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Abstract
Chronic obstructive pulmonary disease (COPD) is a respiratory disorder involving abnormalities of lung parenchymal morphology with different severities. COPD is assessed by pulmonary-function tests and computed tomography-based approaches. We introduce a new classification method for COPD grouping based on deep learning and a parametric-response mapping (PRM) method. We extracted parenchymal functional variables of functional small airway disease percentage (fSAD%) and emphysema percentage (Emph%) with an image registration technique, being provided as input parameters of 3D convolutional neural network (CNN). The integrated 3D-CNN and PRM (3D-cPRM) achieved a classification accuracy of 89.3% and a sensitivity of 88.3% in five-fold cross-validation. The prediction accuracy of the proposed 3D-cPRM exceeded those of the 2D model and traditional 3D CNNs with the same neural network, and was comparable to that of 2D pretrained PRM models. We then applied a gradient-weighted class activation mapping (Grad-CAM) that highlights the key features in the CNN learning process. Most of the class-discriminative regions appeared in the upper and middle lobes of the lung, consistent with the regions of elevated fSAD% and Emph% in COPD subjects. The 3D-cPRM successfully represented the parenchymal abnormalities in COPD and matched the CT-based diagnosis of COPD.
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1 Kyungpook National University, School of Mechanical Engineering, Daegu, Republic of Korea (GRID:grid.258803.4) (ISNI:0000 0001 0661 1556)
2 Kangwon National University, Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea (GRID:grid.412010.6) (ISNI:0000 0001 0707 9039)
3 Seoul National University Hospital, Department of Radiology, College of Medicine, Seoul National University, Seoul, Republic of Korea (GRID:grid.412484.f) (ISNI:0000 0001 0302 820X); The University of Iowa, Department of Radiology, College of Medicine, Iowa City, USA (GRID:grid.214572.7) (ISNI:0000 0004 1936 8294)
4 Research Institute of Clinical Medicine of Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, Department of Radiology, Jeonju, Republic of Korea (GRID:grid.214572.7)
5 Kangwon National University Hospital, Kangwon National University School of Medicine, Department of Radiology, Chuncheon, Republic of Korea (GRID:grid.412010.6) (ISNI:0000 0001 0707 9039)
6 Research Institute of Clinical Medicine of Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, Department of Radiology, Jeonju, Republic of Korea (GRID:grid.412010.6)
7 Kosin University, Department of Medical Humanities and Social Medicine, College of Medicine, Busan, Republic of Korea (GRID:grid.411144.5) (ISNI:0000 0004 0532 9454)