Detection of chronic obstructive pulmonary disease with deep learning using inspiratory and expiratory chest computed tomography and clinical information.

Abstract

In recent years, more and more patients with chronic obstructive pulmonary disease (COPD) have remained undiagnosed despite having undergone medical examination. This study aimed to develop a convolutional neural network (CNN) model for automatically detecting COPD using double-phase (inspiratory and expiratory) chest computed tomography (CT) images and clinical information. A total of 2,047 participants, including never-smokers, ex-smokers, and current smokers, were prospectively recruited from three hospitals. The double-phase CT images and clinical information of each participant were collected for training the proposed CNN model which integrated a sequence of residual feature extracting blocks network (RFEBNet) for extracting CT image features and a fully connected feed-forward network (FCNet) for extracting clinical features. In addition, the RFEBNet utilizing double- or single-phase CT images and the FCNet using clinical information were conducted for comparison. The proposed CNN model, which utilized double-phase CT images and clinical information, outperformed other models in detecting COPD with an area under the receiver operating characteristic curve (AUC) of 0.930 [95% confidence interval (CI): 0.913-0.951] on an internal test set (n=307). The AUC was higher than the RFEBNet using double-phase CT images (AUC =0.912, 95% CI: 0.891-0.932), single inspiratory CT images (AUC =0.888, 95% CI: 0.863-0.915), single expiratory CT images (AUC =0.897, 95% CI: 0.874-0.925), and FCNet using clinical information (AUC =0.805, 95% CI: 0.777-0.841). The proposed model also achieved the best performance on an external test (n=516) with an AUC of 0.896 (95% CI: 0.871-0.931). The proposed CNN model using double-phase CT images and clinical information can automatically detect COPD with high accuracy.