Diagnostic Accuracy of AI-Assisted Automated HRCT Emphysema Quantification versus Spirometry in Smokers with Subclinical Airflow Limitation

This study compared the diagnostic accuracy of AI-based automated high-resolution CT (HRCT) emphysema quantification with spirometry for detecting subclinical airflow limitation in smokers. A total of 100 smokers underwent both HRCT and spirometry, and emphysema was quantified using AVIEW software (Coreline Soft). The AI-based HRCT analysis demonstrated high sensitivity (92%) and specificity (88%), with a strong correlation to spirometry results (r = 0.85). Notably, AI-based HRCT quantification outperformed spirometry in detecting early-stage emphysema. By automating quantitative analysis, AVIEW enabled rapid and objective assessment of emphysema burden. These findings suggest that AI-based HRCT may serve as a valuable tool for early diagnosis and risk stratification of subclinical COPD.