Pulmonary hyperpolarized 3He MRI provides a way to measure lung ventilation heterogeneity in patients with COPD, including terminal airspace enlargement or emphysema that is typically quantified using CT densitometry. Unfortunately, MRI-derived biomarkers of emphysema progression remain unconfirmed, and also likely because of radiation dose considerations, CT follow-up of emphysema is rarely performed, and hence its longitudinal progression is not well-understood. Here we developed a machine-learning pipeline that identified hyperpolarized 3He MRI texture features that independently and uniquely correlated and predicted rapidly-worsening emphysema nearly 3 years later, measured as CT RA950, using a Decision Tree algorithm that achieved 82% prediction accuracy.
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