Publication
Title
Computed tomography–based machine learning for donor lung screening before transplantation
Author
Abstract
Background Assessment and selection of donor lungs remain largely subjective and experience based. Criteria to accept or decline lungs are poorly standardized and are not compliant with the current donor pool. Using ex vivo computed tomography (CT) images, we investigated the use of a CT-based machine learning algorithm for screening donor lungs before transplantation. Methods Clinical measures and ex situ CT scans were collected from 100 cases as part of a prospective clinical trial. Following procurement, donor lungs were inflated, placed on ice according to routine clinical practice, and imaged using a clinical CT scanner before transplantation while stored in the icebox. We trained and tested a supervised machine learning method called dictionary learning, which uses CT scans and learns specific image patterns and features pertaining to each class for a classification task. The results were evaluated with donor and recipient clinical measures. Results Of the 100 lung pairs donated, 70 were considered acceptable for transplantation (based on standard clinical assessment) before CT screening and were consequently implanted. The remaining 30 pairs were screened but not transplanted. Our machine learning algorithm was able to detect pulmonary abnormalities on the CT scans. Among the patients who received donor lungs, our algorithm identified recipients who had extended stays in the intensive care unit and were at 19 times higher risk of developing chronic lung allograft dysfunction within 2 years posttransplant. Conclusions We have created a strategy to ex vivo screen donor lungs using a CT-based machine learning algorithm. As the use of suboptimal donor lungs rises, it is important to have in place objective techniques that will assist physicians in accurately screening donor lungs to identify recipients most at risk of posttransplant complications.
Language
English
Source (journal)
Journal of heart and lung transplantation. - St-Louis, Mo.
Publication
St-Louis, Mo. : 2024
ISSN
1053-2498
DOI
10.1016/J.HEALUN.2023.09.018
Volume/pages
43 :3 (2024) , p. 394-402
Pubmed ID
37778525
Full text (Publisher's DOI)
Full text (open access)
UAntwerpen
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Research group
Publication type
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Affiliation
Publications with a UAntwerp address
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Creation 12.12.2023
Last edited 30.03.2024
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