Meningiomas are the most common extra-axial tumors of the central nervous system (CNS). Even though recurrence is uncommon after surgery and most meningiomas are benign, an aggressive behavior may still be exhibited in some cases. Although the diagnosis can be made by radiologists, typically with magnetic resonance imaging, qualitative analysis has some limitations in regard to outcome prediction and risk stratification. The acquisition of this information could help the referring clinician in the decision-making process and selection of the appropriate treatment. Following the increased attention and potential of radiomics and artificial intelligence in the healthcare domain, including oncological imaging, researchers have investigated their use over the years to overcome the current limitations of imaging. The aim of these new tools is the replacement of subjective and, therefore, potentially variable medical image analysis by more objective quantitative data, using computational algorithms. Although radiomics has not yet fully entered clinical practice, its potential for the detection, diagnostic, and prognostic characterization of tumors is evident. In this review, we present a wide-ranging overview of radiomics and artificial intelligence applications in meningioma imaging.
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