ORIGINAL RESEARCH article
Front. Radiol.
Sec. Artificial Intelligence in Radiology
Volume 5 - 2025 | doi: 10.3389/fradi.2025.1635425
This article is part of the Research TopicEmerging Fast Medical Imaging Techniques in RadiologyView all 4 articles
The value of CT texture analysis in predicting mitotic activity and morphological variants of adrenocortical carcinoma
Provisionally accepted
Natalya Tarbaeva1
Almaz Manaev1,2
Kseniya Ivashchenko1*Nadegda Platonova1Dmitry Beltsevich1Nano Pachuashvili1Liliya Urusova1
Natalya Mokrysheva1- 1Endocrinology Research Center, Moscow, Russia
- 2Nacional'nyj issledovatel'skij adernyj universitet Moskovskij inzenerno-fiziceskij institut, Moscow, Russia
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Adrenocortical carcinoma presents significant diagnostic challenges due to its histological heterogeneity and variable clinical behavior. This study aimed to evaluate the diagnostic value of radiomic features in predicting mitotic activity (low/high-grade) and morphological variants (conventional, oncocytic, myxoid) of adrenocortical carcinoma. A retrospective analysis of 32 patients with histologically confirmed ACC (18 conventional, 9 oncocytic and 5 myxoid cases) was performed, with mitotic data available for 25 cases (13 low-grade and 12 high-grade cases). Radiomic features including Gray-Level Co-occurrence Matrix (GLCM), Run-Length (GLRLM), Size-Zone (GLSZM), Dependence (GLDM), Neighboring-Tone (NGTDM) and first order features were extracted from fourphase CT using PyRadiomics after manual 3D segmentation. Statistical analysis (Mann-Whitney U, Kruskal-Wallis tests) and ROC curve (AUC, sensitivity, specificity) and PPV, NPV assessment revealed significant differences between tumor grades with firstorder_Skewness (AUC = 0.924, 95% CI: 0.819-0.986; p = 0.005) showing high predictive performance in the venous phase. Radiomic features did not show statistically significant differences between morphological variants of ACC after adjustment for multiple comparisons. Our results confirm the value of CT radiomics for preoperative stratification of ACC grade, but the question of differentiation of morphological variants remains unresolved and requires further validation in larger cohorts.
Keywords: сomputed tomography1, adrenocortical carcinoma2, radiomics3, low-grade4, high-grade5, conventional variant6, oncocytic variant7, myxoid variant8
Received: 26 May 2025; Accepted: 17 Jul 2025.
Copyright: © 2025 Tarbaeva, Manaev, Ivashchenko, Platonova, Beltsevich, Pachuashvili, Urusova and Mokrysheva. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kseniya Ivashchenko, Endocrinology Research Center, Moscow, Russia
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