Automated 3D chest CT muscle segmentation–derived model development and explanation in discrimination of normal, preserved ratio impaired spirometry, and COPD: a multicenter study.

Objectives: To develop and validate an automated 3D chest CT muscle segmentation model using an exploratory normalization method to discriminate normal, preserved ratio impaired spirometry (PRISm), and chronic obstructive pulmonary disease (COPD) subjects. Materials and methods: In this retrospectiv...

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Publicado en:Insights into Imaging Vol. 17; no. 1; pp. 1 - 16
Autores principales: Wang, Yi, Zhai, Weihao, Zhou, Qian, Zhou, Xiuxiu, Li, Yueze, Zhou, Taohu, Jiang, Xin'ang, Jin, Qianxi, Ge, Yanming, Dong, Peng, Wang, Ruoyao, Liu, Shiyuan, Fan, Li
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature 8/27/2026
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        10.1186/s13244-026-02384-4
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        atl: Automated 3D chest CT muscle segmentation–derived model development and explanation in discrimination of normal, preserved ratio impaired spirometry, and COPD: a multicenter study.
      aug:
        au:
          Wang, Yi
          Zhai, Weihao
          Zhou, Qian
          Zhou, Xiuxiu
          Li, Yueze
          Zhou, Taohu
          Jiang, Xin'ang
          Jin, Qianxi
          Ge, Yanming
          Dong, Peng
          Wang, Ruoyao
          Liu, Shiyuan
          Fan, Li
        affil: https://ror.org/04tavpn47 Department of Radiology, Second Affiliated Hospital of Naval Medical University, Shanghai, China
      sug:
        subj:
          Pulmonary Disease, Chronic Obstructive Radiography
          Tomography, X-Ray Computed
          Spirometry
          Muscle, Skeletal
          Image Processing, Computer Assisted
          Human
          Funding Source
          Male
          Female
          Aged
          Multicenter Studies
          Retrospective Design
          Record Review
          Prospective Studies
          Descriptive Statistics
          Confidence Intervals
          ROC Curve
          Interrater Reliability
          Intraclass Correlation Coefficient
          Analysis of Variance
          Kruskal-Wallis Test
          Data Analysis Software
          Diagnostic Imaging
          Machine Learning
          Sensitivity and Specificity
          Body Composition
          Scales
          Aged: 65+ years
          Male
          Female
      ab: Objectives: To develop and validate an automated 3D chest CT muscle segmentation model using an exploratory normalization method to discriminate normal, preserved ratio impaired spirometry (PRISm), and chronic obstructive pulmonary disease (COPD) subjects. Materials and methods: In this retrospective study, we used TotalSegmentator to acquire 3D pectoral muscle (PM) and erector spinae muscle (ESM) volumes from chest CT, normalizing them to height and vertebral bone volume, respectively. 2D quantitative parameters were acquired and normalized. The support vector machine models were developed based on normalized 3D and 2D muscle parameters, respectively, with ten-fold cross-validation. Receiver operating characteristic curves were used to analyze the discriminative performance of models, and the SHapley Additive exPlanations algorithm was used to quantify the importance of each parameter. Results: 1660 subjects (616 normal, 646 PRISm, 398 COPD) (median age, 66 years [IQR: 60–72 years]; 1014 males) were included and divided into training set (n = 1162), test set (n = 498). In the test set, the 3D model (macro-average AUC, 0.735; micro-average AUC, 0.733) outperformed the 2D model (macro-average AUC, 0.646; micro-average AUC, 0.665), and 3D ESM density was the most relevant muscle parameter. 3D muscle density showed a decreasing trend from normal to PRISm to COPD. In COPD, females exhibited decreased density (difference range: −14.48 to −7.79; p < 0.001), while males had a more significant decrease in volume, especially pectoralis major volume index (difference: −11.18; 95% CI −15.57, −5.08; p < 0.001). Conclusions: The 3D muscle parameter model demonstrated higher discriminative performance than the 2D model for discriminating normal, PRISm, and COPD subjects. Key Points: Question The discriminative performance of 3D CT-based muscle quantification in subjects with impaired pulmonary function remains unclear. Findings 3D muscle analysis achieved superior discrimination of normal, PRISm, and COPD subjects, with density-related parameters showing consistent group differences, particularly ESM density. Critical relevance By comparison with conventional 2D assessment, 3D CT-based muscle quantification showed better discrimination of normal, PRISm, and COPD, which might advance the personalized precision and comprehensive assessment, including muscle alteration for subjects with impaired pulmonary function.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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