The applications of CT with artificial intelligence in the prognostic model of idiopathic pulmonary fibrosis

Abstract

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and heterogeneous interstitial lung disease with a median survival of 2–5 years. Though the diagnosis has been improved due to newly published guidelines, the recognition of the prognosis of IPF remains a challenge. Recently, several studies attempted to build prognostic models by extracting predictive variates from pulmonary function data, basic information, or chest computed tomography (CT) and CT-derived parameters with clinical characteristics. Artificial intelligence (AI) algorithms, including principal component analysis, support vector machine, random survival forest, and convolutional neural network, could be applied to the procedure of IPF prognostic model, that is, region of interest extraction, image feature selection, clinical feature selection, and model construction. Compared to human visualization, AI algorithms show a higher efficiency in calculating and extracting deep features and a lower inter-observer variation. Thus, this review provides a comprehensive CT evaluation of IPF prognostic models and discusses the role of AI in constructing IPF prognostic models. The potential improvements of AI in CT assessments, including time-series CT analysis, optimization of AI algorithms, utilization of multi-modal data, and discovery of new biomarkers through unsupervised algorithms, could be introduced to make a more accurate and convenient assessment for the prognosis of IPF patients. This review describes the status quo and future direction of AI applications in CT analysis for prognostic models of IPF. Take home message The review summarizes the applications of CT and AI algorithms for prognostic models in IPF and procedures of model construction. It reveals the current limitations and prospects of AI-aid models, and helps clinicians to recognize the AI algorithms and apply them to more clinical work.