Abstract
BACKGROUND: The adrenal glands are small retroperitoneal organs, few reference standards exist for adrenal CT measurements in clinical practice. This study aims to develop a deep learning (DL) model for automated adrenal gland segmentation on non-contrast CT images, and to conduct a preliminary large-scale study on age-related volume changes in normal adrenal glands using the model output values. METHODS: The model was trained and evaluated on a development dataset of annotated non-contrast CT scans of bilateral adrenal glands, utilizing nnU-Net for segmentation task. The ground truth was manually established by two experienced radiologists, and the model performance was assessed using the Dice similarity coefficient (DSC). Additionally, five radiologists provided annotations on a subset of 20 randomly selected cases to measure inter-observer variability. Following validation, the model was applied to a large-scale normal adrenal glands dataset to segment adrenal glands. RESULTS: The DL model development dataset contained 1301 CT examinations. In the test set, the median DSC scores for the segmentation model of left and right adrenal glands were 0.899 and 0.904 respectively, and in the independent test set were 0.900 and 0.896. Inter-observer DSC for radiologist manual segmentation did not differ from automated machine segmentation (P = 0.541). The large-scale normal adrenal glands dataset contained 2000 CT examinations, the graph shows that adrenal gland volume increases first and then decreases with age. CONCLUSION: The developed DL model demonstrates accurate adrenal gland segmentation, and enables a comprehensive study of age-related adrenal gland volume variations.