted papilloma is a benign but aggressive tumour of the sinonasal tract. It has the potential for malignant transformation into sinonasal squamous cell carcinoma. Radiomics, which involves the extraction and analysis of quantitative imaging features, has emerged as a promising tool in prediction of tumour behaviour. This systematic review aims to critically evaluate the current literature on the application of radiomics in predicting the malignant transformation of sinonasal inverted papilloma.

A comprehensive literature search was conducted across Medline (via PubMed), EMBASE, and Web of Science. Studies investigating the use of radiomics to predict malignant transformation in sinonasal inverted papilloma were selected based on predefined inclusion criteria. Methodological quality and risk of bias were assessed using the QUADAS-2 tool and the Radiomics Quality Score (RQS).

Five studies were included, encompassing 837 participants. All studies were retrospective and utilised MRI-based radiomics in the construction of their models. The radiomic models demonstrated satisfactory predictive performance. The median AUCs across the included studies were 0.954 (range: 0.901-0.987) in the training set and 0.914 (range: 0.8-0.989) in the validation set.

This systematic review highlights the potential of radiomics as a predictive tool for the malignant transformation of sinonasal inverted papilloma. Radiomics shows promise as a non-invasive adjunct for clinical decision-making. However, further research is needed to standardise methodologies and validate these findings in larger multicentre cohorts.