Emphysema quantification using low-dose computed tomography with deep learning–based kernel conversion comparison



This study determined the effect of dose reduction and kernel selection on quantifying emphysema using low-dose computed tomography (LDCT) and evaluated the efficiency of a deep learning–based kernel conversion technique in normalizing kernels for emphysema quantification.


A sample of 131 participants underwent LDCT and standard-dose computed tomography (SDCT) at 1- to 2-year intervals. LDCT images were reconstructed with B31f and B50f kernels, and SDCT images were reconstructed with B30f kernels. A deep learning model was used to convert the LDCT image from a B50f kernel to a B31f kernel. Emphysema indices (EIs), lung attenuation at 15th percentile (perc15), and mean lung density (MLD) were calculated. Comparisons among the different kernel types for both LDCT and SDCT were performed using Friedman’s test and Bland-Altman plots.


All values of LDCT B50f were significantly different compared with the values of LDCT B31f and SDCT B30f (p < 0.05). Although there was a statistical difference, the variation of the values of LDCT B50f significantly decreased after kernel normalization. The 95% limits of agreement between the SDCT and LDCT kernels (B31f and converted B50f) ranged from − 2.9 to 4.3% and from − 3.2 to 4.4%, respectively. However, there were no significant differences in EIs and perc15 between SDCT and LDCT converted B50f in the non-chronic obstructive pulmonary disease (COPD) participants (p > 0.05).


The deep learning–based CT kernel conversion of sharp kernel in LDCT significantly reduced variation in emphysema quantification, and could be used for emphysema quantification.

Key Points

• Low-dose computed tomography with smooth kernel showed adequate performance in quantifying emphysema compared with standard-dose CT.

• Emphysema quantification is affected by kernel selection and the application of a sharp kernel resulted in a significant overestimation of emphysema.

• Deep learning–based kernel normalization of sharp kernel significantly reduced variation in emphysema quantification.

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Fig. 1
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Conversion neural network


Chronic obstructive pulmonary disease

CTDIvol :

Volumetric computed tomography dose index


Dose-length product


Emphysema index


Hounsfield unit


Low-dose computed tomography


Mean lung density


Lung attenuation at 15th percentile


Standard-dose computed tomography


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The scientific grantor of this research is So Hyeon Bak. This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF 2018R1D1A1B07049670).

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Corresponding authors

Correspondence to Jong Hyo Kim or Woo Jin Kim.

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This scientific guarantor of this research is Woo Jin Kim.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

Two of the authors (Sung Ok Kwon and Bom Kim) have significant statistical expertise.

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Written informed consent was obtained from all subjects (patients) in this study.

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Institutional Review Board approval was obtained.


• retrospective

• cross sectional study

• performed at one institution

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Bak, S.H., Kim, J.H., Jin, H. et al. Emphysema quantification using low-dose computed tomography with deep learning–based kernel conversion comparison. Eur Radiol (2020). https://doi.org/10.1007/s00330-020-07020-3

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  • Emphysema
  • Deep learning
  • Densitometry
  • Tomography