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Improving clinical disease subtyping and future events prediction through a chest CT‐based deep learning approach
Author(s) -
Singla Sumedha,
Gong Mingming,
Riley Craig,
Sciurba Frank,
Batmanghelich Kayhan
Publication year - 2021
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1002/mp.14673
Subject(s) - medicine , concordance , exacerbation , copd , radiology , high resolution computed tomography , stage (stratigraphy) , metric (unit) , population , bode index , computed tomography , paleontology , operations management , environmental health , biology , economics , pulmonary rehabilitation
Purpose To develop and evaluate a deep learning (DL) approach to extract rich information from high‐resolution computed tomography (HRCT) of patients with chronic obstructive pulmonary disease (COPD). Methods We develop a DL‐based model to learn a compact representation of a subject, which is predictive of COPD physiologic severity and other outcomes. Our DL model learned: (a) to extract informative regional image features from HRCT; (b) to adaptively weight these features and form an aggregate patient representation; and finally, (c) to predict several COPD outcomes. The adaptive weights correspond to the regional lung contribution to the disease. We evaluate the model on 10 300 participants from the COPDGene cohort. Results Our model was strongly predictive of spirometric obstruction ( r 2 = 0.67) and grouped 65.4% of subjects correctly and 89.1% within one stage of their GOLD severity stage. Our model achieved an accuracy of 41.7% and 52.8% in stratifying the population‐based on centrilobular (5‐grade) and paraseptal (3‐grade) emphysema severity score, respectively. For predicting future exacerbation, combining subjects’ representations from our model with their past exacerbation histories achieved an accuracy of 80.8% (area under the ROC curve of 0.73). For all‐cause mortality, in Cox regression analysis, we outperformed the BODE index improving the concordance metric (ours: 0.61 vs BODE: 0.56). Conclusions Our model independently predicted spirometric obstruction, emphysema severity, exacerbation risk, and mortality from CT imaging alone. This method has potential applicability in both research and clinical practice.