CT-Based Radiomic Nomogram for the Prediction of Chronic Obstructive Pulmonary Disease in Patients with Lung cancer.

RATIONALE AND OBJECTIVES: To develop and validate a model for predicting chronic obstructive pulmonary disease (COPD) in patients with lung cancer based on computed tomography (CT) radiomic signatures and clinical and imaging features. MATERIALS AND METHODS: We retrospectively enrolled 443 patients with lung cancer who underwent pulmonary function test as the primary cohort. They were randomly assigned to the training (n = 311) or validation (n = 132) set in a 7:3 ratio. Additionally, an independent external cohort of 54 patients was evaluated. The radiomic lung nodule signature was constructed using the least absolute shrinkage and selection operator algorithm, while key variables were selected using logistic regression to develop the clinical and combined models presented as a nomogram. RESULTS: COPD was significantly related to the radiomics signature in both cohorts. Moreover, the signature served as an independent predictor of COPD in the multivariate regression analysis. For the training, internal, and external cohorts, the area under the receiver operating characteristic curve (ROC, AUC) values of our radiomics signature for COPD prediction were 0.85, 0.85, and 0.76, respectively. Additionally, the AUC values of the radiomic nomogram for COPD prediction were 0.927, 0.879, and 0.762 for the three cohorts, respectively, which outperformed the other two models. CONCLUSION: The present study presents a nomogram that incorporates radiomics signatures and clinical and radiological features, which could be used to predict the risk of COPD in patients with lung cancer with one-stop chest CT scanning.