CNN-based Deformable Registration Facilitates Fast and Accurate Air Trapping Measurements at Inspiratory and Expiratory CT (Jan, 10.1148/ryai.219003, 2022)

Purpose: To develop a convolutional neural network (CNN)–based deformable lung registration algorithm to reduce computation time and assess its potential for lobar air trapping quantification. Materials and Methods: In this retrospective study, a CNN algorithm was developed to perform deformable registration of lung CT (LungReg) using data on 9118 patients from the COPDGene Study (data collected between 2007 and 2012). Loss function constraints included cross-correlation, displacement field regularization, lobar segmentation overlap, and the Jacobian determinant. LungReg was compared with a standard diffeomorphic registration (SyN) for lobar Dice overlap, percentage voxels with nonpositive Jacobian determinants, and inference runtime using paired t tests. Landmark colocalization error (LCE) across 10 patients was compared using a random effects model. Agreement between LungReg and SyN air trapping measurements was assessed using intraclass correlation coefficient. The ability of LungReg versus SyN emphysema and air trapping measurements to predict Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages was compared using area under the receiver operating characteristic curves. Results: Average performance of LungReg versus SyN showed lobar Dice overlap score of 0.91–0.97 versus 0.89–0.95, respectively (P, .001); percentage voxels with nonpositive Jacobian determinant of 0.04 versus 0.10, respectively (P, .001); inference run time of 0.99 second (graphics processing unit) and 2.27 seconds (central processing unit) versus 418.46 seconds (central processing unit) (P, .001); and LCE of 7.21 mm versus 6.93 mm (P, .001). LungReg and SyN whole-lung and lobar air trapping measurements achieved excellent agreement (intraclass correlation coefficients. 0.98). LungReg versus SyN area under the receiver operating characteristic curves for predicting GOLD stage were not statistically different (range, 0.88–0.95 vs 0.88–0.95, respectively; P = .31–.95). Conclusion: CNN-based deformable lung registration is accurate and fully automated, with runtime feasible for clinical lobar air trapping quantification, and has potential to improve diagnosis of small airway diseases. © RSNA, 2021.