Multi-level digital-twin models of pulmonary mechanics: correlation analysis of 3D CT lung volume and 2D Chest motion.

Creating multi-level digital-twin models for mechanical ventilation requires a detailed estimation of regional lung volume. An accurate generic map between 2D chest surface motion and 3D regional lung volume could provide improved regionalisation and clinically acceptable estimates localising lung damage. This work investigates the relationship between CT lung volumes and the forced vital capacity (FVC) a surrogate of tidal volume proven linked to 2D chest motion. In particular, a convolutional neural network (CNN) with U-Net architecture is employed to build a lung segmentation model using a benchmark CT scan dataset. An automated thresholding method is proposed for image morphology analysis to improve model performance. Finally, the trained model is applied to an independent CT dataset with FVC measurements for correlation analysis of CT lung volume projection to lung recruitment capacity. Model training results show a clear improvement of lung segmentation performance with the proposed automated thresholding method compared to a typically suggested fixed value selection, achieving accuracy greater than 95% for both training and independent validation sets. The correlation analysis for 160 patients shows a good correlation ofsquared value of 0.73 between the proposed 2D volume projection and the FVC value, which indicates a larger and denser projection of lung volume relative to a greater FVC value and lung recruitable capacity. The overall results thus validate the potential of using non-contact, non-invasive 2D measures to enable regionalising lung mechanics models to equivalent 3D models with a generic map based on the good correlation. The clinical impact of improved lung mechanics digital twins due to regionalising the lung mechanics and volume to specific lung regions could be very high in managing mechanical ventilation and diagnosing or locating lung injury or dysfunction based on regular monitoring instead of intermittent and invasive lung imaging modalities.