Validation of a DIXON-based fat quantification technique for the measurement of visceral fat using a CT-based reference standard
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The purpose of the study is to determine whether a novel semi-automated DIXON-based fat quantification algorithm can reliably quantify visceral fat using a CT-based reference standard.
This was an IRB-approved retrospective cohort study of 27 subjects who underwent abdominopelvic CT within 7 days of proton density fat fraction (PDFF) mapping on a 1.5T MRI. Cross-sectional visceral fat area per slice (cm2) was measured in blinded fashion in each modality at intervertebral disc levels from T12 to L4. CT estimates were obtained using a previously published semi-automated computational image processing system that sums pixels with attenuation − 205 to − 51 HU. MR estimates were obtained using two novel semi-automated DIXON-based fat quantification algorithms that measure visceral fat area by spatially regularizing non-uniform fat-only signal intensity or de-speckling PDFF 2D images and summing pixels with PDFF ≥ 50%. Pearson’s correlations and Bland–Altman analyses were performed.
Visceral fat area per slice ranged from 9.2 to 429.8 cm2 for MR and from 1.6 to 405.5 cm2 for CT. There was a strong correlation between CT and MR methods in measured visceral fat area across all studied vertebral body levels (r = 0.97; n = 101 observations); the least (r = 0.93) correlation was at T12. Bland–Altman analysis revealed a bias of 31.7 cm2 (95% CI [− 27.1]–90.4 cm2), indicating modestly higher visceral fat assessed by MR.
MR- and CT-based visceral fat quantification are highly correlated and have good cross-modality reliability, indicating that visceral fat quantification by either method can yield a stable and reliable biomarker.
KeywordsMorphometry Visceral fat Quantitative imaging Biomarker Proton density fat fraction (PDFF)
Compliance with ethical standards
No funding was solicited or used for this work. Institutional review board approval was obtained. The requirement for informed consent was waived by the IRB. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Matthew Davenport—Royalties from Wolters Kluwer, Katherine M. Heckman—No conflict of interest, Bamidele Otemuyiwa—No conflict of interest, Thomas L. Chenevert—No conflict of interest, Dariya Malyarenko—No conflict of interest, Brian A. Derstine—No conflict of interest, Stewart C Wang—No conflict of interest.
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