Results of studying the changes in emphysema associated with chronic obstructive pulmonary disease using AI Quantitative CT analysis

Abstract

Background: Chronic obstructive pulmonary disease (COPD) has emerged as a predominant cause of mortality globally, with an estimated annual death toll exceeding 3.3 million individuals attributed to this condition. Recent advancements in imaging modalities, particularly high-resolution computed tomography (HRCT), facilitate an intricate assessment of lung parenchyma and the airway architecture. These technologies enable precise identification of emphysema and various structural anomalies, along with comprehensive analysis of their prevalence and distribution across different populations. However, there is a notable paucity of studies employing these advanced imaging techniques to conduct an in-depth investigation of COPD, thereby highlighting the necessity for this research endeavor. Aim: This study aims to evaluate the utility of quantitative 3D CT analysis in assessing emphysema severity and its correlation with lung function and clinical outcomes among COPD patients in Mongolia. Materials and Methods: This retrospective study included 125 patients, diagnosed with COPD, and excluded 653 patients according to the exclusion criteria out of 778, over 40 years of age who underwent CT during hospitalization at the Pulmonology-Allergy Department of the First Central Hospital between June 2021 and July 2024. Quantitative CT analysis was conducted using the open-source 3D Slicer software (version 5.0.3). Results: In this study, gender was 4:1 male, female with a mean age of 68.12±10.5 years. The average body mass index (BMI) was 25.6±5.6. Out of the 125 patients, 97 (77.6%) were current smokers, and 28 (22.4%) had never smoked, average smoking was 34.02±22.04. BMI (r =-0.472, p<0.0001) and FEV1% (r=-0.487, p=0.0001) showed a moderate negative correlation, while the GOLD score (r=0.216, p=0.016) and COPD stage (r=0.4, p=0.0001) showed a positive correlation with the outcome. Furthermore, each unit increase in BMI leads to a 0.79% decrease in TLE% (r=0.099, p<0.001) and each 1% increase in TLE% leading to a 0.36% decrease in FEV1% (r=0.077, p=0.002). Also, there was a statistically significant positive relationship (r=0.326, p=0.0002) between TLE% and smoking year, with each additional year of smoking leading to a 0.16% increase in TLE% (r=0.059, p=0.006). Conclusion: Our study findings indicated that higher total lung emphysema percentage (TLE %) is associated with longer smoking duration, lower BMI, and reduced lung function, as measured by FEV1%. The study supports advanced imaging techniques such as 3D CT for more accurate diagnosis and monitoring of COPD.