Brain metastases (BMs) are the most prevalent intracranial malignancies. Brain metastases from lung cancer (LC) are particularly common in clinical practice and are strongly associated with poor prognosis and high mortality. Consequently, the precise diagnosis and treatment of BMs are crucial for improving clinical outcomes. Diagnosis primarily relies on radiological data and clinical history. Magnetic resonance imaging (MRI) is widely regarded as the primary imaging technique for diagnosing BMs and assessing prognosis due to its exceptional sensitivity and specificity. Radiomics, a field increasingly empowered by artificial intelligence (AI), is used to assist healthcare professionals in conducting in-depth analyses of medical images, thereby enhancing diagnostic accuracy and personalizing treatment. It utilizes high-throughput feature extraction techniques to derive numerous quantitative imaging characteristics from medical images, which exhibit strong correlations with tumor biology and clinical outcomes. Recent research has demonstrated that MRI-based radiomics applications show great potential at improving the accuracy and efficiency of clinicians in BMs diagnosis, classification, treatment, and prognosis prediction. Radiomics methods can precisely characterize the internal structure and heterogeneity of tumors, thereby providing clinicians with comprehensive decision-support information.The review comprehensively summarizes the latest applications of MRI-based radiomics in BMs, focusing on data segmentation processing and model establishment in order to provide insights into current research in this emerging field. For LC BMs, integrating multi-center, high-quality standardized data with deep learning algorithms and MRI radiomics is crucial for clinical application.
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