Radiomics Analysis of Intracranial Aneurysms: A Systematic Review and Meta-Analysis of Radiomics Quality Score and Clinical Applications

• Radiomics models demonstrate good performance (pooled AUC 0.86) for predicting intracranial aneurysm rupture risk. • The overall quality of radiomics studies on intracranial aneurysms is moderate, with a median Radiomics Quality Score (RQS) of 10. • External validation and higher RQS are associated with improved model performance, highlighting the need for rigorous methodology. • Current radiomics studies on intracranial aneurysms face challenges including small sample sizes, lack of standardization, and limited clinical integration.