{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T18:17:42Z","timestamp":1780337862445,"version":"3.54.1"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100001448","name":"Alpha-1 Foundation","doi-asserted-by":"publisher","award":["1037165"],"award-info":[{"award-number":["1037165"]}],"id":[{"id":"10.13039\/100001448","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute of Health","award":["1R01HL149877"],"award-info":[{"award-number":["1R01HL149877"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Digit. Med."],"DOI":"10.1038\/s41746-025-01917-3","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T17:11:44Z","timestamp":1756401104000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Emphysema progression risk in COPD using a localized foundational model of density evolution"],"prefix":"10.1038","volume":"8","author":[{"given":"Ariel H.","family":"Curiale","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Pistenmaa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rub\u00e9n","family":"San Jos\u00e9 Est\u00e9par","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro A.","family":"Diaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Washko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ra\u00fal","family":"San Jos\u00e9 Est\u00e9par","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"1917_CR1","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1517\/17425247.2011.588697","volume":"8","author":"L Marin","year":"2011","unstructured":"Marin, L., Colombo, P., Bebawy, M., Young, P. M. & Traini, D. Chronic obstructive pulmonary disease: patho-physiology, current methods of treatment and the potential for simvastatin in disease management. Expert Opin. Drug Deliv. 8, 1205\u20131220 (2011).","journal-title":"Expert Opin. Drug Deliv."},{"key":"1917_CR2","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1159\/000439544","volume":"90","author":"A Valipour","year":"2015","unstructured":"Valipour, A. et al. Patterns of emphysema heterogeneity. Respiration 90, 402\u2013411 (2015).","journal-title":"Respiration"},{"key":"1917_CR3","doi-asserted-by":"publisher","first-page":"1647","DOI":"10.1093\/aje\/kwad114","volume":"192","author":"PJ Castaldi","year":"2023","unstructured":"Castaldi, P. J. et al. Heterogeneity and progression of chronic obstructive pulmonary disease: emphysema-predominant and non\u2013emphysema-predominant disease. Am. J. Epidemiol. 192, 1647\u20131658 (2023).","journal-title":"Am. J. Epidemiol."},{"key":"1917_CR4","unstructured":"World Health Organization. Chronic obstructive pulmonary disease (COPD). https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/chronic-obstructive-pulmonary-disease-(copd). 12, 2025 (2024)"},{"key":"1917_CR5","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","volume":"396","author":"T Vos","year":"2020","unstructured":"Vos, T. et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396, 1204\u20131222 (2020).","journal-title":"Lancet"},{"key":"1917_CR6","doi-asserted-by":"publisher","first-page":"1326","DOI":"10.1164\/rccm.200510-1677OC","volume":"173","author":"FJ Martinez","year":"2006","unstructured":"Martinez, F. J. et al. Predictors of mortality in patients with emphysema and severe airflow obstruction. Am. J. Respir. Crit. Care Med 173, 1326\u20131334 (2006).","journal-title":"Am. J. Respir. Crit. Care Med"},{"key":"1917_CR7","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.rmed.2009.08.004","volume":"104","author":"HA Gietema","year":"2010","unstructured":"Gietema, H. A. et al. Distribution of emphysema in heavy smokers: Impact on pulmonary function. Respir. Med 104, 76\u201382 (2010).","journal-title":"Respir. Med"},{"key":"1917_CR8","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1148\/radiol.2018172294","volume":"288","author":"DA Lynch","year":"2018","unstructured":"Lynch, D. A. et al. CT-based visual classification of emphysema: Association with mortality in the COPDGene study. Radiology 288, 859\u2013866 (2018).","journal-title":"Radiology"},{"key":"1917_CR9","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1111\/crj.12432","volume":"11","author":"X Tang","year":"2017","unstructured":"Tang, X. et al. Emphysema is an independent risk factor for 5-year mortality in patients with bronchiectasis. Clin. Respiratory J. 11, 887\u2013894 (2017).","journal-title":"Clin. Respiratory J."},{"key":"1917_CR10","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1148\/radiol.2021203531","volume":"299","author":"SY Ash","year":"2021","unstructured":"Ash, S. Y. et al. Relationship between emphysema progression at CT and mortality in ever-smokers: results from the COPDGene and ECLIPSE Cohorts. Radiology 299, 222\u2013231 (2021).","journal-title":"Radiology"},{"key":"1917_CR11","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1183\/09031936.04.00026504","volume":"23","author":"JD Newell","year":"2004","unstructured":"Newell, J. D., Hogg, J. C. & Snider, G. L. Report of a workshop: quantitative computed tomography scanning in longitudinal studies of emphysema. Eur. Respiratory J. 23, 769\u2013775 (2004).","journal-title":"Eur. Respiratory J."},{"key":"1917_CR12","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1148\/radiol.2443061330","volume":"244","author":"HA Gietema","year":"2007","unstructured":"Gietema, H. A. et al. Monitoring of smoking-induced emphysema with CT in a lung cancer screening setting: detection of real increase in extent of emphysema. Radiology 244, 890\u2013897 (2007).","journal-title":"Radiology"},{"key":"1917_CR13","doi-asserted-by":"publisher","unstructured":"Milne, S. & King, G. G. Advanced imaging in COPD: Insights into pulmonary pathophysiology. J. Thorac. Dis. https:\/\/doi.org\/10.3978\/j.issn.2072-1439.2014.11.30 (2014).","DOI":"10.3978\/j.issn.2072-1439.2014.11.30"},{"key":"1917_CR14","doi-asserted-by":"publisher","unstructured":"Parr, D. G., Sevenoaks, M., Deng, C., Stoel, B. C. & Stockley, R. A. Detection of emphysema progression in alpha 1-antitrypsin deficiency using CT densitometry; Methodological advances. Respir. Res. https:\/\/doi.org\/10.1186\/1465-9921-9-21 (2008).","DOI":"10.1186\/1465-9921-9-21"},{"key":"1917_CR15","doi-asserted-by":"publisher","first-page":"1345","DOI":"10.1183\/09031936.00159408","volume":"33","author":"A Dirksen","year":"2009","unstructured":"Dirksen, A. et al. Exploring the role of CT densitometry: a randomised study of augmentation therapy in alpha 1-antitrypsin deficiency. Eur. Respiratory J. 33, 1345\u20131353 (2009).","journal-title":"Eur. Respiratory J."},{"key":"1917_CR16","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s12194-017-0394-5","volume":"10","author":"B van Ginneken","year":"2017","unstructured":"van Ginneken, B. Fifty years of computer analysis in chest imaging: rule-based, machine learning, deep learning. Radio. Phys. Technol. 10, 23\u201332 (2017).","journal-title":"Radio. Phys. Technol."},{"key":"1917_CR17","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1164\/ajrccm.156.1.9606093","volume":"156","author":"R Uppaluri","year":"1997","unstructured":"Uppaluri, R., Mitsa, T., Sonka, M., Hoffman, E. A. & McLennan, G. Quantification of pulmonary emphysema from lung computed tomography images. Am. J. Respir. Crit. Care Med. 156, 248\u2013254 (1997).","journal-title":"Am. J. Respir. Crit. Care Med"},{"key":"1917_CR18","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1016\/j.acra.2012.04.020","volume":"19","author":"SB Ginsburg","year":"2012","unstructured":"Ginsburg, S. B., Lynch, D. A., Bowler, R. P. & Schroeder, J. D. Automated texture-based quantification of centrilobular nodularity and centrilobular emphysema in chest CT images. Acad. Radio. 19, 1241\u20131251 (2012).","journal-title":"Acad. Radio."},{"key":"1917_CR19","doi-asserted-by":"publisher","unstructured":"Serrano, G. G., Washko, G. R. & Est\u00e9par, R. S. J. Deep learning for biomarker regression: application to osteoporosis and emphysema on chest CT scans, in Medical Imaging 2018: Image Processing, E. D. Angelini and B. A. Landman, Eds., SPIE, 2018. https:\/\/doi.org\/10.1117\/12.2293455.","DOI":"10.1117\/12.2293455"},{"key":"1917_CR20","doi-asserted-by":"crossref","unstructured":"Singla, S. et al. Subject2Vec: generative-discriminative approach from a set of image patches to a vector. In Medical Image Computing and Computer Assisted Intervention MICCAI 2018, Springer International Publishing, 2018, 502\u2013510.","DOI":"10.1007\/978-3-030-00928-1_57"},{"key":"1917_CR21","doi-asserted-by":"crossref","unstructured":"Gorbunova, V. et al. Early detection of emphysema progression. In Medical Image Computing and Computer-Assisted Intervention MICCAI 2010, Springer Berlin Heidelberg, 2010, 193\u2013200.","DOI":"10.1007\/978-3-642-15745-5_24"},{"key":"1917_CR22","doi-asserted-by":"publisher","unstructured":"Staring, M. et al. Towards local estimation of emphysema progression using image registration, in SPIE Proceedings, J. P. W. Pluim and B. M. Dawant, Eds., SPIE, 2009. https:\/\/doi.org\/10.1117\/12.811576.","DOI":"10.1117\/12.811576"},{"key":"1917_CR23","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/S2213-2600(13)70006-7","volume":"1","author":"HO Coxson","year":"2013","unstructured":"Coxson, H. O. et al. The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression: a prospective analysis from the ECLIPSE study. Lancet Respir. Med. 1, 129\u2013136 (2013).","journal-title":"Lancet Respir. Med."},{"key":"1917_CR24","doi-asserted-by":"publisher","unstructured":"Tanabe, N. et al. Longitudinal study of spatially heterogeneous emphysema progression in current smokers with chronic obstructive pulmonary disease, PLoS One https:\/\/doi.org\/10.1371\/journal.pone.0044993 (2012).","DOI":"10.1371\/journal.pone.0044993"},{"key":"1917_CR25","doi-asserted-by":"crossref","unstructured":"Woo, S., Park, J., Lee, J. Y. & Kweon, I. S. CBAM: convolutional block attention module. CoRR http:\/\/arxiv.org\/abs\/1807.06521 (2018)","DOI":"10.1007\/978-3-030-01234-2_1"},{"key":"1917_CR26","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.neucom.2021.02.091","volume":"443","author":"Y Huang","year":"2021","unstructured":"Huang, Y. et al. See more than once: Kernel-sharing atrous convolution for semantic segmentation. Neurocomputing 443, 26\u201334 (2021).","journal-title":"Neurocomputing"},{"key":"1917_CR27","doi-asserted-by":"publisher","first-page":"32","DOI":"10.3109\/15412550903499522","volume":"7","author":"EA Regan","year":"2010","unstructured":"Regan, E. A. et al. Genetic epidemiology of COPD (COPDGene) study design. COPD: J. Chronic Obstr. Pulm. Dis. 7, 32\u201343 (2010).","journal-title":"COPD: J. Chronic Obstr. Pulm. Dis."},{"key":"1917_CR28","unstructured":"Global Initiative for Chronic Obstructive Lung Disease, Global strategy for the diagnosis, mangement, and prevention of chronic obstructive pulmonary disease, 2023 report. Available at: https:\/\/goldcopd.org\/wp-content\/uploads\/2022\/12\/GOLD-2023-ver-1.1-2Dec2022_WMV.pdf (Accessed: 12 August 2025)."},{"key":"1917_CR29","doi-asserted-by":"publisher","unstructured":"JVestbo J. et al. Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE). Eur. Respir. J. https:\/\/doi.org\/10.1183\/09031936.00111707 (2008).","DOI":"10.1183\/09031936.00111707"},{"key":"1917_CR30","doi-asserted-by":"publisher","unstructured":"Tsutsumi, A. et al. Characteristics of chronic obstructive pulmonary disease patients with robust progression of emphysematous change. Sci. Rep. https:\/\/doi.org\/10.1038\/s41598-021-87724-8 (2021).","DOI":"10.1038\/s41598-021-87724-8"},{"key":"1917_CR31","doi-asserted-by":"publisher","unstructured":"Shaker, S. B. et al. Factors influencing the decline in lung density in a Danish lung cancer screening cohort. Eur. Respir. J. https:\/\/doi.org\/10.1183\/09031936.00207911 (2012).","DOI":"10.1183\/09031936.00207911"},{"key":"1917_CR32","doi-asserted-by":"publisher","unstructured":"Jobst, B. J. et al. Effect of smoking cessation on quantitative computed tomography in smokers at risk in a lung cancer screening population. Eur. Radiol. https:\/\/doi.org\/10.1007\/s00330-017-5030-6 (2018).","DOI":"10.1007\/s00330-017-5030-6"},{"key":"1917_CR33","doi-asserted-by":"publisher","unstructured":"Shaker, S. B., Stavngaard, T., Laursen, L. C., Stoel, B. C. & Dirksen, A. Rapid fall in lung density following smoking cessation in COPD. COPD: J. Chronic Obstruct. Pul. Dis https:\/\/doi.org\/10.3109\/15412555.2010.541306 (2011).","DOI":"10.3109\/15412555.2010.541306"},{"key":"1917_CR34","doi-asserted-by":"crossref","unstructured":"Tian, L. et al. GradICON: approximate diffeomorphisms via gradient inverse consistency. In Proceedings of the IEEE\/CVF Conference on Computer Vision and Pattern Recognition, 18084\u201318094 (2023).","DOI":"10.1109\/CVPR52729.2023.01734"},{"key":"1917_CR35","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s43556-023-00144-0","volume":"4","author":"R Zhou","year":"2023","unstructured":"Zhou, R., Yang, G., Zhang, Y. & Wang, Y. Spatial transcriptomics in development and disease. Mol. biomedicine 4, 32 (2023).","journal-title":"Mol. biomedicine"},{"key":"1917_CR36","doi-asserted-by":"crossref","unstructured":"Curiale, A. H. & San Jose Estepar, R. Detection of local emphysema progression using conditional CNN, in SPIE Medical Imaging (San Diego, 2024).","DOI":"10.1117\/12.3006943"},{"key":"1917_CR37","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1164\/rccm.201305-0873OC","volume":"188","author":"PJ Castaldi","year":"2013","unstructured":"Castaldi, P. J. et al. Distinct quantitative computed tomography emphysema patterns are associated with physiology and function in smokers. Am. J. Respir. Crit. Care Med 188, 1083\u20131090 (2013).","journal-title":"Am. J. Respir. Crit. Care Med"},{"key":"1917_CR38","first-page":"474","volume":"2012","author":"CS Mendoza","year":"2012","unstructured":"Mendoza, C. S. et al. Emphysema quantification in a multi-scanner HRCT cohort using local intensity distributions. 9th IEEE Int. Symp. Biomed. Imaging (ISBI) 2012, 474\u2013477 (2012).","journal-title":"9th IEEE Int. Symp. Biomed. Imaging (ISBI)"},{"key":"1917_CR39","unstructured":"Ramachandran, P., Zoph, B. & Le, Q. V. Searching for activation functions, arXiv preprint arXiv:1710.05941 (2017)."}],"container-title":["npj Digital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01917-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01917-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01917-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T05:11:44Z","timestamp":1757481104000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01917-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,28]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1917"],"URL":"https:\/\/doi.org\/10.1038\/s41746-025-01917-3","relation":{},"ISSN":["2398-6352"],"issn-type":[{"value":"2398-6352","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,28]]},"assertion":[{"value":"22 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"556"}}