RepAir: A Framework for Airway Segmentation and Discontinuity Correction in CT

Accurate airway segmentation from chest computed tomography (CT) scans is essential for quantitative lung analysis, yet manual annotation is impractical and many automated U-Net-based methods yield disconnected components that hinder reliable biomarker extraction. We present RepAir, a three-stage framework for robust 3D airway segmentation that combines an nnU-Net-based network with anatomically informed topology correction. The segmentation network produces an initial airway mask, after which a skeleton-based algorithm identifies potential discontinuities and proposes reconnections. A 1D convolutional classifier then determines which candidate links correspond to true anatomical branches versus false or obstructed paths. We evaluate RepAir on two distinct datasets: ATM'22, comprising annotated CT scans from predominantly healthy subjects and AeroPath, encompassing annotated scans with severe airway pathology. Across both datasets, RepAir outperforms existing 3D U-Net-based approaches such as Bronchinet and NaviAirway on both voxel-level and topological metrics, and produces more complete and anatomically consistent airway trees while maintaining high segmentation accuracy.

Robust deep labeling of radiological emphysema subtypes using squeeze and excitation convolutional neural networks: The MESA Lung and SPIROMICS Studies

Pulmonary emphysema, the progressive, irreversible loss of lung tissue, is conventionally categorized into three subtypes identifiable on pathology and on lung computed tomography (CT) images. Recent work has led to the unsupervised learning of ten spatially-informed lung texture patterns (sLTPs) on lung CT, representing distinct patterns of emphysematous lung parenchyma based on both textural appearance and spatial location within the lung, and which aggregate into 6 robust and reproducible CT Emphysema Subtypes (CTES). Existing methods for sLTP segmentation, however, are slow and highly sensitive to changes in CT acquisition protocol. In this work, we present a robust 3-D squeeze-and-excitation CNN for supervised classification of sLTPs and CTES on lung CT. Our results demonstrate that this model achieves accurate and reproducible sLTP segmentation on lung CTscans, across two independent cohorts and independently of scanner manufacturer and model.