Glioblastoma, IDH-wildtype (GBM), is the most aggressive and complex brain tumour classified by the World Health Organization (WHO), characterised by high mortality rates and diagnostic limitations inherent to invasive conventional procedures. Early detection is essential for improving patient outcomes, underscoring the need for non-invasive diagnostic tools. This study presents a convolutional neural network (CNN) specifically optimised for GBM detection from T1-weighted magnetic resonance imaging (MRI), with systematic evaluations of layer depth, activation functions, and hyperparameters. The model was trained on the RSNA-MICCAI data set and externally validated on the Erasmus Glioma Database (EGD), which includes gliomas of various grades and preserves cranial structures, unlike the skull-stripped RSNA-MICCAI images. This morphological discrepancy demonstrates the generalisation capacity of the model across anatomical and acquisition differences, achieving an F1-score of 0.88. Furthermore, statistical tests, such as Shapiro–Wilk, Mann–Whitney U, and Chi-square, confirmed the absence of demographic bias in model predictions, based on p-values, confidence intervals, and statistical power analyses supporting its demographic fairness. The proposed model achieved an area under the curve–receiver operating characteristic (AUC-ROC) of 0.63 on the RSNA-MICCAI test set, surpassing all prior results submitted to the BraTS 2021 challenge, and establishing a reliable and generalisable approach for non-invasive GBM detection.

Background: Glioblastoma multiforme (GBM) is an aggressive brain tumor with a poor prognosis. Traditional diagnosis relies on invasive biopsies, which pose surgical risks. Advances in artificial intelligence (AI) and machine learning (ML) have improved non-invasive GBM diagnosis using magnetic resonance imaging (MRI), offering potential advantages in accuracy and efficiency. Objective: This review aims to identify the methodologies and technologies employed in AI-based GBM diagnostics. It further evaluates the performance of AI models using standard metrics, highlighting both their strengths and limitations. Methodology: In accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, a systematic review was conducted across major academic databases. A total of 104 articles were identified in the initial search, and 15 studies were selected for final analysis after applying inclusion and exclusion criteria. Outcomes: The included studies indicated that the signal T1-weighted imaging (T1WI) is the most frequently used MRI modality in AI-based GBM diagnostics. Multimodal approaches integrating T1WI with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) have demonstrated improved classification performance. Additionally, AI models have shown potential in surpassing conventional diagnostic methods, enabling automated tumor classification and enhancing prognostic predictions.