Abstract:
Chronic heart failure, pulmonary hypertension, acute respiratory distress syndrome (ARDS), coronavirus disease (COVID), and kidney failure are leading causes of death in the U.S. and across the globe. The cornerstone for managing these diseases is assessing patients’ volume fluid status in lungs. Available methods for measuring fluid accumulation in lungs are either expensive and invasive, thus unsuitable for continuous monitoring, or inaccurate and unreliable. With the recent COVID-19 epidemic, the development of a non-invasive, affordable, and accurate method for assessing lung water content in patients became utmost priority for controlling these widespread respiratory related diseases. In this paper, we propose a novel approach for non-invasive assessment of lung water content in patients. The assessment includes quantitative baseline assessment of fluid accumulation in lungs (normal, moderate edema, edema), as well as continuous monitoring of changes in lung water content. The proposed method is based on using a pair of chest patch radio frequency (RF) sensors and measuring the scattering parameters (S-parameters) of a 915-MHz signal transmitted into the body. To conduct an extensive computational study and validate our results, we utilize a National Institute of Health (NIH) database of computerized tomography (CT) scans of lungs in a diverse population of patients. An automatic workflow is proposed to convert CT scan images to three-dimensional lung objects in High-Frequency Simulation Software and obtain the S-parameters of the lungs at different water levels. Then a personalized machine learning model is developed to assess lung water status based on patient attributes and S-parameter measurements. Decision trees are chosen as our models for the superior accuracy and interpretability. Important patient attributes are identified for lung water assessment. A “cluster-then-predict” approach is adopted, where we cluster the patients based on their ages and fat thickness and train a decision tree for each cluster, resulting in simpler and more interpretable decision trees with improved accuracy. The developed machine learning models achieve areas under the receiver operating characteristic curve of 0.719 and 0.756 for 115 male and 119 female patients, respectively. These results suggest that the proposed “Chest Patch” RF sensors and machine learning models present a promising approach for non-invasive monitoring of patients with respiratory diseases.