Modern advances in diagnostic approaches for pituitary and adrenal disease

The field of pituitary and adrenal research has undergone a remarkable transformation with the emergence of novel diagnostic technologies that are reshaping disease classification, imaging interpretation, and biological insight. In pituitary disease, a major shift has occurred with the reclassification of pituitary adenomas as Pituitary Neuroendocrine Tumours (PitNETs), emphasizing the importance of cell lineage and molecular phenotype in predicting tumour behaviour. Advances in diagnostic technologies now enable earlier and more accurate detection of these tumours, with promising approaches such as liquid biopsy and exosomal mRNA detection offering non-invasive perspectives into disease activity. Despite the potential of magnetic resonance imaging, a subset of functioning PitNETs remain difficult to detect, which has prompted the integration of radiomics and artificial intelligence-driven analysis to extract deeper diagnostic information from conventional MRI. Concomitantly, molecular imaging techniques, including [11C]methionine and [18F]FET PET, are showing increasing clinical utility in localising lesions and uncovering in vivo metabolic activity, contributing to a more precise clinical workflow.Developments in adrenal diagnostics have followed a similar trajectory. Emerging evidence suggests that urinary steroid profiling offers powerful stratification potential, aiding the distinction between benign and malignant lesions and supporting more accurate subtyping of adrenal disorders. Molecular imaging now complements these biochemical tests by enabling non-invasive lesion characterisation and prognostic evaluation. Radiomic techniques refined in pituitary research are increasingly being tailored to evaluate tumour heterogeneity in adrenal pathologies. Simultaneously, advances in computational biology have opened avenues for exploring epigenetic and multi-omic signatures, particularly in pheochromocytomas and paragangliomas with SDHB mutations, yielding novel insights into their metastatic potential. Patient-derived organoids are further enabling the study of tumour microenvironment and therapeutic vulnerability, linking molecular insights to translational outcomes. Together, these multi-disciplinary innovations illustrate a pivotal shift toward precision diagnostics and integrated disease modelling.This Research Topic aims to bring together cutting-edge research and translational studies that are advancing diagnostic precision in pituitary and adrenal diseases. The objective is to provide a unified platform highlighting the most recent technological, computational, and biomolecular discoveries shaping new diagnostic paradigms. It seeks to answer key questions about the combined utility of imaging biomarkers, molecular profiling, and artificial intelligence–based systems in improving patient outcomes. Furthermore, it intends to strengthen international collaboration among centres of excellence, fostering an evidence-based approach toward earlier disease detection, enhanced risk stratification, and personalised therapeutic interventions.To gather further insights into the evolving diagnostic landscape of pituitary and adrenal disorders, we welcome contributions addressing, but not limited to, the following themes:- Histopathological and molecular reclassification of PitNETs and adrenal tumours- Novel imaging biomarkers, radiomics, and artificial intelligence applications in endocrine imaging- Integration of liquid biopsy, metabolomics, and other minimally invasive diagnostic platforms- Multi-omic signatures and epigenetic regulation in adrenal and pituitary tumour biology- Machine learning–based predictive modelling for disease behaviour and treatment outcomes- Development and use of organoid and in vitro systems for studying endocrine tumour mechanisms- Translational studies linking molecular diagnostics with clinical management and prognosis. Topic editors: Russell Senanayake, Ilaria Bonaventura, Yasmine Kemkem Source: https://www.frontiersin.org/research-topics/83729/modern-advances-in-diagnostic-approaches-for-pituitary-and-adrenal-disease