An NLP-informed AGI clinic is a viable approach to efficiently improve teh systemwide quality of care for patients with AGIs.
BIRMINGHAM,AL,2025-06-17
Cutting-edge tech teams with human care to find and treat adrenal gland problems.
- Artificial intelligence helps identify patients with adrenal gland issues.
- Dedicated nurse practitioner connects patients to specialized care.
- outpatient surgery can cure high blood pressure related to the adrenal gland.
A study published in the *World Journal of Surgery* in December 2024, reveals how natural language processing (NLP) combined with dedicated healthcare professionals, helps pinpoint unusual findings in radiology images, improving patient care. This method, developed at the University of Alabama at Birmingham, focuses on adrenal gland incidentalomas (AGIs), or nodules on the adrenal glands.
agis are nodules found on the adrenal glands, often discovered during scans for unrelated health issues. While most are benign, they require investigation due to the potential for hormone imbalances.
Patients often get a scan for an unrelated reason, such as after an accident. During image analysis, radiologists might find an AGI. While most AGIs aren’t cancerous, they often need investigation because they can cause serious health problems.
The adrenal glands produce vital hormones like cortisol and adrenaline.An AGI coudl be releasing too many hormones, which elevates blood pressure and increases the risk of stroke, diabetes complications, bone disease, and other conditions.
- Elevated blood pressure
- Increased risk of stroke
- Diabetes complications
- Bone disease
“Not everyone with high blood pressure or diabetes has an adrenal nodule; but for people who do have this hormone hypersecretion, to think that an outpatient operation can cure your high blood pressure or improve your diabetes is amazing,” said Brenessa Lindeman M.D., associate professor in the UAB Department of Surgery and medical director of UAB’s Adrenal Gland Incidentaloma Clinic, which was launched in 2022.
The UAB team’s approach blends computer science and human support to find and engage patients with AGIs. NLP, a form of artificial intelligence, is used to understand human language within radiology reports. Then, a dedicated nurse practitioner contacts patients, informs them about the AGI Clinic, and guides them through evaluation.
From March 2022 to February 2023, the UAB team contacted 899 patients and invited them to the AGI Clinic. Of those, 382 were seen, and 322 were part of the intervention. Ninety-nine percent of the patients underwent biochemical testing, and 40 percent had adrenal-specific imaging. Sixteen patients had an adrenalectomy, a minimally invasive procedure to remove the AGI.
- 899 patients contacted
- 382 patients seen at the AGI Clinic
- 99% underwent biochemical testing
- 16 patients had an adrenalectomy
Expanding the Scope of AI in Healthcare
“In this report, we have demonstrated that natural language processing can be successfully utilized to search thousands of radiology reports to efficiently identify patients with AGIs,” the authors wrote.”an NLP-informed AGI clinic is a viable approach to efficiently improve the systemwide quality of care for patients with AGIs.”
the researchers are broadening this technique to find other incidental findings frequently enough missed in radiology follow-up.Haleigh negrete, the nurse practitioner at the clinic, follows up with patients who have AGIs. She discusses the adrenal gland, the potential long-term effects of hormone imbalances, and the need for further evaluation. Not all visits require a trip to the clinic; telehealth is utilized when appropriate. In many instances, testing reveals that the AGI isn’t causing any problems, providing reassurance to patients.
“The Department of Radiology is really excited about the possibilities we can get to,” said Srini Tridandapani Ph.D., M.D., professor and interim department chair. “In some ways, we are changing the way we practise based on these outcomes. We are developing programs to identify these incidental findings and establishing the clinical partnerships to connect patients to appropriate follow-up.”
The Critical Role of Early Detection and Management
The utilization of AI through NLP in identifying and managing adrenal gland incidentalomas highlights a crucial shift in healthcare. Early detection and proper management of AGIs can considerably improve patient outcomes. This is why the work being done at the UAB AGI Clinic is so crucial. The integration of technology with dedicated human care offers a comprehensive approach to patient well-being.
As the initial article detailed,AGIs are often discovered incidentally during imaging for unrelated conditions. These masses, while frequently enough benign, can sometimes be functional, leading to hormone imbalances and potentially serious health issues. The ability to swiftly identify and assess these incidental findings is paramount to preventing complications.
Why early Intervention Matters:
- Hormonal Imbalances: AGIs can produce excess hormones such as cortisol or aldosterone.
- Cardiovascular Risk: Uncontrolled hormone levels can elevate blood pressure, increasing the risk of heart attack and stroke.
- Metabolic Issues: Hormone imbalances can worsen or lead to the progress of diabetes.
- Bone Health: Excessive hormone production can lead to osteoporosis and other bone diseases.
The effectiveness of the UAB AGI Clinic exemplifies this. The clinic’s process includes rigorous biochemical testing to assess hormone levels and adrenal-specific imaging to characterize the incidentaloma.Those found to have problematic AGIs can then receive targeted treatment. This may range from medication aimed at blocking hormone overproduction, to the minimally invasive procedure of adrenalectomy [[3]].
the Diagnostic Process: What Patients Can Expect
If an AGI is detected, the diagnostic journey typically involves several steps. Initially, patients undergo a comprehensive evaluation to determine if the adrenal incidentaloma may be producing excess hormones. These tests measure hormone levels like cortisol, aldosterone, and catecholamines.
Following blood tests, adrenal-specific imaging, often through CT scans or MRI, helps provide detailed images of the adrenal glands.These imaging modalities allow specialists to assess the size,shape,and characteristics of the AGI.This level of detail helps determine the likelihood of malignancy [[3]].
depending on the test results, the UAB AGI Clinic team designs a personalized approach.The approach may include medication, further monitoring, or surgical intervention to remove the adrenal mass.The goal, as highlighted in the initial article, is to restore hormonal balance and avert potential long-term health complications. This comprehensive diagnostic process ensures appropriate and timely management.
Actionable Steps for Patients
Detecting any health problem early improves outcomes. individuals discovered to have an adrenal incidentaloma must follow a course of action to address and potentially resolve the health concern.
Steps to Take:
- Seek Expert Evaluation: Prompt consultation with an endocrinologist is crucial.
- Undergo Diagnostic Testing: Compliance with recommended biochemical and imaging tests is vital.
- Discuss Treatment Options: Collaborate with your healthcare team on the most appropriate treatment plan.
- regular Follow-up: Adhere to scheduled follow-up appointments. These are important for monitoring hormone levels and overall health.
- Lifestyle Adjustments: Follow your care team’s recommendations, which may include lifestyle changes to support overall health and recovery.
What happens if an incidentally discovered adrenal mass is left untreated? Without proper care, patients with AGIs may experience severe health consequences. High blood pressure, diabetes complications, and cardiovascular diseases can result from hormone imbalances. These conditions reduce the quality of life and may result in life-threatening events.
Haleigh Negrete, the nurse practitioner at UAB, plays a huge role in ensuring that patients receive proper care. Her role is also crucial as she helps patients understand their diagnosis and treatment options. This approach, as initially highlighted, leads to optimal patient outcomes and shows the potential of AI in healthcare.
Frequently Asked Questions
What are the primary causes of AGIs? The exact cause is frequently enough unknown. However, they can be caused by noncancerous growths such as adenomas [[2]], or, less often, more serious conditions like adrenal cancer or metastasis.
How are AGIs diagnosed? Diagnosis typically involves imaging scans (CT or MRI) and hormone level testing to check for overproduction of hormones like cortisol or aldosterone.
What treatments are available for AGIs? Treatments include medication to manage hormone levels and potentially an adrenalectomy, a minimally invasive surgery for tumor removal.
Are all AGIs cancerous? No, the vast majority are benign. However, all require assessment to rule out malignancy or hormonal overproduction.
How often should I follow up with my doctor? Follow-up frequency depends on the AGI type and risk. Your healthcare provider will give you specific guidance.
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