Faculty, Staff and Student Publications

Language

English

Publication Date

4-1-2023

Journal

Radiology

DOI

10.1148/radiol.221109

PMID

36511808

PMCID

PMC10068886

PubMedCentral® Posted Date

12-13-2022

PubMedCentral® Full Text Version

Post-print

Abstract

Background

CT is the standard method used to assess bronchiectasis. A higher airway-to-artery diameter ratio (AAR) is typically used to identify enlarged bronchi and bronchiectasis; however, current imaging methods are limited in assessing the extent of this metric in CT scans.

Purpose

To determine the extent of AARs using an artificial intelligence–based chest CT and assess the association of AARs with exacerbations over time.

Materials and Methods

In a secondary analysis of ever-smokers from the prospective, observational, multicenter COPDGene study, AARs were quantified using an artificial intelligence tool. The percentage of airways with AAR greater than 1 (a measure of airway dilatation) in each participant on chest CT scans was determined. Pulmonary exacerbations were prospectively determined through biannual follow-up (from July 2009 to September 2021). Multivariable zero-inflated regression models were used to assess the association between the percentage of airways with AAR greater than 1 and the total number of pulmonary exacerbations over follow-up. Covariates included demographics, lung function, and conventional CT parameters.

Results

Among 4192 participants (median age, 59 years; IQR, 52–67 years; 1878 men [45%]), 1834 had chronic obstructive pulmonary disease (COPD). During a 10-year follow-up and in adjusted models, the percentage of airways with AARs greater than 1 (quartile 4 vs 1) was associated with a higher total number of exacerbations (risk ratio [RR], 1.08; 95% CI: 1.02, 1.15; P = .01). In participants meeting clinical and imaging criteria of bronchiectasis (ie, clinical manifestations with ≥3% of AARs >1) versus those who did not, the RR was 1.37 (95% CI: 1.31, 1.43; P < .001). Among participants with COPD, the corresponding RRs were 1.10 (95% CI: 1.02, 1.18; P = .02) and 1.32 (95% CI: 1.26, 1.39; P < .001), respectively.

Conclusion

In ever-smokers with chronic obstructive pulmonary disease, artificial intelligence-based CT measures of bronchiectasis were associated with more exacerbations over time.

Keywords

Aged, Female, Humans, Male, Middle Aged, Artificial Intelligence, Bronchi, Bronchiectasis, Follow-Up Studies, Pulmonary Disease, Chronic Obstructive, Regression Analysis, Smokers, Tomography, Emission-Computed, Cohort Studies

Comments

Clinical trial registration no. NCT00608764

Published Open-Access

yes

Additional Files
radiol.221109.VA.jpg (88 kB)
Graphical Abstract
Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.