Deep radiomics-based survival prediction in patients with chronic obstructive pulmonary disease.

Journal: Scientific reports
Published Date:

Abstract

Heterogeneous clinical manifestations and progression of chronic obstructive pulmonary disease (COPD) affect patient health risk assessment, stratification, and management. Pulmonary function tests are used to diagnose and classify the severity of COPD, but they cannot fully represent the type or range of pathophysiologic abnormalities of the disease. To evaluate whether deep radiomics from chest computed tomography (CT) images can predict mortality in patients with COPD, we designed a convolutional neural network (CNN) model for extracting representative features from CT images and then performed random survival forest to predict survival in COPD patients. We trained CNN-based binary classifier based on six-minute walk distance results (> 440 m or not) and extracted high-throughput image features (i.e., deep radiomics) directly from the last fully connected layer of it. The various sizes of fully connected layers and combinations of deep features were experimented using a discovery cohort with 344 patients from the Korean Obstructive Lung Disease cohort and an external validation cohort with 102 patients from Penang General Hospital in Malaysia. In the integrative analysis of discovery and external validation cohorts, with combining 256 deep features from the coronal slice of the vertebral body and two sagittal slices of the left/right lung, deep radiomics for survival prediction achieved concordance indices of 0.8008 (95% CI, 0.7642-0.8373) and 0.7156 (95% CI, 0.7024-0.7288), respectively. Deep radiomics from CT images could be used to predict mortality in COPD patients.

Authors

  • Jihye Yun
    Department of Convergence Medicine, Biomedical Engineering Research Center, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil Songpa-Gu, Seoul 05505, South Korea.
  • Young Hoon Cho
    Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
  • Sang Min Lee
    Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • Jeongeun Hwang
    Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea.
  • Jae Seung Lee
    Department of Pulmonary and Critical Care Medicine, Asthma Center, and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Yeon-Mok Oh
    Department of Pulmonary and Critical Care Medicine, Asthma Center, and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Sang-Do Lee
    Department of Pulmonary and Critical Care Medicine, Asthma Center, and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Li-Cher Loh
    Department of Medicine, RCSI & UCD Malaysia Campus, Penang, Malaysia.
  • Choo-Khoon Ong
    Department of Medicine, RCSI & UCD Malaysia Campus, Penang, Malaysia.
  • Joon Beom Seo
    Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.
  • Namkug Kim
    Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.