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Sharifi H, Bertini CD, Alkhunaizi M, Hernandez M, Musa Z, Borges C, Turk I, Bashoura L, Dickey BF, Cheng GS, Yanik G, Galban CJ, Guo HH, Godoy MCB, Reinhardt JM, Hoffman EA, Castro M, Rondon G, Alousi AM, Champlin RE, Shpall EJ, Lu Y, Peterson S, Datta K, Nicolls MR, Hsu J, Sheshadri A. CT strain metrics allow for earlier diagnosis of bronchiolitis obliterans syndrome after hematopoietic cell transplant. Blood Adv 2024; 8:5156-5165. [PMID: 39163616 DOI: 10.1182/bloodadvances.2024013748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/29/2024] [Accepted: 07/29/2024] [Indexed: 08/22/2024] Open
Abstract
ABSTRACT Bronchiolitis obliterans syndrome (BOS) after hematopoietic cell transplantation (HCT) is associated with substantial morbidity and mortality. Quantitative computed tomography (qCT) can help diagnose advanced BOS meeting National Institutes of Health (NIH) criteria (NIH-BOS) but has not been used to diagnose early, often asymptomatic BOS (early BOS), limiting the potential for early intervention and improved outcomes. Using pulmonary function tests (PFTs) to define NIH-BOS, early BOS, and mixed BOS (NIH-BOS with restrictive lung disease) in patients from 2 large cancer centers, we applied qCT to identify early BOS and distinguish between types of BOS. Patients with transient impairment or healthy lungs were included for comparison. PFTs were done at month 0, 6, and 12. Analysis was performed with association statistics, principal component analysis, conditional inference trees (CITs), and machine learning (ML) classifier models. Our cohort included 84 allogeneic HCT recipients, 66 with BOS (NIH-defined, early, or mixed) and 18 without BOS. All qCT metrics had moderate correlation with forced expiratory volume in 1 second, and each qCT metric differentiated BOS from those without BOS (non-BOS; P < .0001). CITs distinguished 94% of participants with BOS vs non-BOS, 85% of early BOS vs non-BOS, 92% of early BOS vs NIH-BOS. ML models diagnosed BOS with area under the curve (AUC) of 0.84 (95% confidence interval [CI], 0.74-0.94) and early BOS with AUC of 0.84 (95% CI, 0.69-0.97). qCT metrics can identify individuals with early BOS, paving the way for closer monitoring and earlier treatment in this vulnerable population.
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Affiliation(s)
- Husham Sharifi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Christopher D Bertini
- Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX
| | - Mansour Alkhunaizi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Maria Hernandez
- Division of Hospital Medicine, Northwestern University, Chicago, IL
| | - Zayan Musa
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Carlos Borges
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Ihsan Turk
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Lara Bashoura
- Department of Pulmonary Medicine, MD Anderson Cancer Center, Houston, TX
| | - Burton F Dickey
- Department of Pulmonary Medicine, MD Anderson Cancer Center, Houston, TX
| | - Guang-Shing Cheng
- Division of Pulmonary, Critical Care and Sleep Medicine, Fred Hutchinson Cancer Center, Seattle, WA
| | - Gregory Yanik
- Blood and Marrow Transplant Division, University of Michigan Health, Ann Arbor, MI
| | - Craig J Galban
- Department of Radiology, Blood and Marrow Transplant Division, University of Michigan Health, Ann Arbor, MI
| | - Huawei Henry Guo
- Department of Radiology, Stanford University School of Medicine, Stanford, CA
| | - Myrna C B Godoy
- Department of Pulmonary Medicine, MD Anderson Cancer Center, Houston, TX
| | | | - Eric A Hoffman
- Department of Radiology, University of Iowa, Iowa City, IA
| | - Mario Castro
- Division of Pulmonary, Critical Care and Sleep Medicine, Kansas University Medical Center, Kansas City, KS
| | - Gabriela Rondon
- Department of Pulmonary Medicine, MD Anderson Cancer Center, Houston, TX
| | - Amin M Alousi
- Department of Pulmonary Medicine, MD Anderson Cancer Center, Houston, TX
| | - Richard E Champlin
- Department of Pulmonary Medicine, MD Anderson Cancer Center, Houston, TX
| | - Elizabeth J Shpall
- Department of Pulmonary Medicine, MD Anderson Cancer Center, Houston, TX
| | - Ying Lu
- Department of Biomedical Data Sciences, Stanford University, Stanford, CA
| | | | - Keshav Datta
- Department of Radiology, Stanford University School of Medicine, Stanford, CA
| | - Mark R Nicolls
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Joe Hsu
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Ajay Sheshadri
- Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX
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Chen B, Gao P, Yang Y, Ma Z, Sun Y, Lu J, Qi L, Li M. Discordant definitions of small airway dysfunction between spirometry and parametric response mapping: the HRCT-based study. Insights Imaging 2024; 15:233. [PMID: 39356413 PMCID: PMC11447176 DOI: 10.1186/s13244-024-01819-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 09/06/2024] [Indexed: 10/03/2024] Open
Abstract
OBJECTIVES To analyze the lung structure of small airway dysfunction (SAD) defined by spirometry and parametric response mapping (PRM) using high-resolution computed tomography (HRCT), and to analyze the predictive factors for SAD. METHODS A prospective study was conducted with 388 participants undergoing pulmonary function test (PFT) and inspiratory-expiratory chest CT scans. The clinical data and HRCT assessments of SAD patients defined by both methods were compared. A prediction model for SAD was constructed based on logistic regression. RESULTS SAD was defined in 122 individuals by spirometry and 158 by PRM. In HRCT visual assessment, emphysema, tree-in-bud sign, and bronchial wall thickening have higher incidence in SAD defined by each method. (p < 0.001). Quantitative CT showed that spirometry-SAD had thicker airway walls (p < 0.001), smaller lumens (p = 0.011), fewer bronchi (p < 0.001), while PRM-SAD had slender blood vessels. Predictive factors for spirometry-SAD were age, male gender, the volume percentage of emphysema in PRM (PRMEmph), tree-in-bud sign, bronchial wall thickening, bronchial count; for PRM-SAD were age, male gender, BMI, tree-in-bud sign, emphysema, the percentage of blood vessel volume with a cross-sectional area less than 1 mm2 (BV1/TBV). The area under curve (AUC) values for the fitted predictive models were 0.855 and 0.808 respectively. CONCLUSIONS Compared with PRM, SAD defined by spirometry is more closely related to airway morphology, while PRM is sensitive to early pulmonary dysfunction but may be interfered by pulmonary vessels. Models combining patient information and HRCT assessment have good predictive value for SAD. CRITICAL RELEVANCE STATEMENT HRCT reveals lung structural differences in small airway dysfunction defined by spirometry and parametric response mapping. This insight aids in understanding methodological differences and developing radiological tools for small airways that align with pathophysiology. KEY POINTS Spirometry-SAD shows thickened airway walls, narrowed lumen, and reduced branch count, which are closely related to airway morphology. PRM shows good sensitivity to early pulmonary dysfunction, although its assessment of SAD based on gas trapping may be affected by the density of pulmonary vessels and other lung structures. Combining patient information and HRCT features, the fitted model has good predictive performance for SAD defined by both spirometry and PRM (AUC values are 0.855 and 0.808, respectively).
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Affiliation(s)
- Bin Chen
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Pan Gao
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Yuling Yang
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Zongjing Ma
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Yingli Sun
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Jinjuan Lu
- Department of Radiology, Shanghai Geriatric Medical Center, Shanghai, China
| | - Lin Qi
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China.
| | - Ming Li
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
- Zhang Guozhen Small pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China.
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Sim DW, Choi S, Jeong J, Lee SY, Nam YH, Kim BK, Lee YS, Shim JS, Yang MS, Kim MH, Kim SR, Koh YI, Kim SH, Park HW. Computed tomography-based measurements associated with rapid lung function decline in severe asthma. Ann Allergy Asthma Immunol 2024:S1081-1206(24)01502-3. [PMID: 39243811 DOI: 10.1016/j.anai.2024.08.957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 08/28/2024] [Accepted: 08/29/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Patients with severe asthma are susceptible to lung function decline (LFD), but biomarkers that reliably predict an accelerated LFD have not been fully recognized. OBJECTIVE To identify variables associated with previous LFD occurrences in patients with severe asthma by exploring the computed tomography (CT) imaging features within predefined LFD groups. METHODS We obtained inspiratory and expiratory CT images of 102 patients with severe asthma and derived 2 airway structural parameters (wall thickness [WT] and hydraulic diameter) and 2 parenchymal variables (functional small airway disease and emphysema). We retrospectively calculated the annual changes in forced expiratory volume in 1 second and grouped participants by their values determined. The 4-imaging metrics, along with levels of several biomarkers, were compared among the LFD groups. RESULTS Patients with severe asthma with enhanced LFD exhibited significantly lower WT and smaller hydraulic diameter compared with those with minimal change or slight decline in lung function, after an adjustment of smoking status. Conversely, CT-based percentages of emphysema and functional small airway disease did not significantly differ according to LFD. Furthermore, fractional exhaled nitric oxide (FeNO) level and the blood matrix metalloproteinase-9/TIMP metallopeptidase inhibitor 1 ratio were significantly higher in patients with severe asthma with enhanced LFD compared with those in the others. CONCLUSION Lower WT on CT scans with increased FeNO that may represent increased airway inflammation significantly correlated with enhanced LFD in patients with severe asthma. Consequently, active management plans may help to attenuate LFD for patients with severe asthma with lower WT and high FeNO.
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Affiliation(s)
- Da Woon Sim
- Department of Allergy, Asthma and Clinical Immunology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sanghun Choi
- College of Engineering, School of Mechanical Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Jinyoung Jeong
- College of Engineering, School of Mechanical Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Suh-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young-Hee Nam
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Byung-Keun Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young-Soo Lee
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Ji-Su Shim
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Min-Suk Yang
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University, Boramae Medical Center, Seoul, Republic of Korea
| | - Min-Hye Kim
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - So Ri Kim
- Division of Respiratory Medicine and Allergy, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Young-Il Koh
- Department of Allergy, Asthma and Clinical Immunology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Heung-Woo Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Wu CP, Sleiman J, Fakhry B, Chedraoui C, Attaway A, Bhattacharyya A, Bleecker ER, Erdemir A, Hu B, Kethireddy S, Meyers DA, Rashidi HH, Zein JG. Novel Machine Learning Identifies 5 Asthma Phenotypes Using Cluster Analysis of Real-World Data. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:2084-2091.e4. [PMID: 38685479 PMCID: PMC11340628 DOI: 10.1016/j.jaip.2024.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/25/2024] [Accepted: 04/19/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Asthma classification into different subphenotypes is important to guide personalized therapy and improve outcomes. OBJECTIVES To further explore asthma heterogeneity through determination of multiple patient groups by using novel machine learning (ML) approaches and large-scale real-world data. METHODS We used electronic health records of patients with asthma followed at the Cleveland Clinic between 2010 and 2021. We used k-prototype unsupervised ML to develop a clustering model where predictors were age, sex, race, body mass index, prebronchodilator and postbronchodilator spirometry measurements, and the usage of inhaled/systemic steroids. We applied elbow and silhouette plots to select the optimal number of clusters. These clusters were then evaluated through LightGBM's supervised ML approach on their cross-validated F1 score to support their distinctiveness. RESULTS Data from 13,498 patients with asthma with available postbronchodilator spirometry measurements were extracted to identify 5 stable clusters. Cluster 1 included a young nonsevere asthma population with normal lung function and higher frequency of acute exacerbation (0.8 /patient-year). Cluster 2 had the highest body mass index (mean ± SD, 44.44 ± 7.83 kg/m2), and the highest proportion of females (77.5%) and Blacks (28.9%). Cluster 3 comprised patients with normal lung function. Cluster 4 included patients with lower percent of predicted FEV1 of 77.03 (12.79) and poor response to bronchodilators. Cluster 5 had the lowest percent of predicted FEV1 of 68.08 (15.02), the highest postbronchodilator reversibility, and the highest proportion of severe asthma (44.9%) and blood eosinophilia (>300 cells/μL) (34.8%). CONCLUSIONS Using real-world data and unsupervised ML, we classified asthma into 5 clinically important subphenotypes where group-specific asthma treatment and management strategies can be designed and deployed.
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Affiliation(s)
- Chao-Ping Wu
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | - Joelle Sleiman
- Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Battoul Fakhry
- Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Amy Attaway
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio; Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Eugene R Bleecker
- Department of Medicine, Division of Pulmonary Medicine, Mayo Clinic, Scottsdale, Ariz
| | - Ahmet Erdemir
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | - Bo Hu
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Deborah A Meyers
- Department of Medicine, Division of Pulmonary Medicine, Mayo Clinic, Scottsdale, Ariz
| | - Hooman H Rashidi
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Ohio
| | - Joe G Zein
- Department of Medicine, Division of Pulmonary Medicine, Mayo Clinic, Scottsdale, Ariz.
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Chaudhary MFA, Gerard SE, Christensen GE, Cooper CB, Schroeder JD, Hoffman EA, Reinhardt JM. LungViT: Ensembling Cascade of Texture Sensitive Hierarchical Vision Transformers for Cross-Volume Chest CT Image-to-Image Translation. IEEE TRANSACTIONS ON MEDICAL IMAGING 2024; 43:2448-2465. [PMID: 38373126 PMCID: PMC11227912 DOI: 10.1109/tmi.2024.3367321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Chest computed tomography (CT) at inspiration is often complemented by an expiratory CT to identify peripheral airways disease. Additionally, co-registered inspiratory-expiratory volumes can be used to derive various markers of lung function. Expiratory CT scans, however, may not be acquired due to dose or scan time considerations or may be inadequate due to motion or insufficient exhale; leading to a missed opportunity to evaluate underlying small airways disease. Here, we propose LungViT- a generative adversarial learning approach using hierarchical vision transformers for translating inspiratory CT intensities to corresponding expiratory CT intensities. LungViT addresses several limitations of the traditional generative models including slicewise discontinuities, limited size of generated volumes, and their inability to model texture transfer at volumetric level. We propose a shifted-window hierarchical vision transformer architecture with squeeze-and-excitation decoder blocks for modeling dependencies between features. We also propose a multiview texture similarity distance metric for texture and style transfer in 3D. To incorporate global information into the training process and refine the output of our model, we use ensemble cascading. LungViT is able to generate large 3D volumes of size 320×320×320 . We train and validate our model using a diverse cohort of 1500 subjects with varying disease severity. To assess model generalizability beyond the development set biases, we evaluate our model on an out-of-distribution external validation set of 200 subjects. Clinical validation on internal and external testing sets shows that synthetic volumes could be reliably adopted for deriving clinical endpoints of chronic obstructive pulmonary disease.
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Leung C, Fain SB, Hoffman EA, Fahy JV. Reply to Mozaffaripour et al.: Dose Modulation, Body Mass Index, and Computed Tomography Air Trapping. Am J Respir Crit Care Med 2024; 209:1413-1414. [PMID: 38574365 PMCID: PMC11146563 DOI: 10.1164/rccm.202402-0453le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/03/2024] [Indexed: 04/06/2024] Open
Affiliation(s)
- Clarus Leung
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, and
| | - Sean B. Fain
- Department of Radiology, University of Iowa, Iowa City, Iowa
| | - Eric A. Hoffman
- Department of Radiology, University of Iowa, Iowa City, Iowa
| | - John V. Fahy
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, and
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California; and
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Ash SY. Quantitative Imaging and Bronchial Thermoplasty: Technically Impressive But Clinically Uncertain. Chest 2024; 165:755-756. [PMID: 38599744 DOI: 10.1016/j.chest.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 02/17/2024] [Indexed: 04/12/2024] Open
Affiliation(s)
- Samuel Y Ash
- Department of Critical Care Medicine, South Shore Hospital, Weymouth, MA.
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Chen B, Liu Z, Lu J, Li Z, Kuang K, Yang J, Wang Z, Sun Y, Du B, Qi L, Li M. Deep learning parametric response mapping from inspiratory chest CT scans: a new approach for small airway disease screening. Respir Res 2023; 24:299. [PMID: 38017476 PMCID: PMC10683250 DOI: 10.1186/s12931-023-02611-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVES Parametric response mapping (PRM) enables the evaluation of small airway disease (SAD) at the voxel level, but requires both inspiratory and expiratory chest CT scans. We hypothesize that deep learning PRM from inspiratory chest CT scans can effectively evaluate SAD in individuals with normal spirometry. METHODS We included 537 participants with normal spirometry, a history of smoking or secondhand smoke exposure, and divided them into training, tuning, and test sets. A cascaded generative adversarial network generated expiratory CT from inspiratory CT, followed by a UNet-like network predicting PRM using real inspiratory CT and generated expiratory CT. The performance of the prediction is evaluated using SSIM, RMSE and dice coefficients. Pearson correlation evaluated the correlation between predicted and ground truth PRM. ROC curves evaluated predicted PRMfSAD (the volume percentage of functional small airway disease, fSAD) performance in stratifying SAD. RESULTS Our method can generate expiratory CT of good quality (SSIM 0.86, RMSE 80.13 HU). The predicted PRM dice coefficients for normal lung, emphysema, and fSAD regions are 0.85, 0.63, and 0.51, respectively. The volume percentages of emphysema and fSAD showed good correlation between predicted and ground truth PRM (|r| were 0.97 and 0.64, respectively, p < 0.05). Predicted PRMfSAD showed good SAD stratification performance with ground truth PRMfSAD at thresholds of 15%, 20% and 25% (AUCs were 0.84, 0.78, and 0.84, respectively, p < 0.001). CONCLUSION Our deep learning method generates high-quality PRM using inspiratory chest CT and effectively stratifies SAD in individuals with normal spirometry.
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Affiliation(s)
- Bin Chen
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, 221, Yanan West Road, Jingan Temple Street, Jingan District, Shanghai, China
- Zhang Guozhen Small Pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Ziyi Liu
- School of Computer Science, Wuhan University, LuoJiaShan, WuChang District, Wuhan, Hubei, China
- Artificial Intelligence Institute of Wuhan University, Wuhan, Hubei, China
- Hubei Key Laboratory of Multimedia and Network Communication Engineering, Wuhan, Hubei, China
| | - Jinjuan Lu
- Department of Radiology, Shanghai Geriatric Medical Center, Shanghai, China
| | - Zhihao Li
- School of Computer Science, Wuhan University, LuoJiaShan, WuChang District, Wuhan, Hubei, China
- Artificial Intelligence Institute of Wuhan University, Wuhan, Hubei, China
- Hubei Key Laboratory of Multimedia and Network Communication Engineering, Wuhan, Hubei, China
| | - Kaiming Kuang
- Dianei Technology, Shanghai, China
- University of California San Diego, La Jolla, USA
| | - Jiancheng Yang
- Dianei Technology, Shanghai, China
- Computer Vision Laboratory, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland
| | - Zengmao Wang
- School of Computer Science, Wuhan University, LuoJiaShan, WuChang District, Wuhan, Hubei, China
- Artificial Intelligence Institute of Wuhan University, Wuhan, Hubei, China
- Hubei Key Laboratory of Multimedia and Network Communication Engineering, Wuhan, Hubei, China
| | - Yingli Sun
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, 221, Yanan West Road, Jingan Temple Street, Jingan District, Shanghai, China
- Zhang Guozhen Small Pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Bo Du
- School of Computer Science, Wuhan University, LuoJiaShan, WuChang District, Wuhan, Hubei, China.
- Artificial Intelligence Institute of Wuhan University, Wuhan, Hubei, China.
- Hubei Key Laboratory of Multimedia and Network Communication Engineering, Wuhan, Hubei, China.
| | - Lin Qi
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, 221, Yanan West Road, Jingan Temple Street, Jingan District, Shanghai, China.
- Zhang Guozhen Small Pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China.
| | - Ming Li
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, 221, Yanan West Road, Jingan Temple Street, Jingan District, Shanghai, China.
- Zhang Guozhen Small Pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China.
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Ray A, Das J, Wenzel SE. Determining asthma endotypes and outcomes: Complementing existing clinical practice with modern machine learning. Cell Rep Med 2022; 3:100857. [PMID: 36543110 PMCID: PMC9798025 DOI: 10.1016/j.xcrm.2022.100857] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/24/2022] [Accepted: 11/18/2022] [Indexed: 12/24/2022]
Abstract
There is unprecedented opportunity to use machine learning to integrate high-dimensional molecular data with clinical characteristics to accurately diagnose and manage disease. Asthma is a complex and heterogeneous disease and cannot be solely explained by an aberrant type 2 (T2) immune response. Available and emerging multi-omics datasets of asthma show dysregulation of different biological pathways including those linked to T2 mechanisms. While T2-directed biologics have been life changing for many patients, they have not proven effective for many others despite similar biomarker profiles. Thus, there is a great need to close this gap to understand asthma heterogeneity, which can be achieved by harnessing and integrating the rich multi-omics asthma datasets and the corresponding clinical data. This article presents a compendium of machine learning approaches that can be utilized to bridge the gap between predictive biomarkers and actual causal signatures that are validated in clinical trials to ultimately establish true asthma endotypes.
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Affiliation(s)
- Anuradha Ray
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 3459 Fifth Avenue, MUH 628 NW, Pittsburgh, PA 15213, USA; Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Jishnu Das
- Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Center for Systems Immunology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sally E Wenzel
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 3459 Fifth Avenue, MUH 628 NW, Pittsburgh, PA 15213, USA; Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Environmental Medicine and Occupational Health, School of Public Health, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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