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Wisselink HJ, Steerenberg DJD, Rook M, Pelgrim GJ, Heuvelmans MA, van den Berge M, de Bock GH, Vliegenthart R. Predicted versus CT-derived total lung volume in a general population: The ImaLife study. PLoS One 2023; 18:e0287383. [PMID: 37327210 PMCID: PMC10275439 DOI: 10.1371/journal.pone.0287383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 06/05/2023] [Indexed: 06/18/2023] Open
Abstract
Predicted lung volumes based on the Global Lung Function Initiative (GLI) model are used in pulmonary disease detection and monitoring. It is unknown how well the predicted lung volume corresponds with computed tomography (CT) derived total lung volume (TLV). The aim of this study was to compare the GLI-2021 model predictions of total lung capacity (TLC) with CT-derived TLV. 151 female and 139 male healthy participants (age 45-65 years) were consecutively selected from a Dutch general population cohort, the Imaging in Lifelines (ImaLife) cohort. In ImaLife, all participants underwent low-dose, inspiratory chest CT. TLV was measured by an automated analysis, and compared to predicted TLC based on the GLI-2021 model. Bland-Altman analysis was performed for analysis of systematic bias and range between limits of agreement. To further mimic the GLI-cohort all analyses were repeated in a subset of never-smokers (51% of the cohort). Mean±SD of TLV was 4.7±0.9 L in women and 6.2±1.2 L in men. TLC overestimated TLV, with systematic bias of 1.0 L in women and 1.6 L in men. Range between limits of agreement was 3.2 L for women and 4.2 L for men, indicating high variability. Performing the analysis with never-smokers yielded similar results. In conclusion, in a healthy cohort, predicted TLC substantially overestimates CT-derived TLV, with low precision and accuracy. In a clinical context where an accurate or precise lung volume is required, measurement of lung volume should be considered.
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Affiliation(s)
- Hendrik J. Wisselink
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Danielle J. D. Steerenberg
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Mieneke Rook
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Radiology, Martini Hospital, Groningen, The Netherlands
| | - Gert-Jan Pelgrim
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marjolein A. Heuvelmans
- Department of Pulmonology, Medisch Spectrum Twente, Enschede, The Netherlands
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Maarten van den Berge
- Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Geertruida H. de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rozemarijn Vliegenthart
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- DataScience in Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Park H, Yun J, Lee SM, Hwang HJ, Seo JB, Jung YJ, Hwang J, Lee SH, Lee SW, Kim N. Deep Learning-based Approach to Predict Pulmonary Function at Chest CT. Radiology 2023; 307:e221488. [PMID: 36786699 DOI: 10.1148/radiol.221488] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Background Low-dose chest CT screening is recommended for smokers with the potential for lung function abnormality, but its role in predicting lung function remains unclear. Purpose To develop a deep learning algorithm to predict pulmonary function with low-dose CT images in participants using health screening services. Materials and Methods In this retrospective study, participants underwent health screening with same-day low-dose CT and pulmonary function testing with spirometry at a university affiliated tertiary referral general hospital between January 2015 and December 2018. The data set was split into a development set (model training, validation, and internal test sets) and temporally independent test set according to first visit year. A convolutional neural network was trained to predict the forced expiratory volume in the first second of expiration (FEV1) and forced vital capacity (FVC) from low-dose CT. The mean absolute error and concordance correlation coefficient (CCC) were used to evaluate agreement between spirometry as the reference standard and deep-learning prediction as the index test. FVC and FEV1 percent predicted (hereafter, FVC% and FEV1%) values less than 80% and percent of FVC exhaled in first second (hereafter, FEV1/FVC) less than 70% were used to classify participants at high risk. Results A total of 16 148 participants were included (mean age, 55 years ± 10 [SD]; 10 981 men) and divided into a development set (n = 13 428) and temporally independent test set (n = 2720). In the temporally independent test set, the mean absolute error and CCC were 0.22 L and 0.94, respectively, for FVC and 0.22 L and 0.91 for FEV1. For the prediction of the respiratory high-risk group, FVC%, FEV1%, and FEV1/FVC had respective accuracies of 89.6% (2436 of 2720 participants; 95% CI: 88.4, 90.7), 85.9% (2337 of 2720 participants; 95% CI: 84.6, 87.2), and 90.2% (2453 of 2720 participants; 95% CI: 89.1, 91.3) in the same testing data set. The sensitivities were 61.6% (242 of 393 participants; 95% CI: 59.7, 63.4), 46.9% (226 of 482 participants; 95% CI: 45.0, 48.8), and 36.1% (91 of 252 participants; 95% CI: 34.3, 37.9), respectively. Conclusion A deep learning model applied to volumetric chest CT predicted pulmonary function with relatively good performance. © RSNA, 2023 Supplemental material is available for this article.
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Affiliation(s)
- Hyunjung Park
- From the Department of Medical Science and Department of Bioengineering, Asan Medical Institute of Convergence Science and Technology (H.P., N.K.), Department of Radiology and Research Institute of Radiology (J.Y., S.M.L., H.J.H., J.B.S., N.K.), Department of Pulmonology and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases (S.W.L.), and Health Screening and Promotion Center (Y.J.J.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Division of Medical Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea (J.H.); Department of Biomedical Research Center, Korea University Guro Hospital, Seoul, Republic of Korea (J.H.); and Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (S.H.L.)
| | - Jihye Yun
- From the Department of Medical Science and Department of Bioengineering, Asan Medical Institute of Convergence Science and Technology (H.P., N.K.), Department of Radiology and Research Institute of Radiology (J.Y., S.M.L., H.J.H., J.B.S., N.K.), Department of Pulmonology and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases (S.W.L.), and Health Screening and Promotion Center (Y.J.J.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Division of Medical Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea (J.H.); Department of Biomedical Research Center, Korea University Guro Hospital, Seoul, Republic of Korea (J.H.); and Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (S.H.L.)
| | - Sang Min Lee
- From the Department of Medical Science and Department of Bioengineering, Asan Medical Institute of Convergence Science and Technology (H.P., N.K.), Department of Radiology and Research Institute of Radiology (J.Y., S.M.L., H.J.H., J.B.S., N.K.), Department of Pulmonology and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases (S.W.L.), and Health Screening and Promotion Center (Y.J.J.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Division of Medical Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea (J.H.); Department of Biomedical Research Center, Korea University Guro Hospital, Seoul, Republic of Korea (J.H.); and Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (S.H.L.)
| | - Hye Jeon Hwang
- From the Department of Medical Science and Department of Bioengineering, Asan Medical Institute of Convergence Science and Technology (H.P., N.K.), Department of Radiology and Research Institute of Radiology (J.Y., S.M.L., H.J.H., J.B.S., N.K.), Department of Pulmonology and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases (S.W.L.), and Health Screening and Promotion Center (Y.J.J.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Division of Medical Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea (J.H.); Department of Biomedical Research Center, Korea University Guro Hospital, Seoul, Republic of Korea (J.H.); and Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (S.H.L.)
| | - Joon Beom Seo
- From the Department of Medical Science and Department of Bioengineering, Asan Medical Institute of Convergence Science and Technology (H.P., N.K.), Department of Radiology and Research Institute of Radiology (J.Y., S.M.L., H.J.H., J.B.S., N.K.), Department of Pulmonology and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases (S.W.L.), and Health Screening and Promotion Center (Y.J.J.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Division of Medical Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea (J.H.); Department of Biomedical Research Center, Korea University Guro Hospital, Seoul, Republic of Korea (J.H.); and Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (S.H.L.)
| | - Young Ju Jung
- From the Department of Medical Science and Department of Bioengineering, Asan Medical Institute of Convergence Science and Technology (H.P., N.K.), Department of Radiology and Research Institute of Radiology (J.Y., S.M.L., H.J.H., J.B.S., N.K.), Department of Pulmonology and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases (S.W.L.), and Health Screening and Promotion Center (Y.J.J.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Division of Medical Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea (J.H.); Department of Biomedical Research Center, Korea University Guro Hospital, Seoul, Republic of Korea (J.H.); and Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (S.H.L.)
| | - Jeongeun Hwang
- From the Department of Medical Science and Department of Bioengineering, Asan Medical Institute of Convergence Science and Technology (H.P., N.K.), Department of Radiology and Research Institute of Radiology (J.Y., S.M.L., H.J.H., J.B.S., N.K.), Department of Pulmonology and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases (S.W.L.), and Health Screening and Promotion Center (Y.J.J.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Division of Medical Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea (J.H.); Department of Biomedical Research Center, Korea University Guro Hospital, Seoul, Republic of Korea (J.H.); and Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (S.H.L.)
| | - Se Hee Lee
- From the Department of Medical Science and Department of Bioengineering, Asan Medical Institute of Convergence Science and Technology (H.P., N.K.), Department of Radiology and Research Institute of Radiology (J.Y., S.M.L., H.J.H., J.B.S., N.K.), Department of Pulmonology and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases (S.W.L.), and Health Screening and Promotion Center (Y.J.J.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Division of Medical Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea (J.H.); Department of Biomedical Research Center, Korea University Guro Hospital, Seoul, Republic of Korea (J.H.); and Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (S.H.L.)
| | - Sei Won Lee
- From the Department of Medical Science and Department of Bioengineering, Asan Medical Institute of Convergence Science and Technology (H.P., N.K.), Department of Radiology and Research Institute of Radiology (J.Y., S.M.L., H.J.H., J.B.S., N.K.), Department of Pulmonology and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases (S.W.L.), and Health Screening and Promotion Center (Y.J.J.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Division of Medical Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea (J.H.); Department of Biomedical Research Center, Korea University Guro Hospital, Seoul, Republic of Korea (J.H.); and Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (S.H.L.)
| | - Namkug Kim
- From the Department of Medical Science and Department of Bioengineering, Asan Medical Institute of Convergence Science and Technology (H.P., N.K.), Department of Radiology and Research Institute of Radiology (J.Y., S.M.L., H.J.H., J.B.S., N.K.), Department of Pulmonology and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases (S.W.L.), and Health Screening and Promotion Center (Y.J.J.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea; Division of Medical Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea (J.H.); Department of Biomedical Research Center, Korea University Guro Hospital, Seoul, Republic of Korea (J.H.); and Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (S.H.L.)
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House JS, Nichols CE, Li H, Brandenberger C, Virgincar RS, DeGraff LM, Driehuys B, Zeldin DC, London SJ. Vagal innervation is required for pulmonary function phenotype in Htr4-/- mice. Am J Physiol Lung Cell Mol Physiol 2017; 312:L520-L530. [PMID: 28130264 PMCID: PMC5407097 DOI: 10.1152/ajplung.00495.2016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/19/2017] [Accepted: 01/25/2017] [Indexed: 11/22/2022] Open
Abstract
Human genome-wide association studies have identified over 50 loci associated with pulmonary function and related phenotypes, yet follow-up studies to determine causal genes or variants are rare. Single nucleotide polymorphisms in serotonin receptor 4 (HTR4) are associated with human pulmonary function in genome-wide association studies and follow-up animal work has demonstrated that Htr4 is causally associated with pulmonary function in mice, although the precise mechanisms were not identified. We sought to elucidate the role of neural innervation and pulmonary architecture in the lung phenotype of Htr4-/- animals. We report here that the Htr4-/- phenotype in mouse is dependent on vagal innervation to the lung. Both ex vivo tracheal ring reactivity and in vivo flexiVent pulmonary functional analyses demonstrate that vagotomy abrogates the Htr4-/- airway hyperresponsiveness phenotype. Hyperpolarized 3He gas magnetic resonance imaging and stereological assessment of wild-type and Htr4-/- mice reveal no observable differences in lung volume, inflation characteristics, or pulmonary microarchitecture. Finally, control of breathing experiments reveal substantive differences in baseline breathing characteristics between mice with/without functional HTR4 in breathing frequency, relaxation time, flow rate, minute volume, time of inspiration and expiration and breathing pauses. These results suggest that HTR4's role in pulmonary function likely relates to neural innervation and control of breathing.
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Affiliation(s)
- John S House
- Immunity, Inflammation, and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Cody E Nichols
- Immunity, Inflammation, and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Huiling Li
- Immunity, Inflammation, and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | | | - Rohan S Virgincar
- Center for In Vivo Microscopy, Duke University Medical Center, Durham, North Carolina.,Biomedical Engineering, Duke University, Durham, North Carolina
| | - Laura M DeGraff
- Immunity, Inflammation, and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Bastiaan Driehuys
- Center for In Vivo Microscopy, Duke University Medical Center, Durham, North Carolina.,Biomedical Engineering, Duke University, Durham, North Carolina.,Radiology, Duke University Medical Center, Durham, North Carolina; and
| | - Darryl C Zeldin
- Immunity, Inflammation, and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Stephanie J London
- Immunity, Inflammation, and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina; .,Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
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