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Artificial Intelligence-based CT Assessment of Bronchiectasis: The COPDGene Study.
Alejandro A Díaz1, Pietro Nardelli1, Wei Wang1
1From the Division of Pulmonary and Critical Care Medicine (A.A.D., W.R.D., A.T., J.L.O., G.R.W.), Department of Radiology (P.N., Rubén San José Estépar, Raúl San José Estépar), Division of Sleep Medicine and Circadian Disorders (W.W.), and Channing Division of Network Medicine (E.K.S.), Brigham and Women's Hospital, Harvard Medical School, 15 Francis St, Boston, MA 02115; Department of Radiology, University of California-San Diego, San Diego, Calif (A.Y., S.K.); Division of Pulmonary Diseases and Critical Care, University of Texas-San Antonio, San Antonio, Tex (D.J.M.); Department of Biomedical Sciences, Humanitas University, Milan, Italy (S.A.); Respiratory Unit, IRCCS Humanitas Research Hospital, Milan, Italy (S.A.); Department of Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); and Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.).
Artificial intelligence (AI) enhanced CT scans can quantify airway dilatation in smokers, identifying more frequent exacerbations in those with chronic obstructive pulmonary disease (COPD) and bronchiectasis over time.
Area of Science:
- Pulmonary Medicine
- Radiology
- Artificial Intelligence in Healthcare
Background:
- Computed tomography (CT) is standard for assessing bronchiectasis using airway-to-artery ratio (AAR).
- Current CT methods have limitations in quantifying the extent of airway dilatation.
- Artificial intelligence (AI) offers potential for advanced imaging analysis.
Purpose of the Study:
- To quantify airway-to-artery ratios (AARs) using AI-based chest CT.
- To assess the association between AARs and the frequency of pulmonary exacerbations over time.
- To evaluate AI's role in identifying bronchiectasis extent in ever-smokers.
Main Methods:
- Secondary analysis of the COPDGene study involving 4192 ever-smokers.
- AI tool quantified percentage of airways with AAR > 1 on CT scans.
- Pulmonary exacerbations tracked over 10 years; multivariable regression models used for analysis.
Main Results:
- Higher percentage of airways with AAR > 1 correlated with increased exacerbations (RR 1.08).
- Participants meeting bronchiectasis criteria (≥3% AAR > 1) showed significantly more exacerbations (RR 1.37).
- Associations remained significant in participants with chronic obstructive pulmonary disease (COPD).
Conclusions:
- AI-based CT analysis of bronchiectasis is feasible and informative in ever-smokers.
- Quantified airway dilatation using AI is associated with a higher burden of exacerbations.
- This AI approach may improve risk stratification for COPD patients.
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