Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
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NeuroImage
Editorial for the Special Issue on Harmonization Techniques for MRI
This editorial introduces the special issue on neuroimaging harmonization and situates its contributions within the broader methodological landscape of multi-site MRI analysis. As large-scale neuroimaging studies continue to aggregate data across scanners, protocols, and institutions, harmonization has become essential for reducing non-biological variability while preserving meaningful biological signals. We review the major classes of harmonization approaches, including statistical methods based on the ComBat family and deep learning methods that operate at the voxel level. We also review domain generalization strategies designed for previously unseen sites, and network-aware harmonization techniques that go beyond the voxel for connectivity and connectome data. Across these developments, several cross-cutting challenges emerge, including modality-specific performance, preservation of biological information, validation using traveling-subjects and large observational datasets, and the need for scalable, standardized, and privacy-preserving frameworks. Collectively, the articles in this special issue illustrate the rapid progress of the field and highlight that robust harmonization will be critical for enabling reproducible and generalizable discoveries in multi-site neuroimaging.
15 July 2026
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AI for prognosis and treatment stratification in glioblastoma neurosurgery: a systematic review.
BACKGROUND: Glioblastoma (GBM) remains one of the most lethal adult primary brain tumors, and neurosurgical decision-making increasingly depends on integrating imaging, molecular, perioperative, and post-treatment data. Artificial intelligence (AI) methods have been proposed for several clinically relevant GBM tasks, but the literature remains heterogeneous and difficult to translate into practice. METHODS: We performed a PROSPERO-registered systematic review of AI, machine learning, and deep learning studies using MRI-derived and/or multimodal perioperative data in GBM for prognosis, risk stratification, treatment-response assessment, post-treatment classification, recurrence/progression prediction, and molecular prediction. Risk of bias was assessed using PROBAST-informed criteria. RESULTS: Thirty studies were included. Survival-focused tasks predominated (20/30, 66.7%), with radiomics plus conventional machine learning as the most common model family (13/30, 43.3%), followed by deep learning (8/30, 26.7%) and hybrid deep learning plus radiomics approaches (4/30, 13.3%). Validation was predominantly internal, and external validation was uncommon (5/30, 16.7%). CONCLUSIONS: AI shows promise for prognosis and treatment stratification in GBM neurosurgery, but current evidence is limited by heterogeneity, incomplete external validation, and inconsistent methodological reporting. CLINICAL TRIAL NUMBER: Not applicable.
20 June 2026
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