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Predictive performance is assessed using C-index and time-dependent ROC AUC, with exploratory analyses by COPD status, treatment type, and TNM stage. Results show whole emphysema and ILA severities independently predict survival, unlike regional findings, and a combined model outperforms TNM alone. Conclusions support improved survival prediction and complementary individualized management 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question does the study address about NSCLC prognosis?","Question",{"text":63,"@type":64},"It evaluates whether artificial intelligence (AI)–quantified emphysema and interstitial lung abnormality (ILA) severity can predict overall survival in non-small cell lung cancer patients.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was AI used in the retrospective study?",{"text":68,"@type":64},"AI quantified emphysema and ILA in NSCLC patients diagnosed between January 2015 and December 2017, and the associations between severity and overall survival were analyzed with Cox proportional hazards models.",{"name":70,"@type":61,"acceptedAnswer":71},"Which measurements were most predictive: whole or regional emphysema/ILA?",{"text":72,"@type":64},"Whole emphysema and ILA severity were independent prognostic factors, whereas regional emphysema and regional ILA severity were not significant.",{"name":74,"@type":61,"acceptedAnswer":75},"How does the combined AI model compare with TNM staging alone?",{"text":76,"@type":64},"The model combining AI-quantified whole emphysema severity and ILA severity outperformed the TNM-only model, showing higher C-index and AUC values for predicting survival.","https://schema.org",{"og:url":32,"og:type":79,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":81,"canonical":32},"index,follow",{"doc_id":83,"site_id":7},443380,1791065168,{"code":4,"msg":86,"data":87},"success",[88,92,96,100,105,110,114,118,123,126,130],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Story & 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Insights into Imaging (2026)17:7 [https://doi.org/10.1186/s13244-025-02180-6](https://doi.org/10.1186/s13244-025-02180-6)  \nORIGINAL ARTICLE Open Access  \nAssociation of automated quantified   emphysema and interstitial lung  \nabnormality with survival in non-small cell lung cancer  \nGuangjing Weng 1,2, Junli Tao2, Yu Pu2, Changyu Liang2, Bohui Chen2, Zhenyu Wang2, Chengzhan Qi2 and Jiuquan Zhang 1,2*   \nAbstract  \nObjectives To investigate the prognostic value of artificial intelligence (AI) quantified emphysema and interstitial lung abnormality (ILA) in patients with non-small cell lung cancer (NSCLC) .  \nMaterials and methods This retrospective study used AI to quantify emphysema and ILA in patients diagnosed with NSCLC between January 2015 and December 2017. Associations between AI-quantified emphysema and ILA severity and overall survival (OS) were evaluated using Cox proportional hazards models. The ability of AI-quantified emphysema and ILA severity to predict OS was explored via concordance index (C-index) and area under the timedependent receiver operating characteristic curve (AUC) . Furthermore, exploratory OS analyses were performed on subgroups stratified by chronic obstructive pulmonary disease status, treatment type, and tumor-node-metastasis (TNM) staging.  \nResults Of 1675 patients, 830 (49 . 6%) survived, and 845 (50 .4%) died. Whole emphysema (mild: HR, 1 . 66 [95% CI: 1 . 26, 2. 18]; p \u003C 0 . 001; more than mild: HR, 2 . 55 [95% CI: 1 . 88, 3 .48]; p \u003C 0 . 001) and ILA (equivocal ILA: HR, 1 . 63 [95% CI: 1 . 15, 2. 32]; p = 0. 006; definite ILA: HR, 2 . 33 [95% CI: 1 . 61, 3 . 35]; p \u003C 0 . 001) severity were independent prognostic factors for NSCLC, while regional emphysema and regional ILA severity were not. The model combining AI-quantified whole emphysema severity and ILA severity outperformed the TNM staging-only model in predicting NSCLC patient outcome (C-index, 0 . 80 vs. 0. 75; AUC, 0 . 90 vs. 0. 85) .  \nConclusions Increased AI-quantified whole emphysema and ILA severity were associated with worse OS in NSCLC. The model combining AI-quantified emphysema and ILA showed improved performance for predicting patient survival versus TNM staging alone.  \nCritical relevance statement AI-quantified emphysema and ILA severity are associated with NSCLC patient outcome and can provide information complementary to TNM staging for predicting NSCLC patient survival and promoting the development of individualized management strategies.  \nGuangjing Weng and Junli Tao contributed equally to this work.  \n*Correspondence: Jiuquan Zhang  \n[zhangjq_radiol@foxmail.com](zhangjq_radiol@foxmail.com)  \n1School of Medicine, Chongqing University, Chongqing University Cancer Hospital, Chongqing, China  \n2Department of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute, Chongqing, China  \n© The Author(s) 2025 . Open Access This article is licensed under a Creative Commons Attribution 4 . 0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/](http://creativecommons.org/)[ ](http://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/.)[.](licenses/by/4.0/.)  \nKey Points  \n● The study explores artificial intelligence (AI) quantified emphysema and interstitial lung abnormality (ILA) severity in non-small cell lung","cbCaivctzc0nFv22","https://ap.wps.com/l/cbCaivctzc0nFv22","pdf",3875989,14,"English","# Abstract\n# Introduction\n# Materials and methods\n# Results\n# Conclusions\n# Key Points\n# Graphical Abstract","[{\"question\":\"What question does the study address about NSCLC prognosis?\",\"answer\":\"It evaluates whether artificial intelligence (AI)–quantified emphysema and interstitial lung abnormality (ILA) severity can predict overall survival in non-small cell lung cancer patients.\"},{\"question\":\"How was AI used in the retrospective study?\",\"answer\":\"AI quantified emphysema and ILA in NSCLC patients diagnosed between January 2015 and December 2017, and the associations between severity and overall survival were analyzed with Cox proportional hazards models.\"},{\"question\":\"Which measurements were most predictive: whole or regional emphysema/ILA?\",\"answer\":\"Whole emphysema and ILA severity were independent prognostic factors, whereas regional emphysema and regional ILA severity were not significant.\"},{\"question\":\"How does the combined AI model compare with TNM staging alone?\",\"answer\":\"The model combining AI-quantified whole emphysema severity and ILA severity outperformed the TNM-only model, showing higher C-index and AUC values for predicting survival.\"}]","Association of automated quantified emphysema and interstitial lung abnormality with survival in non-small cell lung cancer | PDF",1790703817,35]