Optimizing Convolutional Neural Networks for Chronic Obstructive Pulmonary Disease Detection in Clinical Computed Tomography Imaging

Purpose: To optimize the binary detection of Chronic Obstructive Pulmonary Disease (COPD) based on emphysema presence in the lung with convolutional neural networks (CNN) by exploring manually adjusted versus automated window-setting optimization (WSO) on computed tomography (CT) images. Methods: 7,194 CT images (3,597 with COPD; 3,597 healthy controls) from 78 subjects (43 with COPD; 35 healthy controls) were selected retrospectively (10.2018-12.2019) and preprocessed. For each image, intensity values were manually clipped to the emphysema window setting and a baseline 'full-range' window setting. Class-balanced train, validation, and test sets contained 3,392, 1,114, and 2,688 images. The network backbone was optimized by comparing various CNN architectures. Furthermore, automated WSO was implemented by adding a customized layer to the model. The image-level area under the Receiver Operating Characteristics curve (AUC) [lower, upper limit 95% confidence] and P-values calculated from one-sided Mann-Whitney U-test were utilized to compare model variations. Results: Repeated inference (n=7) on the test set showed that the DenseNet was the most efficient backbone and achieved a mean AUC of 0.80 [0.76, 0.85] without WSO. Comparably, with input images manually adjusted to the emphysema window, the DenseNet model predicted COPD with a mean AUC of 0.86 [0.82, 0.89] (P=0.03). By adding a customized WSO layer to the DenseNet, an optimal window in the proximity of the emphysema window setting was learned automatically, and a mean AUC of 0.82 [0.78, 0.86] was achieved. Conclusion: Detection of COPD with DenseNet models was improved by WSO of CT data to the emphysema window setting range.