# Automatic Emphysema Detection using Weakly Labeled HRCT Lung Images

## TL;DR

This paper introduces a weakly supervised machine learning approach using HRCT scans to automatically detect and quantify emphysema in COPD patients, reducing reliance on manual annotations and improving correlation with pulmonary function tests.

## Contribution

It presents a novel weakly labeled learning method for emphysema detection that does not require manual scan annotations, utilizing MIL classifiers trained on functional lung measurements.

## Key findings

- miSVM outperforms MILES in classification accuracy
- The method correlates strongly with pulmonary function tests
- It reduces inter-observer variability in emphysema assessment

## Abstract

A method for automatically quantifying emphysema regions using High-Resolution Computed Tomography (HRCT) scans of patients with chronic obstructive pulmonary disease (COPD) that does not require manually annotated scans for training is presented. HRCT scans of controls and of COPD patients with diverse disease severity are acquired at two different centers. Textural features from co-occurrence matrices and Gaussian filter banks are used to characterize the lung parenchyma in the scans. Two robust versions of multiple instance learning (MIL) classifiers, miSVM and MILES, are investigated. The classifiers are trained with the weak labels extracted from the forced expiratory volume in one minute (FEV$_1$) and diffusing capacity of the lungs for carbon monoxide (DLCO). At test time, the classifiers output a patient label indicating overall COPD diagnosis and local labels indicating the presence of emphysema. The classifier performance is compared with manual annotations by two radiologists, a classical density based method, and pulmonary function tests (PFTs). The miSVM classifier performed better than MILES on both patient and emphysema classification. The classifier has a stronger correlation with PFT than the density based method, the percentage of emphysema in the intersection of annotations from both radiologists, and the percentage of emphysema annotated by one of the radiologists. The correlation between the classifier and the PFT is only outperformed by the second radiologist. The method is therefore promising for facilitating assessment of emphysema and reducing inter-observer variability.