@article {1674761,
	title = {Artificial Intelligence-based CT Assessment of Bronchiectasis: The COPDGene Study},
	journal = {Radiology},
	volume = {307},
	number = {1},
	year = {2023},
	month = {2023 Apr},
	pages = {e221109},
	abstract = {Background CT is the standard method used to assess bronchiectasis. A higher airway-to-artery diameter ratio (AAR) is typically used to identify enlarged bronchi and bronchiectasis; however, current imaging methods are limited in assessing the extent of this metric in CT scans. Purpose To determine the extent of AARs using an artificial intelligence-based chest CT and assess the association of AARs with exacerbations over time. Materials and Methods In a secondary analysis of ever-smokers from the prospective, observational, multicenter COPDGene study, AARs were quantified using an artificial intelligence tool. The percentage of airways with AAR greater than 1 (a measure of airway dilatation) in each participant on chest CT scans was determined. Pulmonary exacerbations were prospectively determined through biannual follow-up (from July 2009 to September 2021). Multivariable zero-inflated regression models were used to assess the association between the percentage of airways with AAR greater than 1 and the total number of pulmonary exacerbations over follow-up. Covariates included demographics, lung function, and conventional CT parameters. Results Among 4192 participants (median age, 59 years; IQR, 52-67 years; 1878 men [45\%]), 1834 had chronic obstructive pulmonary disease (COPD). During a 10-year follow-up and in adjusted models, the percentage of airways with AARs greater than 1 (quartile 4 vs 1) was associated with a higher total number of exacerbations (risk ratio [RR], 1.08; 95\% CI: 1.02, 1.15; P = .01). In participants meeting clinical and imaging criteria of bronchiectasis (ie, clinical manifestations with >=3\% of AARs \>1) versus those who did not, the RR was 1.37 (95\% CI: 1.31, 1.43; P \< .001). Among participants with COPD, the corresponding RRs were 1.10 (95\% CI: 1.02, 1.18; P = .02) and 1.32 (95\% CI: 1.26, 1.39; P \< .001), respectively. Conclusion In ever-smokers with chronic obstructive pulmonary disease, artificial intelligence-based CT measures of bronchiectasis were associated with more exacerbations over time. Clinical trial registration no. NCT00608764 {\textcopyright} RSNA, 2022 Supplemental material is available for this article. See also the editorial by Schiebler and Seo in this issue.},
	issn = {1527-1315},
	doi = {10.1148/radiol.221109},
	author = {D{\'\i}az, Alejandro A and Nardelli, Pietro and Wang, Wei and San Jos{\'e} Est{\'e}par, Rub{\'e}n and Yen, Andrew and Kligerman, Seth and Maselli, Diego J and Dolliver, Wojciech R and Tsao, Andrew and Orejas, Jos{\'e} L and Aliberti, Stefano and Aksamit, Timothy R and Young, Kendra A and Kinney, Gregory L and Washko, George R and Silverman, Edwin K and San Jos{\'e} Est{\'e}par, Ra{\'u}l}
}