Age-related changes in the parotid gland: a computed tomography-based radiomics study

Background: Age-related degeneration of parotid glands impacts oral and systemic health, yet non-invasive assessment remains limited. This study characterizes parotid gland aging using computed tomography (CT)-based radiomics for the early detection of glandular dysfunction or diseases. Methods: This retrospective study included 320 healthy individuals (aged 12-84 years), stratified into four age groups (adolescent: 59 years) with balanced sex distribution. Axial medial-lateral diameter (AMLD) and mean Hounsfield unit (HU) attenuation were manually measured on axial CT slices. Three-dimensional (3D) radiomic features were extracted from automatically segmented glands via PyRadiomics platform. Dimensionality reduction was performed by probabilistic principal component analysis (PCA) and unsupervised K-means clustering was applied to shape-, first-order-, and texture-related features to identify age-associated patterns. Results: AMLD increased significantly with age from 32.1±3.5 mm in the adolescent group to 40.3±4.1 mm in the elderly group (P