AI Identifies First Chronic Stress Biomarker on Routine CT Scans

Seeing Stress on a Scan: How AI Is Changing the Way We Measure Chronic Strain

For years, doctors have relied on questionnaires, cortisol tests, or indirect blood markers to gauge a patient’s stress load. Now a deep‑learning model can turn a routine chest CT into a quantitative “stress meter” by measuring the size of the adrenal glands—opening a new frontier in preventive cardiology.

From Hormones to Images: The Rise of the Adrenal Volume Index

The Adrenal Volume Index (AVI) is calculated as adrenal gland volume divided by body‑surface area. In a landmark study of 2,842 participants from the Multi‑Ethnic Study of Atherosclerosis (MESA), researchers showed that a higher AVI correlates with elevated cortisol exposure, greater allostatic load, and a higher risk of heart failure.

Because each year tens of millions of chest CTs are performed in the United States alone, AVI can be extracted without any extra radiation or cost—just an AI algorithm running on existing images.

Future Trends: Where This Technology Could Go Next

• Population‑wide stress mapping. Health systems could automatically flag patients with elevated AVI for early lifestyle counseling or pharmacologic intervention.
• Integration into electronic health records (EHRs). Seamless AVI reporting alongside labs and vitals would give clinicians a single dashboard of physiological stress.
• Predictive analytics for chronic disease. Combining AVI with genetic risk scores may improve prediction models for hypertension, type 2 diabetes, and even neurodegenerative disorders.
• Remote monitoring. Portable low‑dose CT units in community clinics could bring stress imaging to underserved areas, reducing health disparities.

Real‑World Example: A 62‑Year‑Old COPD Patient

Mr. Patel, a 62‑year‑old former smoker with chronic obstructive pulmonary disease (COPD), received a chest CT for routine surveillance. The AI algorithm flagged an AVI of 1.8 cm³/m², well above the cohort median. His primary care physician, using this data, initiated a stress‑reduction program that included mindfulness training and a referral to a cardiologist for early cardiac remodeling assessment. Six months later, follow‑up imaging showed a modest reduction in AVI, and his left ventricular mass index stabilized.

This case illustrates how an “invisible” risk factor can become actionable when visualized on a scan.

Why the Medical Community Is Paying Attention

Chronic stress is linked to heart disease, depression, obesity, and immune dysfunction according to the American Psychological Association. By providing a concrete, image‑based biomarker, AVI bridges the gap between subjective stress reports and hard clinical outcomes. The approach is already being discussed at the Radiological Society of North America (RSNA) annual meeting.

Pro Tips for Clinicians Looking to Leverage AVI

1. Start with existing chest CT datasets—no extra scan is needed.
2. Validate the AI model on your local population before clinical rollout.
3. Combine AVI with traditional risk scores (e.g., Framingham) for a more nuanced risk profile.
4. Educate patients: explain that a larger adrenal volume isn’t “dangerous” per se, but a signal to address lifestyle stressors.

Connecting the Dots: Stress, Imaging, and Prevention

When stress is quantified through a visual marker, it becomes part of the diagnostic conversation—just like blood pressure or cholesterol. This shift could move stress management from a “nice‑to‑have” recommendation to a core component of cardiovascular prevention.

Related Reading on Our Site

• Why single cortisol tests miss the bigger picture
• Top 5 evidence‑based ways to lower allostatic load
• AI in radiology: What to expect in the next decade

FAQ – Quick Answers to Common Questions

What is the Adrenal Volume Index (AVI)?

AVI is adrenal gland volume (in cm³) divided by a person’s height squared (m²). It serves as an imaging‑based proxy for chronic stress exposure.

Do I need a special CT scan to get an AVI?

No. AVI can be extracted from any standard chest CT that was already ordered for other clinical reasons.

Can lifestyle changes reduce my adrenal volume?

Early evidence suggests that stress‑reduction programs (mindfulness, exercise, sleep hygiene) may lead to modest decreases in adrenal size over time.

Is AVI covered by insurance?

Since AVI uses existing imaging data, there is no additional billing for the scan itself. Some insurers may reimburse for the AI analysis as a diagnostic service.

How reliable is AVI compared to cortisol tests?

AVI reflects long‑term cumulative stress, whereas cortisol captures a snapshot. Both have value, but AVI aligns better with chronic disease risk.

What’s Next for AI‑Driven Stress Biomarkers?

Researchers are already exploring how AVI could be combined with wearable data (heart‑rate variability, sleep patterns) to create a multi‑modal stress score. There’s also interest in applying similar AI models to MRI and PET scans, potentially expanding the toolbox for mental‑health diagnostics.