Abstract
Non-contrast (NC) computed tomography (CT) ventilation imaging derives surrogates of regional lung function from paired inspiratory and expiratory breath-hold scans, avoiding the cost and complexity of contrast agents. Two method families dominate: intensity-based measures, which capture local density change but ignore volume change, and transformation-based (Jacobian) measures, which capture volume change. Hybrid measures combine both, but comparative evidence spanning health and obstructive disease is scarce, and healthy controls are largely absent from the NC CT validation literature. Here, we report an independent comparison of three conceptually distinct methods in a retrospective cohort of 254 subjects (143 asthma, 65 COPD, 46 healthy): intensity-based (HUVent), transformation-based (JacVent), and a two-compartment air-tissue hybrid (HybridVent) method. Using whole-lung mean ventilation as the primary biomarker, all three methods separated COPD from healthy subjects strongly (area under the curve, AUC, up to 0.94) and asthmatics with airway obstruction from healthy subjects moderately (AUC ≈ 0.77), but none differentiated asthma without airway obstruction from health. Mean ventilation correlated moderately with FEV₁/FVC and FEV₁ % predicted. At the whole-lung scale discrimination was largely indistinguishable between methods, although only the hybrid separated COPD both with and without spirometric obstruction from health. Lobar analysis showed only the hybrid’s discrimination was lobe-dependent, separating COPD from health in the lower lobes (AUC up to 0.91) but not the upper.
Links to Paper and Supplementary Materials
Main Paper (Open Access Version): https://papers.miccai.org/miccai-2026-sat/paper/TIA_015.pdf
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SpringerLink (DOI): Not yet available
Supplementary Material: Not Submitted
Link to Open Review
Open Review Page: Not Available
BibTex
@InProceedings{ClaWil_Comparison_MICCAISAT2026,
author = { Clark, William AND Hartley, Ruth AND Novotny, Petr AND Astley, Joshua R. AND Biancardi, Alberto M. AND Marshall, Helen AND Soniya, Soniya AND Gerard, Sarah E. AND Reinhardt, Joseph M. AND Brightling, Christopher E. AND Wild, Jim M. AND Tahir, Bilal A.},
title = { { Comparison of intensity, transformation, and hybrid non-contrast CT ventilation methods for discriminating health from obstructive lung disease } },
booktitle = {Medical Image Computing and Computer Assisted Intervention -- MICCAI 2026 Workshops and Challenges},
year = {2026},
publisher = {Springer Nature Switzerland},
volume = {LNCS 17269},
month = {pending},
page = {pending}
}