Development of a 3-D standardized lung template from low-dose CT scans

Lung imaging lacks a standardized reference space, hindering the large-scale, voxel-wise analyses that are routine in neuroimaging. To address this gap, we developed a high-resolution, open-source 3-D lung template and probabilistic lobar atlas from a cohort of 30 subjects from the National Lung Screening Trial (NLST). Created using a fully automatic pipeline based on the Advanced Normalization Tools (ANTs) ecosystem, this template reached convergence (dice similarity coefficient of 0.992 between consecutive iterations) after 11 iterations. We demonstrated its utility by registering 60 subjects with varying emphysema severity, finding that voxel-wise Jacobian analysis could distinguish disease-specific deformation patterns. This work provides a foundational, open resource for standardizing anatomical localization, enabling robust group-level studies in lung cancer screening research.