Bragman Felix J S, McClelland Jamie R, Jacob Joseph, Hurst John R, Hawkes David J
Centre for Medical Image Computing, University College London, UK.
UCL Respiratory, University College London, UK.
Med Image Comput Comput Assist Interv. 2017 Sep;10435:46-54. doi: 10.1007/978-3-319-66179-7_6. Epub 2017 Sep 4.
Analysis of CT scans for studying Chronic Obstructive Pulmonary Disease (COPD) is generally limited to mean scores of disease extent. However, the evolution of local pulmonary damage may vary between patients with discordant effects on lung physiology. This limits the explanatory power of mean values in clinical studies. We present local disease and deformation distributions to address this limitation. The disease distribution aims to quantify two aspects of parenchymal damage: locally diffuse/dense disease and global homogeneity/heterogeneity. The deformation distribution links parenchymal damage to local volume change. These distributions are exploited to quantify inter-patient differences. We used manifold learning to model variations of these distributions in 743 patients from the COPDGene study. We applied manifold fusion to combine distinct aspects of COPD into a single model. We demonstrated the utility of the distributions by comparing associations between learned embeddings and measures of severity. We also illustrated the potential to identify trajectories of disease progression in a manifold space of COPD.
用于研究慢性阻塞性肺疾病(COPD)的CT扫描分析通常仅限于疾病范围的平均分数。然而,局部肺损伤的演变在不同患者之间可能有所不同,对肺生理产生不一致的影响。这限制了临床研究中平均值的解释力。我们提出局部疾病和变形分布以解决这一局限性。疾病分布旨在量化实质损伤的两个方面:局部弥漫性/致密性疾病和整体同质性/异质性。变形分布将实质损伤与局部体积变化联系起来。利用这些分布来量化患者间差异。我们使用流形学习对来自COPDGene研究的743名患者的这些分布变化进行建模。我们应用流形融合将COPD的不同方面组合成一个单一模型。通过比较学习到的嵌入与严重程度测量之间的关联,我们证明了这些分布的实用性。我们还展示了在COPD的流形空间中识别疾病进展轨迹的潜力。