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Constructing a Predictive Model for Children with Autism Spectrum Disorder Based on Whole-Brain MR Radiomics: A Machine Learning Study.

AJNR. American journal of neuroradiology2026

Chen Xi, Peng Jiaxuan, Zhang Zihan, Song Qiaowei, Li Dongxue, Zhai Gongyong, Fu Wanyun, Shu Zhenyu

What this study means for families

Researchers used brain scans and computer technology to create a tool that might help identify autism in children. They analyzed brain images from 310 children total, looking at detailed patterns in brain tissue. When combined with verbal intelligence scores, their computer model correctly identified autism about 84-89% of the time. While promising, the tool still missed some cases and incorrectly flagged others, so more research is needed before it could be used clinically.

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Research summary

This machine learning study developed a predictive model for autism spectrum disorder (ASD) using whole-brain MRI radiomics features from 223 subjects, with external validation on 87 additional participants. The researchers extracted quantitative features from white matter, gray matter, and cerebrospinal fluid, combining these with clinical data including Verbal Intelligence Quotient (VIQ). A decision tree algorithm integrating radiomics signatures with VIQ achieved the best performance, with areas under the curve of 0.87, 0.84, and 0.83 for training, test, and external validation sets respectively. The model demonstrated sensitivity ranging from 0.84-0.89 and specificity of 0.63-0.70 across datasets, successfully stratifying participants into statistically significant low-risk and high-risk subgroups.

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Key findings

  • 1

    Combined radiomics and VIQ model achieved AUC values of 0.87, 0.84, and 0.83 across training, test, and external validation sets

    Confidence: moderateRelevance: Demonstrates potential for objective neuroimaging-based autism identification tool
  • 2

    Verbal Intelligence Quotient identified as an independent predictor of ASD in multivariate analysis

    Confidence: moderateRelevance: Confirms importance of cognitive assessment in autism evaluation
  • 3

    Model sensitivity ranged from 0.84-0.89 with specificity of 0.63-0.70 across datasets

    Confidence: moderateRelevance: High sensitivity suggests good detection but moderate specificity indicates risk of false positives

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Clinical implications

Shows potential for developing objective neuroimaging tools to support autism diagnosis, but current performance limitations prevent immediate clinical application. High sensitivity suggests utility as a screening tool, though moderate specificity requires improvement. Integration of neuroimaging with cognitive assessments may enhance diagnostic accuracy.

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Limitations

Limited by moderate specificity (63-70%) leading to false positives. Study lacks details on participant demographics, age ranges, and autism severity levels. External validation sample relatively small. No comparison to standard diagnostic methods or clinical implementation feasibility discussed.

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Original abstract

Current autism spectrum disorder (ASD) diagnosis depends on subjective behavioral assessments causing delays and variability. Structural MRI shows brain abnormalities but traditional analysis lacks sensitivity. This study aims to construct a prediction model based on whole-brain imaging radiomics analysis by using machine learning for identifying children with ASD. This study used imaging and clinical data from 223 subjects in the Autism Brain Imaging Data Exchange database, including 120 patients diagnosed with ASD.

These data were randomly divided into training and test sets in a 7:3 ratio. An independent external test set comprising 87 participants (38 with ASD) from the Georgetown University and University of Miami ASD data set was also utilized. Then, quantitative radiomics features of white matter, gray matter, and CSF were extracted from the whole-brain MR structural images of each subject, and feature dimensionality reduction was performed based on the training set data to construct radiomics signature. Afterward, multivariate logistic regression was used to screen independent predictors of ASD from clinical features and then, combined with radiomics signature, multiple machine learning models were constructed to predict ASD.

Finally, the optimal model was selected, and the receiver operating characteristic curve was used to evaluate the training, test, and external test sets data. Simultaneously, the model divides the data set into low-risk and high-risk subgroups, comparing the actual number of individuals with ASD between the 2 subgroups to evaluate the clinical efficacy of the model. The areas under the curve (AUCs) of radiomics markers in the training set, test set, and external test set were 0.78 (95% CI, 0.71-0.85), 0.75 (95% CI, 0.67-0.83), and 0.74 (95% CI, 0.64-0.83), respectively. Multivariate logistic regression showed that the Verbal Intelligence Quotient (VIQ) was a predictor of ASD.

The joint model constructed by the decision tree algorithm with radiomics markers performed best, with AUC of 0.87 (95% CI, 0.81-0.92), 0.84 (95% CI, 0.76-0.91), and 0.83 (95% CI, 0.74-0.91), a sensitivity of 0.89 (95% CI, 0.82-0.95), 0.84 (95% CI, 0.73-0.93), and 0.86 (95% CI, 0.72-0.96), and the specificity of 0.70 (95% CI, 0.60-0.79), 0.63 (95% CI, 0.52-0.74), and 0.66 (95% CI, 0.49-0.80), respectively. The low-risk subgroup and high-risk subgroup classified according to the cutoff value of 0.4285 of the model showed statistically significant differences in the actual number of patients with ASD in the training set (χ= 21.325;< .05), the test set (χ= 5.379;< .05), and the external test set (χ= 21.52;< .05). Radiomics signature for identifying ASD can be constructed based on whole-brain MRI imaging features. The performance of identifying ASD can be improved by adding VIQ data and the decision tree algorithm model, which can provide an adaptive strategy for clinical practice.

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Evidence Grade

Emerging

moderate

Grade assigned by AutismInsights based on study type and published abstract.

Study Details

Journal
AJNR. American journal of neuroradiology
Year
2026
PMID
40721282
DOI
10.3174/ajnr.A8939

MeSH Terms

HumansAutism Spectrum DisorderMachine LearningMaleMagnetic Resonance ImagingFemaleChildBrainChild, PreschoolSensitivity and SpecificityPredictive Value of TestsAdolescentRadiomics