Single-inspiratory quantitative CT nomogram for enhanced PRISm and COPD differentiation: a cross-sectional study with...

Area of Science:

• Pulmonary Medicine
• Radiology
• Medical Imaging

Background:

• Differentiating preserved ratio impaired spirometry (PRISm) from chronic obstructive pulmonary disease (COPD) is clinically challenging.
• Traditional CT scans involve significant radiation exposure.
• Current deep learning models for CT lack interpretability.

Purpose of the Study:

• Develop a single-inspiratory quantitative computed tomography (QCT) nomogram.
• Integrate parenchymal, airway, and vascular parameters for improved imaging definitions.
• Establish a radiation-efficient method for differentiating PRISm from COPD.

Main Methods:

• Retrospective study of 658 patients (Normal, PRISm, COPD).
• Quantification of single-inspiratory CT metrics using the Aview® system.
• Logistic regression models and ROC-AUC analysis to evaluate diagnostic performance.

Main Results:

• PRISm patients showed distinct age, sex, and pulmonary function profiles compared to normal and COPD groups.
• CT markers, including Pi10 and superficial vessel diameter (AVD9), differed significantly between groups.
• Diagnostic models achieved high AUCs, up to 0.984 for PRISm vs. severe COPD.

Conclusions:

• The developed QCT nomogram reliably differentiates PRISm from COPD.
• Reduced superficial vessel diameter is identified as a crucial biomarker.
• This approach facilitates early COPD stratification using interpretable metrics.