Original Investigation|Articles in Press

Computed Tomography Radiomics-based Prediction Model for Gender–Age–Physiology Staging of Connective Tissue Disease-associated Interstitial Lung Disease

Published:March 02, 2023DOI:


      To analyze the feasibility of predicting gender–age–physiology (GAP) staging in patients with connective tissue disease-associated interstitial lung disease (CTD-ILD) by radiomics based on computed tomography (CT) of the chest.

      Materials and Methods

      Chest CT images of 184 patients with CTD-ILD were retrospectively analyzed. GAP staging was performed on the basis of gender, age, and pulmonary function test results. GAP I, II, and III have 137, 36, and 11 cases, respectively. The cases in GAP Ⅱ and Ⅲ were then combined into one group, and the two groups of patients were randomly divided into the training and testing groups with a 7:3 ratio. The radiomics features were extracted using AK software. Multivariate logistic regression analysis was then conducted to establish a radiomics model. A nomogram model was established on the basis of Rad-score and clinical factors (age and gender).


      For the radiomics model, four significant radiomics features were selected to construct the model and showed excellent ability to differentiate GAP I from GAP Ⅱ and Ⅲ in both the training group (the area under the curve [AUC] = 0.803, 95% confidence interval [CI]: 0.724–0.874) and testing group (AUC = 0.801, 95% CI:0.663–0.912). The nomogram model that combined clinical factors and radiomics features improved higher accuracy of both training (88.4% vs. 82.1%) and testing (83.3% vs. 79.2%).


      The disease severity assessment of patients with CTD-ILD can be evaluated by applying the radiomics method based on CT images. The nomogram model demonstrates better performance for predicting the GAP staging.

      Key Words


      GAP (gender–age–physiology), CTD (connective tissue disease), ILD (interstitial lung disease), CT (computed tomography), AUC (the area under the curve), SSc (systemic sclerosis), RA (rheumatoid arthritis), IPF (idiopathic pulmonary fibrosis), FVC (forced vital capacity), DLCO (diffusing capacity for carbon monoxide), NSIP (nonspecific interstitial pneumonia), PFT (pulmonary function test), FEV1 (forced expiratory volume in 1.0 s), VA (alveolar ventilation), TLC (total lung capacity), VOI (volume of interest)
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