Deep Learning Estimation of Small Airways Disease from Inspiratory Chest CT is Associated with FEV Decline in COPD

Overview

Journal medRxiv

Date 2024 Sep 24

PMID 39314974

Authors

Muhammad F A Chaudhary

Hira A Awan

Sarah E Gerard

Sandeep Bodduluri

Alejandro P Comellas

Igor Z Barjaktarevic

R Graham Barr

Christopher B Cooper

Craig J Galban

MeiLan K Han

Jeffrey L Curtis

Nadia N Hansel

Jerry A Krishnan

Martha G Menchaca

Fernando J Martinez

Jill Ohar

Luis G Vargas Buonfiglio

Robert Paine 3rd

Surya P Bhatt

Eric A Hoffman

Joseph M Reinhardt

Affiliations

Soon will be listed here.

Abstract

Rationale: Quantifying functional small airways disease (fSAD) requires additional expiratory computed tomography (CT) scan, limiting clinical applicability. Artificial intelligence (AI) could enable fSAD quantification from chest CT scan at total lung capacity (TLC) alone (fSAD).

Objectives: To evaluate an AI model for estimating fSAD and study its clinical associations in chronic obstructive pulmonary disease (COPD).

Methods: We analyzed 2513 participants from the SubPopulations and InteRmediate Outcome Measures in COPD Study (SPIROMICS). Using a subset ( = 1055), we developed a generative model to produce virtual expiratory CTs for estimating fSAD in the remaining 1458 SPIROMICS participants. We compared fSAD with dual volume, parametric response mapping fSAD. We investigated univariate and multivariable associations of fSAD with FEV, FEV/FVC, six-minute walk distance (6MWD), St. George's Respiratory Questionnaire (SGRQ), and FEV decline. The results were validated in a subset ( = 458) from COPDGene study. Multivariable models were adjusted for age, race, sex, BMI, baseline FEV, smoking pack years, smoking status, and percent emphysema.

Measurements And Main Results: Inspiratory fSAD was highly correlated with fSAD in SPIROMICS (Pearson's R = 0.895) and COPDGene (R = 0.897) cohorts. In SPIROMICS, fSAD was associated with FEV (L) (adj.β = -0.034, < 0.001), FEV/FVC (adj.β = -0.008, < 0.001), SGRQ (adj.β = 0.243, < 0.001), and FEV decline (mL / year) (adj.β = -1.156, < 0.001). fSAD was also associated with FEV (L) (adj.β = -0.032, < 0.001), FEV/FVC (adj.β = -0.007, < 0.001), SGRQ (adj.β = 0.190, = 0.02), and FEV decline (mL / year) (adj.β = -0.866, = 0.001) in COPDGene. We found fSAD to be more repeatable than fSAD with intraclass correlation of 0.99 (95% CI: 0.98, 0.99) vs. 0.83 (95% CI: 0.76, 0.88).

Conclusions: Inspiratory fSAD captures small airways disease as reliably as fSAD and is associated with FEV decline.

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