Role of MRI-Based Radiomics in Sinonasal Cancer Management: A Scoping Review

Background/Objectives: Malignant tumors of the sinonasal tract are rare, accounting for approximately 3–5% of all head and neck tumors. Despite recent advances in therapy, overall survival in sinonasal cancer remains limited, with local recurrence representing the leading cause of treatment failure. Consequently, the preoperative identification of patients at higher risk of recurrence or developing more aggressive tumors is of critical importance to guide treatment strategies and improve outcomes. The aim of this review is to analyze the results of the most recent literature studying the use of radiomics in malignant sinonasal tumors. Methods: A comprehensive literature review was conducted using the PubMed/MEDLINE, EMBASE and Cochrane Library databases, in accordance with the PRISMA review criteria (from 2020 to July 2025). Results: The final analysis comprised a total of five articles and 629 patients. At present, radiomics in sinonasal cancer is mainly applied to the prediction of Ki-67 expression, the early assessment of recurrence risk, and the evaluation of response to induction chemotherapy. Conclusions: The results of this review indicate that radiomics has the potential to play an important role in the management of sinonasal malignant tumors. However, further research is necessary to confirm these findings.