BACKGROUND: To explore the value of intratumoral and peritumoral radiomics in preoperative prediction of anaplastic lymphoma kinase (ALK) mutation status and survival in patients with lung adenocarcinoma. METHODS: We retrospectively collected data from 505 eligible patients with lung adenocarcinoma from four hospitals (training and external validation sets 1-3). The CT-based radiomics features were extracted separately from the gross tumor volume (GTV) and GTV incorporating peritumoral 3-, 6-, 9-, 12-, and 15-mm regions (GPTV RESULTS: In the four sets, 21.19% (107/505) patients were ALK (+). The GPTV CONCLUSION: The presented combined model based on GPTV