{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T17:11:02Z","timestamp":1760116262793,"version":"build-2065373602"},"reference-count":45,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T00:00:00Z","timestamp":1734739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Objectives: Thin-section CT (TSCT) is currently the most sensitive imaging modality for detecting bronchiectasis. However, conventional TSCT or HRCT may overlook subtle lung involvement such as alveolar and interstitial changes. Artificial Intelligence (AI)-based analysis offers the potential to identify novel information on lung parenchymal involvement that is not easily detectable with traditional imaging techniques. This study aimed to assess lung involvement in patients with bronchiectasis using the Bronchiectasis Radiologically Indexed CT Score (BRICS) and AI-based quantitative lung texture analysis software (IMBIO, Version 2.2.0). Methods: A cross-sectional study was conducted on 45 subjects diagnosed with bronchiectasis. The BRICS severity score was used to classify the severity of bronchiectasis into four categories: Mild, Moderate, Severe, and tractional bronchiectasis. Lung texture mapping using the IMBIO AI software tool was performed to identify abnormal lung textures, specifically focusing on detecting alveolar and interstitial involvement. Results: Based on the Bronchiectasis Radiologically Indexed CT Score (BRICS), the severity of bronchiectasis was classified as Mild in 4 (8.9%) participants, Moderate in 14 (31.1%), Severe in 11 (24.4%), and tractional in 16 (35.6%). AI-based lung texture analysis using IMBIO identified significant alveolar and interstitial abnormalities, offering insights beyond conventional HRCT findings. This study revealed trends in lung hyperlucency, ground-glass opacity, reticular changes, and honeycombing across severity levels, with advanced disease stages showing more pronounced structural and vascular alterations. Elevated pulmonary vascular volume (PVV) was noted in cases with higher BRICSs, suggesting increased vascular remodeling in severe and tractional types. Conclusions: AI-based lung texture analysis provides valuable insights into lung parenchymal involvement in bronchiectasis that may not be detectable through conventional HRCT. Identifying significant alveolar and interstitial abnormalities underscores the potential impact of AI on improving the understanding of disease pathology and disease progression, and guiding future therapeutic strategies.<\/jats:p>","DOI":"10.3390\/diagnostics14242883","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T05:58:27Z","timestamp":1734933507000},"page":"2883","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Artificial Intelligence Unveils the Unseen: Mapping Novel Lung Patterns in Bronchiectasis via Texture Analysis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9617-8740","authenticated-orcid":false,"given":"Athira","family":"Nair","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570004, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8829-4028","authenticated-orcid":false,"given":"Rakesh","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570004, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2236-4588","authenticated-orcid":false,"given":"Mandya Venkateshmurthy","family":"Greeshma","sequence":"additional","affiliation":[{"name":"Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Center and ICMR Collaborating Center of Excellence\u2014ICMR-CCoE), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570015, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5341-6423","authenticated-orcid":false,"given":"Deepak","family":"Benny","sequence":"additional","affiliation":[{"name":"Department of Radiology, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570004, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikram","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Radiology, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570004, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9167-9271","authenticated-orcid":false,"given":"SubbaRao V.","family":"Madhunapantula","sequence":"additional","affiliation":[{"name":"Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Center and ICMR Collaborating Center of Excellence\u2014ICMR-CCoE), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570015, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biligere Siddaiah","family":"Jayaraj","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570004, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sindaghatta Krishnarao","family":"Chaya","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570004, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suhail Azam","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570004, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5651-1123","authenticated-orcid":false,"given":"Komarla Sundararaja","family":"Lokesh","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570004, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhlisa Muhammaed Ali","family":"Laila","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570004, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2693-4281","authenticated-orcid":false,"given":"Vadde","family":"Vijayalakshmi","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570004, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sivasubramaniam","family":"Karunakaran","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570004, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shreya","family":"Sathish","sequence":"additional","affiliation":[{"name":"Father Muller Medical College, Mangaluru 575002, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1632-5945","authenticated-orcid":false,"given":"Padukudru Anand","family":"Mahesh","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570004, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"180016","DOI":"10.1183\/16000617.0016-2018","article-title":"Bronchiectasis: A case-based approach to investigation and management","volume":"27","author":"Contarini","year":"2018","journal-title":"Eur. Respir. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1183\/13993003.00954-2015","article-title":"Bronchiectasis in Germany:A population-based estimation of disease prevalence","volume":"46","author":"Ringshausen","year":"2015","journal-title":"Eur. Respir. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.rmed.2016.10.014","article-title":"Prevalence and incidence of bronchiectasis in Catalonia, Spain: A population-based study","volume":"121","author":"Monteagudo","year":"2016","journal-title":"Respir. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1183\/13993003.01033-2015","article-title":"Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013:A population-based cohort study","volume":"47","author":"Quint","year":"2016","journal-title":"Eur. Respir. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1177\/1479972317709649","article-title":"Prevalence and incidence of noncystic fibrosis bronchiectasis among US adults in 2013","volume":"14","author":"Weycker","year":"2017","journal-title":"Chron. Respir. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1513\/AnnalsATS.201511-740PS","article-title":"Bronchiectasis in China","volume":"13","author":"Lin","year":"2016","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"99","DOI":"10.4103\/0970-258X.310987","article-title":"Bronchiectasis in India: Results from the EMBARC and Respiratory Research Network of India Registry","volume":"33","author":"Hariprasad","year":"2020","journal-title":"Natl. Med. J. India"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1136\/thx.7.3.213","article-title":"A Study of the Pathology and Pathogenesis of Bronchiectasis","volume":"7","author":"Whitwell","year":"1952","journal-title":"Thorax"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"190051","DOI":"10.1183\/16000617.0051-2019","article-title":"Is bronchiectasis really a disease?","volume":"29","author":"Shteinberg","year":"2020","journal-title":"Eur. Respir. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Tolouee, A., Abrishami-Moghaddam, H., Garnavi, R., Forouzanfar, M., and Giti, M. (2008, January 1\u20133). Texture Analysis in lung HRCT images. Proceedings of the Digital Image Computing: Techniques and Applications [DICTA2008], Canberra, Australia.","DOI":"10.1109\/DICTA.2008.27"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"82","DOI":"10.4103\/1817-1737.39675","article-title":"HRCT score in bronchiectasis: Correlation with pulmonary function tests and pulmonary artery pressure","volume":"3","author":"Alzeer","year":"2008","journal-title":"Ann. Thorac. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1148\/radiology.195.3.7753989","article-title":"Bronchiectasis: Comparison of preoperative thin-section CT and pathologic findings in resected specimens","volume":"195","author":"Kang","year":"1995","journal-title":"Radiology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1183\/09031936.04.00142903","article-title":"HRCT lung abnormalities are not a surrogate for exercise limitation in bronchiectasis","volume":"24","author":"Edwards","year":"2004","journal-title":"Eur. Respir. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.crad.2006.08.015","article-title":"Bronchiectasis: Correlation of high-resolution CT findings with health-related quality of life","volume":"62","author":"Eshed","year":"2007","journal-title":"Clin. Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/S1579-2129(06)60410-2","article-title":"Internal consistency and validity of the Spanish version of the St George\u2019s respiratory questionnaire for use in patients with clinically stable bronchiectasis","volume":"41","author":"Tordera","year":"2005","journal-title":"Arch. Bronconeumol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"190120","DOI":"10.1183\/16000617.0120-2019","article-title":"The radiological diagnosis of bronchiectasis: What\u2019s in a name?","volume":"29","author":"Tiddens","year":"2020","journal-title":"Eur. Respir. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/j.chest.2017.11.033","article-title":"The BRICS [Bronchiectasis Radiologically Indexed CT Score]","volume":"153","author":"Bedi","year":"2018","journal-title":"Chest J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1097\/RTI.0b013e3182a21969","article-title":"Quantitative computed tomography imaging of interstitial lung diseases","volume":"28","author":"Bartholmai","year":"2013","journal-title":"J. Thorac. Imaging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1183\/09031936.00071812","article-title":"Automated quantification of radiological patterns predicts survival in idiopathic pulmonary fibrosis","volume":"43","author":"Maldonado","year":"2014","journal-title":"Eur. Respir. J."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Occhipinti, M., Bosello, S., Sisti, L.G., Cicchetti, G., De Waure, C., Pirronti, T., Ferraccioli, G., Gremese, E., and Larici, A.R. (2019). Quantitative and semi-quantitative computed tomography analysis of interstitial lung disease associated with systemic sclerosis: A longitudinal evaluation of pulmonary parenchyma and vessels. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0213444"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"John, J., Clark, A.R., Kumar, H., Vandal, A.C., Burrowes, K.S., Wilsher, M.L., Milne, D.G., Bartholmai, B., Levin, D.L., and Karwoski, R. (2023). Pulmonary vessel volume in idiopathic pulmonary fibrosis compared with healthy controls aged\u2009>\u200950 years. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-31470-6"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"00503","DOI":"10.1183\/23120541.00503-2021","article-title":"Severe pulmonary hypertension associated with lung disease is characterised by a loss of small pulmonary vessels on quantitative computed tomography","volume":"8","author":"Alkhanfar","year":"2022","journal-title":"ERJ Open Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"411","DOI":"10.2147\/COPD.S6133","article-title":"The pathophysiology of bronchiectasis","volume":"4","author":"King","year":"2009","journal-title":"Int. J. Chron. Obs. Pulmon Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1183\/13993003.01878-2015","article-title":"Emphysema- and airway-dominant COPD phenotypes defined by standardised quantitative computed tomography","volume":"48","author":"Subramanian","year":"2016","journal-title":"Eur. Respir. J."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Amariei, D.E., Dodia, N., Deepak, J., Hines, S.E., Galvin, J.R., Atamas, S.P., and Todd, N.W. (2019). Combined Pulmonary Fibrosis and Emphysema: Pulmonary Function Testing and a Pathophysiology Perspective. Medicina, 55.","DOI":"10.3390\/medicina55090580"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1183\/09031936.05.00021005","article-title":"Combined pulmonary fibrosis and emphysema: A distinct underrecognised entity","volume":"26","author":"Cottin","year":"2005","journal-title":"Eur. Respir. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"646","DOI":"10.4103\/0970-2113.192880","article-title":"Quantitative computed tomography imaging in chronic obstructive pulmonary disease","volume":"33","author":"Fernandes","year":"2016","journal-title":"Lung India"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Zhang, H., Li, X., Zhang, X., Yuan, Y., Zhao, C., and Zhang, J. (2024). Quantitative CT analysis of idiopathic pulmonary fibrosis and correlation with lung function study. BMC Pulm. Med., 24.","DOI":"10.1186\/s12890-024-03254-9"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.chest.2019.06.037","article-title":"Lung Hyperlucency: A Clinical-Radiologic Algorithmic Approach to Diagnosis","volume":"157","author":"Cherian","year":"2020","journal-title":"Chest"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1378\/chest.109.2.360","article-title":"Thin-Section CT Detection of Emphysema Associated With Bronchiectasis and Correlation With Pulmonary Function Tests","volume":"109","author":"Loubeyre","year":"1996","journal-title":"Chest"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1148\/radiology.179.3.2027992","article-title":"Cystic fibrosis: Scoring system with thin-section CT","volume":"179","author":"Bhalla","year":"1991","journal-title":"Radiology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1148\/radiology.182.3.1535900","article-title":"High-resolution CT diagnosis of emphysema in symptomatic patients with normal chest radiographs and isolated low diffusing capacity","volume":"182","author":"Klein","year":"1992","journal-title":"Radiology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1136\/thx.5.3.233","article-title":"Reduction in bronchial subdivision in bronchiectasis","volume":"5","author":"Reid","year":"1950","journal-title":"Thorax"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1136\/thx.45.2.89","article-title":"Relation between small airways disease and parenchymal destruction in surgical lung specimens","volume":"45","author":"Willems","year":"1990","journal-title":"Thorax"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1164\/ajrccm\/145.6.1251","article-title":"A model of airway narrowing in asthma and in chronic obstructive pulmonary disease","volume":"145","author":"Wiggs","year":"1992","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1164\/ajrccm\/143.5_Pt_1.1152","article-title":"Morphology of the airway wall in asthma and in chronic obstructive pulmonary disease","volume":"143","author":"Jeffery","year":"1991","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"249","DOI":"10.2214\/ajr.160.2.8424326","article-title":"Ground-Glass Opacity of the Lung Parenchyma: A Guide to Analysis with High-Resolution CT","volume":"160","author":"Engeler","year":"1993","journal-title":"AJR"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1590\/S1806-37132008000900013","article-title":"High-resolution computed tomography patterns of diffuse interstitial lung disease with clinical and pathological correlation","volume":"34","author":"Elicker","year":"2008","journal-title":"J. Bras. Pneumol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.ejrad.2013.05.012","article-title":"Honeycombing on CT; its definition, pathologic correlation, and future direction of its diagnosis","volume":"83","author":"Johkoh","year":"2014","journal-title":"Eur. J. Radiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1164\/rccm.202403-0473PP","article-title":"The Precision Medicine Era of Bronchiectasis","volume":"210","author":"Chotirmall","year":"2024","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e221109","DOI":"10.1148\/radiol.221109","article-title":"Artificial Intelligence\u2013based CT Assessment of Bronchiectasis: The COPDGene Study","volume":"307","author":"Nardelli","year":"2023","journal-title":"Radiology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2328","DOI":"10.4103\/jfmpc.jfmpc_440_19","article-title":"Overview of artificial intelligence in medicine","volume":"8","author":"Amisha","year":"2019","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1111\/resp.12768","article-title":"Factors associated with radiologic progression of non-cystic fibrosis bronchiectasis during long-term follow-up","volume":"21","author":"Park","year":"2016","journal-title":"Respirology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/s12931-017-0691-x","article-title":"Neutrophil elastase in bronchiectasis","volume":"18","author":"Gramegna","year":"2017","journal-title":"Respir. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"L525","DOI":"10.1152\/ajplung.00163.2007","article-title":"TGF-\u03b2-induced EMT: Mechanisms and implications for fibrotic lung disease","volume":"293","author":"Willis","year":"2007","journal-title":"Am. J. Physiol. -Lung Cell. Mol. Physiol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/24\/2883\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:57:44Z","timestamp":1760115464000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/24\/2883"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,21]]},"references-count":45,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["diagnostics14242883"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14242883","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2024,12,21]]}}}