ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
This article is part of the Research TopicRecent developments in artificial intelligence and radiomicsView all 11 articles
Habitat imaging radiomics of chest CT identifies noninfectious acute exacerbations in chronic obstructive pulmonary disease
Provisionally accepted
Zhenxing Feng
Liang Shuo
Minghui HuaYafang ZhengJiwei SunLi Zhou
Yimeng ZhangBoxin LiYi LiBaozhen Ge
Hong Zhang*
Daqiang Sun*- Tianjin Chest Hospital, Tianjin, China
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Objective: Noninfectious acute exacerbations of chronic obstructive pulmonary disease (AECOPD) pose significant diagnostic challenges due to the lack of reliable biomarkers. This study aims to develop and validate a CT-based habitat imaging radiomic model for precise identification of noninfectious AECOPD. Methods: This retrospective study included 352 eligible chronic obstructive pulmonary disease (COPD) patients who received treatment at Tianjin Chest Hospital from January 2019 to December 2023. Among these patients (181 with noninfectious AECOPD, 171 with stable COPD), stratified randomization allocated cohorts to training (n=211) and testing (n=141) cohorts. Whole-lung CT scans were subjected to habitat mapping by voxel-wise K-means clustering, with radiomic features derived from habitat subregions and optimized using least absolute shrinkage and selection operator regression. Logistic regression (LR) and support vector machine (SVM) models combined habitat-derived traits with clinical factors. Results: The CT-based whole lung was segmented into three habitat subregions: habitat subregion 1 (emphysema/bullae-associated), habitat subregion 2 (bronchovascular bundle), and habitat subregion 3 (lung parenchyma). The habitattotal model showed predictive power for identifying noninfectious AECOPD (training: AUC=0.853 [LR], 0.897 [SVM]; test: AUC=0.800 [LR], 0.807 [SVM]). Multivariate analysis identified habitattotal score and GOLD stage as independent predictors of noninfectious AECOPD (p<0.001). Conclusion: In conclusion, this study segmented whole-lung CT scans of noninfectious AECOPD patients into habitat subregions, developing a radiomics model that demonstrated strong diagnostic efficacy. This approach provides an objective imaging biomarker and a potential tool for quantifying COPD heterogeneity.The habitat radiomics model exhibits strong diagnostic efficacy for the detection of noninfectious AECOPD.
Keywords: habitat, Radiomics, chronic obstructive pulmonary disease, Acute exacerbation, CT
Received: 05 Oct 2025; Accepted: 11 Dec 2025.
Copyright: © 2025 Feng, Shuo, Hua, Zheng, Sun, Zhou, Zhang, Li, Li, Ge, Zhang and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hong Zhang
Daqiang Sun
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