Quantitative CT and Artificial Intelligence in Chronic Lung Disease

Computed tomography (CT) is routinely used in diagnosing and managing patients with chronic lung diseases such as chronic obstructive pulmonary disease (COPD) and fibrosing interstitial lung disease (ILD). Visual assessment of disease morphology/phenotype and extent correlates with lung function and patient prognosis, but it is limited by reader subjectivity and interobserver variability. Quantitative CT (QCT) techniques based on density and texture-based features of the lungs have shown stronger correlations with physiologic and survival outcomes in both COPD and ILD cohort studies. Moreover, recent advances in computer processing capabilities have led to the implementation of machine and deep learning-based approaches, allowing for greater robustness and reproducibility beyond visual assessment and density-based methods. This review focuses on QCT and artificial intelligence (AI) techniques for COPD, ILD, and bronchiolitis obliterans syndrome in lung and hematopoietic stem cell transplant recipients. Current challenges and limitations for adoption of these techniques and future directions of QCT and AI in thoracic imaging are also discussed.