Plasma Steroid Profiling Combined With Machine Learning for the Differential Diagnosis in Mild Autonomous Cortisol Secretion From Nonfunctioning Adenoma in Patients With Adrenal Incidentalomas
Authors' conclusion
We have elucidated the utilization of ML-based steroid profiling to discriminate between MACS and NFA in patients with adrenal incidentalomas. This approach holds promise for distinguishing these 2 entities through a single blood collection.
Study context
- Population
- Patients with adrenal incidentalomas with mild autonomous cortisol secretion (MACS) or nonfunctioning adenoma (NFA); plasma steroid profiles January 2021 to December 202376 MACS, 86 NFA
- Comparison
- Machine learning (ML) models on plasma 24-steroid panel with or without clinical characteristics for MACS vs NFA
- Outcome
- Diagnostic performance (AUC) in differentiating MACS from NFA
Methodological detailsretrospective, machine learning (eXtreme Gradient Boosting), internal and external validation
- Retrospective
- Machine learning (eXtreme Gradient Boosting)
- Internal and external validation
Performance
As reported in the abstract
Discrimination of MACS from NFA
| Test or model | AUC | Sensitivity | Specificity |
|---|---|---|---|
| 24 steroids | 0.77 | — not stated in the abstract | — not stated in the abstract |
| Steroids + clinical features | 0.88 | 0.77 | 0.82 |
AUC
24 steroids0.77
Steroids + clinical features0.88
Sensitivity
24 steroids— not stated in the abstract
Steroids + clinical features0.77
Specificity
24 steroids— not stated in the abstract
Steroids + clinical features0.82
— not stated in the abstract
Further findings
SHAP-identified features
- 5 steroids optimal for distinguishing MACS from NFA: DHEA, 11-deoxycortisol, 11β-hydroxytestosterone, testosterone, DHEAS
- Lower testosterone, DHEA, LDL-C, BMI and ACTH plus higher 11-deoxycortisol contributed significantly to identifying MACS
Original publication
Plasma Steroid Profiling Combined With Machine Learning for the Differential Diagnosis in Mild Autonomous Cortisol Secretion From Nonfunctioning Adenoma in Patients With Adrenal Incidentalomas. Endocr Pract. Published 22 April 2024. doi:10.
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