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Nie X, Zhang L, Meng H, Zhong Y, Jiang Y, Chen T, Cheng W. Visceral obesity determined by CT as a predictor of short-term postoperative complications in patients with ovarian cancer. Arch Gynecol Obstet 2024; 309:1491-1498. [PMID: 37698603 DOI: 10.1007/s00404-023-07206-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 08/24/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE To explore the association between visceral obesity and short-term postoperative complications in patients with advanced ovarian cancer undergoing cytoreductive surgery. METHODS The medical records of patients with advanced epithelial ovarian cancer were reviewed. The visceral fat area, subcutaneous fat area and total fat area at the L3/4 level were measured on a preoperative single-slice CT scan. The receiver operating characteristic (ROC) curve was used to calculate the optimal cutoff value for the visceral fat area. The relationship between the visceral fat area and the characteristics of ovarian cancer patients were analyzed. Univariable and multivariable logistic regression analyses were performed to investigate relationship between perioperative characteristics and short-term complications. RESULTS According to the ROC curve, the best cutoff value of the VFA was 93 cm2. Of the 130 patients, 53.8% (70/130) had visceral obesity. Patients with visceral obesity were older than those with nonvisceral obesity (58.4 years old vs. 52.1 years old, p < 0.001). The proportion of patients with hypertension was higher (35.7 vs. 13.3%, p = 0.003). The total fat area and subcutaneous fat area were larger in patients with visceral obesity (294.3 ± 75.5 vs. 176.2 ± 68.7, p < 0.001; 158.9 ± 54.7 vs. 121.7 ± 52.6, p < 0.001). Compared with patients in the nonvisceral obese group, patients in the visceral obese group were more likely to have postoperative fever (21/70 30.0% vs. 8/60 1.25%, p = 0.023), leading to a longer length of hospital stay (21 days vs. 17 days, p = 0.009). The time from surgery to adjuvant chemotherapy for patients with visceral obesity was shorter (24 days vs. 19 days, p = 0.037). Multivariate analysis showed that visceral obesity (OR = 6.451, p < 0.001) and operation time (OR = 1.006, p < 0.001) were independent predictors of postoperative complications. CONCLUSION Visceral obesity is an important risk factor for short-term postoperative complications in patients with advanced ovarian cancer undergoing cytoreductive surgery.
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Affiliation(s)
- Xianglin Nie
- Department of Gynecology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Lin Zhang
- Department of Gynecology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Huangyang Meng
- Department of Gynecology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Yi Zhong
- Department of Gynecology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
- Department of gynaecology and obstetrics, Chongqing Maternal and Child Health Care Hospital, Chongqing, China
| | - Yi Jiang
- Department of Gynecology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Ting Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Wenjun Cheng
- Department of Gynecology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
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Wang PH, Gow CH, Chiu YL, Li TC. Determination of Low Muscle Mass by Muscle Surface Index of the First Lumbar Vertebra Using Low-Dose Computed Tomography. J Clin Med 2022; 11:jcm11092429. [PMID: 35566554 PMCID: PMC9103630 DOI: 10.3390/jcm11092429] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 11/16/2022] Open
Abstract
The muscle index of the first vertebra (L1MI) derived from computed tomography (CT) is an indicator of total skeletal muscle mass. Nevertheless, the cutoff value and utility of L1MI derived from low-dose chest CT (LDCT) remain unclear. Adults who received LDCT for health check-ups in 2017 were enrolled. The cutoff values of L1MI were established in subjects aged 20-60 years. The cutoff values were used in chronic obstructive pulmonary disease (COPD) patients to determine muscle quantity. A total of 1780 healthy subjects were enrolled. Subjects (n = 1393) aged 20-60 years were defined as the reference group. The sex-specific cutoff values of L1MI were 26.2 cm2/m2 for males and 20.9 cm2/m2 for females. Six subjects in the COPD group (6/44, 13.6%) had low L1MI. COPD subjects with low L1MI had lower forced expiratory volume in one second (0.81 ± 0.17 vs. 1.30 ± 0.55 L/s, p = 0.046) and higher COPD assessment test scores (19.5 ± 2.6 vs. 15.0 ± 4.9, p = 0.015) than those with normal L1MI. In conclusion, LDCT in health assessments may provide additional information on sarcopenia.
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Affiliation(s)
- Ping-Huai Wang
- Division of Pulmonology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan;
- Department of Nursing, Asia Eastern University of Science and Technology, New Taipei City 220, Taiwan
| | - Chien-Hung Gow
- Division of Pulmonology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan;
- Department of Healthcare Information and Management, Ming-Chuan University, Taoyuan 333, Taiwan
- Correspondence: ; Tel.: +886-2-772815
| | - Yen-Ling Chiu
- Graduate Institute of Medicine and Graduate Program in Biomedical Informatics, Yuan Ze University, Taoyuan 320, Taiwan;
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Tien-Chi Li
- Department of Radiology, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan;
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Moga TD, Moga I, Sabau M, Nistor-Cseppento CD, Iovanovici DC, Cavalu S, Dogaru BG. Sarcopenia, a major clinical problem in old age, potential causes, clinical consequences and therapeutic possibilities. BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Sarcopenia or degeneration of skeletal muscle tissue with aging, is responsible for functional de-cline and loss of independence in older adults. The purpose of this article is to review the current definitions of sarcopenia, its potential causes, clinical consequences and the potential for prop-hylactic and curative intervention. Sarcopenia is recognized as a major clinical problem for the elderly, and the research in this area is growing exponentially. One of the most important recent developments has been convergence in the operational definition of sarcopenia that combines muscle mass, strength and muscle function. In 2010, the European Working Group on Sarcopenia in Oder People (EWGSOP) published a definition of sarcopenia aimed at promoting progress in the identification and care of the elderly. In early 2018 (EWGSOP2) he met again to update the original definition to reflect the scientific and clinical evidence that has been built over the past decade. The cause of sarcopenia is considered to be multifactorial: hormonal changes, neurologi-cal decline, sedentary / immobilization for a long period, chronic diseases, obesity, all these fac-tors contribute to the onset of sarcopenia. Prophylactic or curative interventions are essentially aimed at nutrition and exercise. Although pharmaceutical agents are developed that target seve-ral biological pathways, proper nutrition and specific physical exercises remain the gold stan-dard for therapy. Through this review, we want to draw attention to the need to implement complex analyzes of the elderly patient, regardless of the acute problem with which he presents himself at the consultation. These analyses should contain tests, measurements, questionnaires that identify in time a possible musculoskeletal degeneration. The results did not show any sig-nificant difference between the perception of sarcopenia, the way of approaching it and the prophylactic or therapeutic treatment. We focused on this pathology because sarcopenia is rela-tively newly observed, defined, it is not fully investigated and a clinical skill has not been for-med for the evaluation of the elderly patient.
Keywords: Skeletal muscle, elderly, sarcopenia, degeneration, exercises
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Affiliation(s)
- Titus David Moga
- Dep. of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Romania
| | - Ioana Moga
- Dep. of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Romania
| | - Monica Sabau
- Dep. of Psycho Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Carmen Delia Nistor-Cseppento
- Dep. of Psycho Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | | | - Simona Cavalu
- Departament of Biophysics, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Roma-nia
| | - Bombonica Gabriela Dogaru
- Department of Medical Rehabilitation, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania
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Htun KT, Pan J, Pasanta D, Tungjai M, Udomtanakunchai C, Petcharoen T, Chamta N, Kosicharoen S, Chukua K, Lai C, Kothan S. Advanced Molecular Imaging (MRI/MRS/ 1H NMR) for Metabolic Information in Young Adults with Health Risk Obesity. Life (Basel) 2021; 11:life11101035. [PMID: 34685406 PMCID: PMC8541404 DOI: 10.3390/life11101035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Obesity or being overweight is a medical condition of abnormal body fat accumulation which is associated with a higher risk of developing metabolic syndrome. The distinct body fat depots on specific parts of the anatomy have unique metabolic properties and different types of regional excessive fat distribution can be a disease hazard. The aim of this study was to identify the metabolome and molecular imaging phenotypes among a young adult population. METHODS The amount and distribution of fat and lipid metabolites profile in the abdomen, liver, and calf muscles of 46 normal weight, 17 overweight, and 13 obese participants were acquired using MRI and MR spectroscopy (MRS), respectively. The serum metabolic profile was obtained using proton NMR spectroscopy. NMR spectra were integrated into seven integration regions, which reflect relative metabolites. RESULTS A significant metabolic disorder symptom appeared in the overweight and obese group, and increased lipid deposition occurred in the abdomen, hepatocytes, and muscles that were statistically significant. Overall, the visceral fat depots had a marked influence on dyslipidemia biomarkers, blood triglyceride (r = 0.592, p < 0.001), and high-density lipoprotein cholesterol (r = -0.484, p < 0.001). Intrahepatocellular lipid was associated with diabetes predictors for hemoglobin (HbA1c%; r = 0.379, p < 0.001) and for fasting blood sugar (r = 0.333, p < 0.05). The lipid signals in serum triglyceride and glucose signals gave similar correspondence to biochemical lipid profiles. CONCLUSIONS This study proves the association between alteration in metabolome in young adults, which is the key population for early prevention of obesity and metabolic syndrome. This study suggests that dyslipidemia prevalence is influenced mainly by the visceral fat depot, and liver fat depot is a key determinant for glucose metabolism and hyperglycemia. Moreover, noninvasive advanced molecular imaging completely elucidated the impact of fat distribution on the anthropometric and laboratory parameters, especially indices of the metabolic syndrome biomarkers in young adults.
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Affiliation(s)
- Khin Thandar Htun
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (K.T.H.); (D.P.); (M.T.); (C.U.); (T.P.); (N.C.); (S.K.); (K.C.)
| | - Jie Pan
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (K.T.H.); (D.P.); (M.T.); (C.U.); (T.P.); (N.C.); (S.K.); (K.C.)
- Shandong Provincial Key Laboratory of Animal Resistant Biology, College of Life Sciences, Shandong Normal University, Jinan 250014, China
- Correspondence: (J.P.); (S.K.); Tel.: +86-13583101188 (J.P.); +66-5394-9213 (S.K.)
| | - Duanghathai Pasanta
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (K.T.H.); (D.P.); (M.T.); (C.U.); (T.P.); (N.C.); (S.K.); (K.C.)
| | - Montree Tungjai
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (K.T.H.); (D.P.); (M.T.); (C.U.); (T.P.); (N.C.); (S.K.); (K.C.)
| | - Chatchanok Udomtanakunchai
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (K.T.H.); (D.P.); (M.T.); (C.U.); (T.P.); (N.C.); (S.K.); (K.C.)
| | - Thanaporn Petcharoen
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (K.T.H.); (D.P.); (M.T.); (C.U.); (T.P.); (N.C.); (S.K.); (K.C.)
| | - Nattacha Chamta
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (K.T.H.); (D.P.); (M.T.); (C.U.); (T.P.); (N.C.); (S.K.); (K.C.)
| | - Supak Kosicharoen
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (K.T.H.); (D.P.); (M.T.); (C.U.); (T.P.); (N.C.); (S.K.); (K.C.)
| | - Kiattisak Chukua
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (K.T.H.); (D.P.); (M.T.); (C.U.); (T.P.); (N.C.); (S.K.); (K.C.)
| | - Christopher Lai
- Health and Social Sciences, Singapore Institute of Technology, 10 Dover Drive, Singapore 138683, Singapore;
| | - Suchart Kothan
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (K.T.H.); (D.P.); (M.T.); (C.U.); (T.P.); (N.C.); (S.K.); (K.C.)
- Correspondence: (J.P.); (S.K.); Tel.: +86-13583101188 (J.P.); +66-5394-9213 (S.K.)
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Rozynek M, Kucybała I, Urbanik A, Wojciechowski W. Use of artificial intelligence in the imaging of sarcopenia: A narrative review of current status and perspectives. Nutrition 2021; 89:111227. [PMID: 33930789 DOI: 10.1016/j.nut.2021.111227] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/28/2021] [Accepted: 02/25/2021] [Indexed: 01/10/2023]
Abstract
Sarcopenia is a muscle disease which previously was associated only with aging, but in recent days it has been gaining more attention for its predictive value in a vast range of conditions and its potential link with overall health. Up to this point, evaluating sarcopenia with imaging methods has been time-consuming and dependent on the skills of the physician. The solution for this problem may be found in artificial intelligence, which may assist radiologists in repetitive tasks such as muscle segmentation and body-composition analysis. The major aim of this review was to find and present the current status and future perspectives of artificial intelligence in the imaging of sarcopenia. We searched the PubMed database to find articles concerning the use of artificial intelligence in diagnostic imaging and especially in body-composition analysis in the context of sarcopenia. We found that artificial-intelligence systems could potentially help with evaluating sarcopenia and better predicting outcomes in a vast range of clinical situations, which could get us closer to the true era of precision medicine.
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Affiliation(s)
- Miłosz Rozynek
- Jagiellonian University Medical College, Department of Radiology, Krakow, Poland
| | - Iwona Kucybała
- Jagiellonian University Medical College, Department of Radiology, Krakow, Poland
| | - Andrzej Urbanik
- Jagiellonian University Medical College, Department of Radiology, Krakow, Poland
| | - Wadim Wojciechowski
- Jagiellonian University Medical College, Department of Radiology, Krakow, Poland.
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Schaudinn A, Hudak A, Linder N, Reinhardt M, Stocker G, Lordick F, Denecke T, Busse H. Toward a Routine Assessment of Visceral Adipose Tissue Volume from Computed Tomographic Data. Obesity (Silver Spring) 2021; 29:294-301. [PMID: 33369246 DOI: 10.1002/oby.23061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/14/2020] [Accepted: 09/22/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The study's aim was to determine to what extent total visceral adipose tissue (VAT) volume (VVAT-T ) measured from segmented VAT areas (AVAT ) on all axial computed tomography (CT) sections (thickness of 5 mm) between the diaphragm and pelvic floor can be predicted by the AVAT of commonly selected landmark sections in patients with overweight or obesity. METHODS A total of 113 patients (31 females, 82 males) with images of full abdominopelvic coverage and proper image quality were included (BMI = 25.0-64.1 kg/m2 , 29.5 ± 4.9 kg/m2 ). Linear regression between AVAT and VVAT-T (reference) was used to determine approximate equations for VAT volume for all parameters (single sex, different anatomical landmarks or lumbar intervertebral disc spaces, one or five axial sections). Agreement was evaluated by the multivariate coefficient of determination and by the SD of the percentage difference (sd% ) between the estimated VAT volume on one or five sections and VVAT-T . RESULTS The VVAT-T was 0.9 to 8.4 (3.8 ± 2.2) L for females and 2.7 to 11.7 (5.6 ± 2.1) L for males. Best agreement was found at L2-3 (sd% = 14.3%-15.5%) for females and at L1-2 or L2-3 (11.7%-12.4%) for males. Agreement at the umbilicus or the femoral heads was poor (20.2%-57.9%). Segmentation of one or five sections was substantially faster (11/70 seconds) than whole-abdomen processing (15 minutes). CONCLUSIONS VVAT-T can be rapidly estimated by VAT segmentation of axial CT sections at sex-specific lumbar intervertebral disc spaces.
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Affiliation(s)
- Alexander Schaudinn
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany
| | - Andrea Hudak
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany
| | - Nicolas Linder
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany
- Integrated Research and Treatment Center, Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Martin Reinhardt
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany
| | - Gertraud Stocker
- Leipzig University Cancer Center, Leipzig University Hospital, Leipzig, Germany
| | - Florian Lordick
- Leipzig University Cancer Center, Leipzig University Hospital, Leipzig, Germany
| | - Timm Denecke
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany
| | - Harald Busse
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany
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Higgins MI, Martini DJ, Patil DH, Steele S, Evans S, Petrinec BP, Psutka SP, Sekhar A, Bilen MA, Master VA. Quantification of body composition in renal cell carcinoma patients: Comparing computed tomography and magnetic resonance imaging measurements. Eur J Radiol 2020; 132:109307. [PMID: 33010681 DOI: 10.1016/j.ejrad.2020.109307] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Body composition measures provide valuable information for prognostication and treatment election in cancer patients. We investigated the novel use of magnetic resonance imaging (MRI) for skeletal muscle and adipose tissue cross-sectional area measurements in preoperative renal cell carcinoma (RCC) patients. MATERIALS AND METHODS RCC patients with pre-operative CT and MRI abdominal imaging were identified. Semi-automatic segmentation measurement of skeletal muscle area (SMA), intramuscular fat area (IMFA), visceral fat area (VFA), subcutaneous fat area (SFA), linear measurements of psoas, paraspinal muscles were performed. Pearson correlation coefficients, Bland-Altman plot analyses were done. Multivariable regression analysis examined the relationship between patient characteristics and skeletal muscle. RESULTS Image analysis was performed on 58 RCC patients with preoperative CT and MRI imaging. For segmentation measures, r = 0.99, 0.99, 0.99, and 0.98 for SMA, IMFA, VFA, SFA, respectively, and 0.96 for linear measures of skeletal muscle. Bland-Altman analysis revealed a bias toward larger CT value for SMA (1.35 %), linear muscle measures (2.79 %), and SFA (10.34 %), and toward larger MRI values for IMFA (0.75 %) and VFA (5.81 %). ECOG ≥ 1 was associated with lower skeletal muscle than ECOG 0 for all measurements. CONCLUSIONS Strong correlation of CT and MRI cross sectional measurements of skeletal muscle and adipose tissues supports the use of axial MRI images for comprehensive measurement of body composition. This has widespread implications for body composition research and cancer patient care.
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Affiliation(s)
- Michelle I Higgins
- Department of Urology, Emory University School of Medicine, Atlanta, GA, United States
| | - Dylan J Martini
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, United States; Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - Dattatraya H Patil
- Department of Urology, Emory University School of Medicine, Atlanta, GA, United States
| | - Sean Steele
- Department of Urology, Emory University School of Medicine, Atlanta, GA, United States
| | - Sean Evans
- Department of Urology, Emory University School of Medicine, Atlanta, GA, United States
| | - Benjamin P Petrinec
- Department of Urology, Emory University School of Medicine, Atlanta, GA, United States
| | - Sarah P Psutka
- Department of Urology, University of Washington, Seattle, WA, United States
| | - Aarti Sekhar
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Mehmet Asim Bilen
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, United States; Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - Viraj A Master
- Department of Urology, Emory University School of Medicine, Atlanta, GA, United States.
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Lee K, Shin Y, Huh J, Sung YS, Lee IS, Yoon KH, Kim KW. Recent Issues on Body Composition Imaging for Sarcopenia Evaluation. Korean J Radiol 2019; 20:205-217. [PMID: 30672160 PMCID: PMC6342757 DOI: 10.3348/kjr.2018.0479] [Citation(s) in RCA: 184] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/15/2018] [Indexed: 02/07/2023] Open
Abstract
Recently, sarcopenia has garnered renewed interest. Sarcopenia is a disease characterized by decreased skeletal muscle mass and strength/function, which can impair the quality of life and increase physical disability, adverse metabolic effects, and mortality. Imaging tools for evaluating and diagnosing sarcopenia have developed rapidly. Radiologists should be aware of sarcopenia and its clinical implications. We review current knowledge about sarcopenia, its pathophysiological impact, and advantages and disadvantages of methods for evaluation of sarcopenia focusing on body composition imaging modalities such as whole-body dual-energy X-ray absorptiometry, CT, and MRI. Controversial issues are discussed, including the lack of consensus and standardization of the disease definition, imaging modality, measurement methods, and diagnostic cutoff points.
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Affiliation(s)
- Koeun Lee
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yongbin Shin
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jimi Huh
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, Suwon, Korea.
| | - Yu Sub Sung
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In Seob Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kwon Ha Yoon
- Department of Radiology, Wonkwang University College of Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Kyung Won Kim
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Park J, Gil JR, Shin Y, Won SE, Huh J, You MW, Park HJ, Sung YS, Kim KW. Reliable and robust method for abdominal muscle mass quantification using CT/MRI: An explorative study in healthy subjects. PLoS One 2019; 14:e0222042. [PMID: 31536542 PMCID: PMC6752777 DOI: 10.1371/journal.pone.0222042] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/20/2019] [Indexed: 01/06/2023] Open
Abstract
Background Quantification of abdominal muscle mass by cross-sectional imaging has been increasingly used to diagnose sarcopenia; however, the technical method for quantification has not been standardized yet. We aimed to determine an optimal method to measure the abdominal muscle area. Methods Among 50 consecutive subjects who underwent abdominal CT and MRI for possible liver donation, total abdominal muscle area (TAMA) and total psoas muscle area (TPA) at the L3 inferior endplate level were measured by two blinded readers. Inter-scan agreement between CT and MRI and inter-reader agreement between the two readers were evaluated using intraclass correlation coefficient (ICC) and within-subject coefficient of variation (WSCV). To evaluate the effect of measurement level, one reader measured TAMA and TPA at six levels from the L2 to L4 vertebral bodies. Results TAMA was a more reliable biomarker than TPA in terms of inter-scan agreement (ICC: 0.928 vs. 0.788 for reader 1 and 0.853 vs. 0.821 for reader 2, respectively; WSCV: 8.3% vs. 23.4% for reader 1 and 10.4% vs. 22.3% for reader 2, respectively) and inter-reader agreement (ICC: 0.986 vs. 0.886 for CT and 0.865 vs. 0.669 for MRI, respectively; WSCV: 8.2% vs. 16.0% for CT and 11.6% vs. 29.7% for MRI, respectively). In terms of the measurement level, TAMA did not differ from the L2inf to L4inf levels, whereas TPA increased with a decrease in measurement level. Conclusions TAMA is a better biomarker than TPA in terms of inter-scan and inter-reader agreement and robustness to the measurement level. CT was a more reliable imaging modality than MRI. Our results support the use of TAMA measured by CT as a standard biomarker for abdominal muscle area measurement.
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Affiliation(s)
- Jisuk Park
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jea Ryung Gil
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Radiology, VHS Medical Center, Seoul, Korea
| | - Youngbin Shin
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Eun Won
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jimi Huh
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea
| | - Myung-Won You
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Radiology, Kyung Hee University Hospital, Seoul, Korea
| | - Hyo Jung Park
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yu Sub Sung
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- * E-mail: (KWK); (YSS)
| | - Kyung Won Kim
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- * E-mail: (KWK); (YSS)
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Wang Z, Meng Y, Weng F, Chen Y, Lu F, Liu X, Hou M, Zhang J. An Effective CNN Method for Fully Automated Segmenting Subcutaneous and Visceral Adipose Tissue on CT Scans. Ann Biomed Eng 2019; 48:312-328. [DOI: 10.1007/s10439-019-02349-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/18/2019] [Indexed: 12/28/2022]
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Khan AI, Reiter DA, Sekhar A, Sharma P, Safdar NM, Patil DH, Psutka SP, Small WC, Bilen MA, Ogan K, Master VA. MRI quantitation of abdominal skeletal muscle correlates with CT-based analysis: implications for sarcopenia measurement. Appl Physiol Nutr Metab 2019; 44:814-819. [PMID: 30615474 DOI: 10.1139/apnm-2018-0473] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Sarcopenia is associated with poor outcomes in a variety of conditions, including malignancy. Abdominal skeletal muscle area (SMA) segmentation using computed tomography (CT) has been shown to be an accurate surrogate for identifying sarcopenia. While magnetic resonance imaging (MRI) segmentation of SMA has been validated in cadaver limbs, few studies have validated abdominal SMA segmentation using MRI at lumbar level mid-L3. Our objective was to assess the reproducibility and concordance of CT and MRI segmentation analyses of SMA at mid-L3. This retrospective analysis included a random sample of 10 patients with renal cell carcinoma (RCC) and CT abdomen/pelvis, used to assess intra-observer variability of SMA measurements using CT. An additional sample of 9 patients with RCC and both CT and T2-weighted (T2w) MRI abdomen/pelvis was used to assess intra-observer variability of SMA using MRI and concordance of SMA between MRI and CT. SMA was segmented using Slice-O-Matic. SMA reproducibility was assessed using intraclass correlation coefficient (ICC). SMA concordance was analyzed using Bland-Altman plot and Pearson correlation coefficient. The intra-observer variability of CT and MRI SMA at mid-L3 was low, with ICC of 0.998 and 0.985, respectively. Bland-Altman analysis revealed bias of 0.74% for T2w MRI over CT. The Pearson correlation coefficient was 0.997 (p < 0.0001), demonstrating strong correlation between CT and T2w MRI. Abdominal SMA at mid-L3 is reproducibly segmented for both CT and T2w MRI, with strong correlation between the 2 modalities. T2w MRI can be used interchangeably with CT for assessment of SMA and sarcopenia. This finding has important clinical implications.
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Affiliation(s)
- Amir Ishaq Khan
- a Emory University School of Medicine, Atlanta, GA 30322, USA
| | - David A Reiter
- b Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Aarti Sekhar
- b Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Puneet Sharma
- b Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Nabile M Safdar
- b Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Dattatraya H Patil
- c Department of Urology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Sarah P Psutka
- d Department of Urology, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - William C Small
- b Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Mehmet A Bilen
- e Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Kenneth Ogan
- c Department of Urology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Viraj A Master
- c Department of Urology, Emory University School of Medicine, Atlanta, GA 30322, USA
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Noumura Y, Kamishima T, Sutherland K, Nishimura H. Visceral adipose tissue area measurement at a single level: can it represent visceral adipose tissue volume? Br J Radiol 2017; 90:20170253. [PMID: 28707539 PMCID: PMC5858805 DOI: 10.1259/bjr.20170253] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 05/25/2017] [Accepted: 06/21/2017] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Measurement of visceral adipose tissue (VAT) needs to be accurate and sensitive to change for risk monitoring. The purpose of this study is to determine the CT slice location where VAT area can best reflect changes in VAT volume and body weight. METHODS 60 plain abdominal CT images from 30 males [mean age (range) 51 (41-68) years, mean body weight (range) 71.1 (101.9-50.9) kg] who underwent workplace screenings twice within a 1-year interval were evaluated. Automatically calculated and manually corrected areas of the VAT of various scan levels using "freeform curve" region of interest on CT were recorded and compared with body weight changes. RESULTS The strongest correlations of VAT area with VAT volume and body weight changes were shown in a slice 3 cm above the lower margin of L3 with r values of 0.853 and 0.902, respectively. CONCLUSION VAT area measurement at a single level 3 cm above the lower margin of the L3 vertebra is feasible and can reflect changes in VAT volume and body weight. Advances in knowledge: As VAT area at a CT slice 3cm above the lower margin of L3 can best reflect interval changes in VAT volume and body weight, VAT area measurement should be selected at this location.
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Affiliation(s)
- Yusuke Noumura
- Department of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Tamotsu Kamishima
- Department of Biomedical Science and Engineering, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Kenneth Sutherland
- Division of Photonic Bioimaging, Faculty of Medicine Research Center for Cooperative Projects, Hokkaido University, Sapporo, Japan
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Denton N, Karpe F. Measuring body composition and regional fat mass accurately. PRACTICAL DIABETES 2016. [DOI: 10.1002/pdi.2043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Nathan Denton
- Oxford Centre for Diabetes; Endocrinology and Metabolism; University of Oxford UK
| | - Fredrik Karpe
- Oxford Centre for Diabetes; Endocrinology and Metabolism; University of Oxford UK
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Sinelnikov A, Qu C, Fetzer DT, Pelletier JS, Dunn MA, Tsung A, Furlan A. Measurement of skeletal muscle area: Comparison of CT and MR imaging. Eur J Radiol 2016; 85:1716-1721. [PMID: 27666607 DOI: 10.1016/j.ejrad.2016.07.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 06/07/2016] [Accepted: 07/14/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate the intra- and inter-observer agreement and correlation between CT and MR measurements of skeletal muscle area (SMA) in the abdomen. METHODS CT and MR images from twelve patients were analyzed by two blinded observers using segmentation software (MITK-3M3, Mint Medical and Slice-O-Matic, Tomovision) to quantify SMA. MR images included T1w "in-phase", T1w "out-of-phase", and T2w sequences. Inter- and intra-observer agreement was assessed using the intraclass correlation coefficient (ICC). Pearson correlation coefficient (r) was used to correlate measurements obtained on MR with CT. CT and MR measurements were compared with Bland-Altman plots. RESULTS Intra- and inter-observer agreement for SMA was high for CT and MR. For MR, the measurements on T2w images showed the highest inter-observer agreement (ICC=0.96). CT SMA correlated closely with MR, with T2w images showing the highest correlation (r=0.98; P<0.01). Bland-Altman plots showed a 1.7%-3.9% bias between CT and MR measurements, lowest for T2w images. CONCLUSIONS MR SMA measurements are reproducible and correlate closely with CT. The T2w sequence is recommended to quantify SMA on MR images.
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Affiliation(s)
- Andrey Sinelnikov
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
| | - Chuanxing Qu
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - David T Fetzer
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | | | - Michael A Dunn
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Allan Tsung
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Alessandro Furlan
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
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Seabolt LA, Welch EB, Silver HJ. Imaging methods for analyzing body composition in human obesity and cardiometabolic disease. Ann N Y Acad Sci 2015; 1353:41-59. [PMID: 26250623 DOI: 10.1111/nyas.12842] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Advances in the technological qualities of imaging modalities for assessing human body composition have been stimulated by accumulating evidence that individual components of body composition have significant influences on chronic disease onset, disease progression, treatment response, and health outcomes. Importantly, imaging modalities have provided a systematic method for differentiating phenotypes of body composition that diverge from what is considered normal, that is, having low bone mass (osteopenia/osteoporosis), low muscle mass (sarcopenia), high fat mass (obesity), or high fat with low muscle mass (sarcopenic obesity). Moreover, advances over the past three decades in the sensitivity and quality of imaging not just to discern the amount and distribution of adipose and lean tissue but also to differentiate layers or depots within tissues and cells is enhancing our understanding of distinct mechanistic, metabolic, and functional roles of body composition within human phenotypes. In this review, we focus on advances in imaging technologies that show great promise for future investigation of human body composition and how they are being used to address the pandemic of obesity, metabolic syndrome, and diabetes.
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Affiliation(s)
- Lynn A Seabolt
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University, Nashville, Tennessee
| | - E Brian Welch
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee
| | - Heidi J Silver
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University, Nashville, Tennessee
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CT Dose Reduction for Visceral Adipose Tissue Measurement: Effects of Model-Based and Adaptive Statistical Iterative Reconstructions and Filtered Back Projection. AJR Am J Roentgenol 2015; 204:W677-83. [PMID: 26001256 DOI: 10.2214/ajr.14.13411] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The objective of our study was to evaluate the effects of radiation dose reduction and the reconstruction algorithm used--filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), or model-based iterative reconstruction (MBIR)--on the measurement of abdominal visceral fat using CT. SUBJECTS AND METHODS Standard-dose and low-dose abdominal CT examinations were performed simultaneously with automatic exposure control in 59 patients; the noise index for a 5-mm slice thickness was 12 for routine-dose CT and 24 for low-dose CT. The routine-dose CT images were reconstructed using FBP (reference standard), and the low-dose CT images were reconstructed using FBP, ASIR (so-called hybrid iterative reconstruction [IR]), and MBIR (so-called pure IR). In the 236 image series obtained, the visceral fat area was measured. Data were analyzed by the Pearson correlation coefficient test and a Bland-Altman difference analysis. RESULTS The radiation dose of the low-dose abdominal CT examinations was 73.0% (mean) lower than that of routine-dose CT examinations. Excellent correlations were observed between the visceral fat areas measured on the routine-dose FBP images and those measured on the low-dose FBP, low-dose ASIR, and low-dose MBIR images (r = 0.998, 0.998, and 0.998, respectively; p < 0.001). A Bland-Altman difference analysis revealed excellent agreements, with mean biases of -0.47, -0.41, and 0.18 cm(2) for the visceral fat area between the routine-dose FBP images and the low-dose FBP, low-dose ASIR, and low-dose MBIR images, respectively. CONCLUSION A 73.0% reduction of the radiation dose would be possible in CT for the measurement of the abdominal visceral fat regardless of which reconstruction algorithm is used (i.e., FBP, hybrid IR, or pure IR).
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Onuma T, Kamishima T, Sasaki T, Sakata M. Absolute reliability of adipose tissue volume measurement by computed tomography: application of low-dose scan and minimal detectable change—a phantom study. Radiol Phys Technol 2015; 8:312-9. [DOI: 10.1007/s12194-015-0322-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/28/2015] [Accepted: 05/29/2015] [Indexed: 10/23/2022]
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Bauer JS, Noël PB, Vollhardt C, Much D, Degirmenci S, Brunner S, Rummeny EJ, Hauner H. Accuracy and reproducibility of adipose tissue measurements in young infants by whole body magnetic resonance imaging. PLoS One 2015; 10:e0117127. [PMID: 25706876 PMCID: PMC4338239 DOI: 10.1371/journal.pone.0117127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 12/19/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE MR might be well suited to obtain reproducible and accurate measures of fat tissues in infants. This study evaluates MR-measurements of adipose tissue in young infants in vitro and in vivo. MATERIAL AND METHODS MR images of ten phantoms simulating subcutaneous fat of an infant's torso were obtained using a 1.5T MR scanner with and without simulated breathing. Scans consisted of a cartesian water-suppression turbo spin echo (wsTSE) sequence, and a PROPELLER wsTSE sequence. Fat volume was quantified directly and by MR imaging using k-means clustering and threshold-based segmentation procedures to calculate accuracy in vitro. Whole body MR was obtained in sleeping young infants (average age 67±30 days). This study was approved by the local review board. All parents gave written informed consent. To obtain reproducibility in vivo, cartesian and PROPELLER wsTSE sequences were repeated in seven and four young infants, respectively. Overall, 21 repetitions were performed for the cartesian sequence and 13 repetitions for the PROPELLER sequence. RESULTS In vitro accuracy errors depended on the chosen segmentation procedure, ranging from 5.4% to 76%, while the sequence showed no significant influence. Artificial breathing increased the minimal accuracy error to 9.1%. In vivo reproducibility errors for total fat volume of the sleeping infants ranged from 2.6% to 3.4%. Neither segmentation nor sequence significantly influenced reproducibility. CONCLUSION With both cartesian and PROPELLER sequences an accurate and reproducible measure of body fat was achieved. Adequate segmentation was mandatory for high accuracy.
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Affiliation(s)
- Jan Stefan Bauer
- Department of Neuroradiology, Technische Universität München, Munich, Germany
- * E-mail:
| | | | - Christiane Vollhardt
- Else Kröner-Fresenius-Center for Nutritional Medicine, Technische Universität München, Munich, Germany
| | - Daniela Much
- Else Kröner-Fresenius-Center for Nutritional Medicine, Technische Universität München, Munich, Germany
| | - Saliha Degirmenci
- Department of Radiology, Technische Universität München, Munich, Germany
| | - Stefanie Brunner
- Else Kröner-Fresenius-Center for Nutritional Medicine, Technische Universität München, Munich, Germany
| | | | - Hans Hauner
- Else Kröner-Fresenius-Center for Nutritional Medicine, Technische Universität München, Munich, Germany
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Fosbøl MØ, Zerahn B. Contemporary methods of body composition measurement. Clin Physiol Funct Imaging 2014; 35:81-97. [DOI: 10.1111/cpf.12152] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 03/18/2014] [Indexed: 12/29/2022]
Affiliation(s)
- Marie Ø. Fosbøl
- Department of Clinical Physiology and Nuclear Medicine; Center of Functional and Diagnostic Imaging and Research; University of Copenhagen; Hvidovre Hospital; Hvidovre Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine; University of Copenhagen; Herlev Hospital; Herlev Denmark
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An exploration of the needling depth in acupuncture: the safe needling depth and the needling depth of clinical efficacy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:740508. [PMID: 23935678 PMCID: PMC3722841 DOI: 10.1155/2013/740508] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 05/23/2013] [Indexed: 02/05/2023]
Abstract
Objective. To explore the existing scientific information regarding safe needling depth of acupuncture points and the needling depth of clinical efficacy. Methods. We searched the PubMed, EMBASE, Cochrane, Allied and Complementary Medicine (AMED), The National Center for Complementary and Alternative Medicine (NCCAM), and China National Knowledge Infrastructure (CNKI) databases to identify relevant monographs and related references from 1991 to 2013. Chinese journals and theses/dissertations were hand searched. Results. 47 studies were recruited and divided into 6 groups by measuring tools, that is, MRI, in vivo evaluation, CT, ultrasound, dissected specimen of cadavers, and another group with clinical efficacy. Each research was analyzed for study design, definition of safe depth, and factors that would affect the measured depths. Depths of clinical efficacy were discussed from the perspective of de-qi and other clinical observations. Conclusions. Great inconsistency in depth of each point measured from different subject groups and tools exists. The definition of safe depth should be established through standardization. There is also lack of researches to compare the clinical efficacy. A well-designed clinical trial selecting proper measuring tools to decide the actual and advisable needling depth for each point, to avoid adverse effects or complications and promote optimal clinical efficacy, is a top priority.
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Abstract
Obesity is a risk factor for colorectal cancer based on its molecular and metabolic effects on insulin and IGF-1, leptin, adipocytokines, and sex hormones. Obese men have a higher risk of colorectal cancer compared with normal weight men, but the association between obesity and rectal cancer is weaker than with colon cancer. There is a weaker association between obesity and colon cancer in women than in men, and no appreciable association between obesity and rectal cancer in women. Although obesity does not seem to have an effect on the number of lymph nodes harvested with resection, obesity does seem to be associated with more-aggressive colorectal cancers in a handful of studies. Survival and local recurrence studies are contradictory with no conclusive evidence that obesity predisposes to worse overall survival or increased recurrence in colon and rectal cancers. The literature is not definitive as far as overall morbidity and mortality rates in the obese are concerned, though obese rectal cancer patients seem to incur proportionally more morbidity and mortality. Preexisting steatosis or steatohepatitis in obese colorectal cancer patients or chemotherapy-induced liver dysfunction may lead to an increased mortality in obese patients with colorectal liver metastases. Diabetes may cause poorer response to neoadjuvant therapy in rectal cancer and contribute to higher mortality and recurrence in colon cancer.
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Affiliation(s)
- Irena Gribovskaja-Rupp
- Department of Surgery, Division of Colorectal Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
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Poonawalla AH, Sjoberg BP, Rehm JL, Hernando D, Hines CD, Irarrazaval P, Reeder SB. Adipose tissue MRI for quantitative measurement of central obesity. J Magn Reson Imaging 2012; 37:707-16. [PMID: 23055365 DOI: 10.1002/jmri.23846] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 08/29/2012] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To validate adipose tissue magnetic resonance imaging (atMRI) for rapid, quantitative volumetry of visceral adipose tissue (VAT) and total adipose tissue (TAT). MATERIALS AND METHODS Data were acquired on normal adults and clinically overweight girls with Institutional Review Board (IRB) approval/parental consent using sagittal 6-echo 3D-spoiled gradient-echo (SPGR) (26-sec single-breath-hold) at 3T. Fat-fraction images were reconstructed with quantitative corrections, permitting measurement of a physiologically based fat-fraction threshold in normals to identify adipose tissue, for automated measurement of TAT, and semiautomated measurement of VAT. TAT accuracy was validated using oil phantoms and in vivo TAT/VAT measurements validated with manual segmentation. Group comparisons were performed between normals and overweight girls using TAT, VAT, VAT-TAT-ratio (VTR), body-mass-index (BMI), waist circumference, and waist-hip-ratio (WHR). RESULTS Oil phantom measurements were highly accurate (<3% error). The measured adipose fat-fraction threshold was 96% ± 2%. VAT and TAT correlated strongly with manual segmentation (normals r(2) ≥ 0.96, overweight girls r(2) ≥ 0.99). VAT segmentation required 30 ± 11 minutes/subject (14 ± 5 sec/slice) using atMRI, versus 216 ± 73 minutes/subject (99 ± 31 sec/slice) manually. Group discrimination was significant using WHR (P < 0.001) and VTR (P = 0.004). CONCLUSION The atMRI technique permits rapid, accurate measurements of TAT, VAT, and VTR.
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Affiliation(s)
- Aziz H Poonawalla
- Department of Radiology, University of Wisconsin, Madison, Wisconsin 53792-3252, USA
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Klopfenstein BJ, Kim MS, Krisky CM, Szumowski J, Rooney WD, Purnell JQ. Comparison of 3 T MRI and CT for the measurement of visceral and subcutaneous adipose tissue in humans. Br J Radiol 2012; 85:e826-30. [PMID: 22514099 DOI: 10.1259/bjr/57987644] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE CT is considered the gold standard imaging modality for measurement of visceral adipose tissue area. However, as CT imaging exposes subjects to ionising radiation, a comparable imaging technique without this exposure is desirable, such as MRI. Therefore, we compared the agreement of measures of visceral adipose tissue and subcutaneous adipose tissue area from single-slice images obtained at the umbilicus using a 3 T MRI scanner with single-slice images obtained via CT scan. METHODS 64 images were obtained from 27 subjects who underwent MRI and CT scanning on the same day, after 10-12 hours of fasting. Visceral and subcutaneous adipose tissue depots were manually separated and quantified using a multimodality image-processing software program. RESULTS We found good agreement between CT and MRI for the measurement of both visceral adipose tissue and subcutaneous adipose tissue. Bland-Altman difference analysis demonstrated a mean bias of -2.9% (as a portion of total abdominal area) for visceral adipose tissue and +0.4% for subcutaneous adipose tissue, as measured by MRI compared with CT. CONCLUSION MRI is a safe, accurate and precise imaging modality for measuring both visceral and subcutaneous adipose tissue, making it a favourable alternative to CT for quantification of these adipose depots.
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Affiliation(s)
- B J Klopfenstein
- Division of Endocrinology, Diabetes, and Clinical Nutrition, Portland, OR 97239, USA.
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Nam SY, Choi IJ, Ryu KH, Park BJ, Kim HB, Nam BH. Abdominal visceral adipose tissue volume is associated with increased risk of erosive esophagitis in men and women. Gastroenterology 2010; 139:1902-1911.e2. [PMID: 20727886 DOI: 10.1053/j.gastro.2010.08.019] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Revised: 07/12/2010] [Accepted: 08/12/2010] [Indexed: 12/28/2022]
Abstract
BACKGROUND & AIMS Data on the association between erosive esophagitis and obesity are inconsistent because of variations in study populations and methods used to determine obesity. METHODS Participants in a prospective health-screening cohort underwent esophagogastroduodenoscopy and computed tomography. The association between erosive esophagitis and obesity (measured by body mass index [BMI], waist circumference, and abdominal visceral adipose tissue volume) was estimated with odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for confounding factors. We also analyzed the association between obesity and erosive esophagitis by sex. RESULTS The prevalence of erosive esophagitis was 9.3% (495/5329). The OR for erosive esophagitis correlated with obesity measured by BMI, waist circumference, and abdominal visceral adipose tissue volume (P < .001 for each factor). The multivariate OR for erosive esophagitis was 1.97 (95% CI: 1.34-2.90) for a visceral adipose tissue volume of 500-999 cm(3), 2.27 (95% CI: 1.51-3.39) for 1000-1499 cm(3), and 2.94 (95% CI: 1.87-4.62) for ≥1500 cm(3), compared with participants who had visceral adipose tissue volumes less than 500 cm(3). When measures of obesity were analyzed simultaneously, abdominal visceral adipose tissue volume, but not BMI or waist circumference, was associated with erosive esophagitis. The 3 measures of obesity were significantly associated with erosive esophagitis in males, but only visceral adipose tissue volume was associated with erosive esophagitis in females (P = .002). CONCLUSIONS In contrast to BMI or waist circumference, abdominal visceral adipose tissue volume is associated with an increased risk of erosive esophagitis in males and females.
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Affiliation(s)
- Su Youn Nam
- Center for Cancer Prevention and Detection, National Cancer Center, Goyang, Korea
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Giles JT, Allison M, Blumenthal RS, Post W, Gelber AC, Petri M, Tracy R, Szklo M, Bathon JM. Abdominal adiposity in rheumatoid arthritis: association with cardiometabolic risk factors and disease characteristics. ACTA ACUST UNITED AC 2010; 62:3173-82. [PMID: 20589684 DOI: 10.1002/art.27629] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Abdominal adiposity, especially visceral adiposity, is emerging as a recognized cardiometabolic risk factor. This study was undertaken to investigate how abdominal fat is distributed in rheumatoid arthritis (RA), and its RA-related determinants. METHODS Men and women with RA were compared with non-RA controls from the Multi-Ethnic Study of Atherosclerosis. Participants underwent anthropometric studies and quantification of visceral and subcutaneous fat areas (VFA and SFA) using abdominal computed tomography. RESULTS A total of 131 RA patients were compared with 121 controls. Despite similar body mass index and waist circumference between the RA and control groups, the adjusted mean VFA was 45 cm2 higher (+51%) in male RA patients versus male controls (P = 0.005), but did not significantly differ by RA status in women. The adjusted mean SFA was 119 cm2 higher (+68%) in female RA patients versus female controls (P < 0.001), but did not significantly differ by RA status in men. Elevated VFA (≥75th percentile) was associated with a significantly higher adjusted probability of having an elevated fasting glucose level, hypertension, or meeting the composite definition of the metabolic syndrome in the RA group compared with controls. Within the RA group, rheumatoid factor seropositivity and higher cumulative prednisone exposure were significantly associated with a higher mean adjusted VFA. Higher C-reactive protein levels and lower Sharp/van der Heijde scores were significantly associated with both VFA and SFA. CONCLUSION The distribution of abdominal fat differs significantly by RA status. Higher VFA in men with RA, and the more potent association of VFA with cardiometabolic risk factors in men and women with RA, may contribute to cardiovascular risk in RA populations.
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Affiliation(s)
- Jon T Giles
- Johns Hopkins University, Baltimore, Maryland 21224, USA.
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Nam SY, Kim BC, Han KS, Ryu KH, Park BJ, Kim HB, Nam BH. Abdominal visceral adipose tissue predicts risk of colorectal adenoma in both sexes. Clin Gastroenterol Hepatol 2010; 8:443-50.e1-2. [PMID: 20144736 DOI: 10.1016/j.cgh.2010.02.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 01/17/2010] [Accepted: 02/01/2010] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Small studies have shown inconsistent results regarding the association between abdominal visceral adipose tissue and colorectal adenomas. We evaluated the effects of visceral adipose tissue volume on the development and growth of colorectal adenomas. METHODS A total of 3922 participants underwent colonoscopy and computed tomography from February to November 2008. The associations between waist circumference, visceral adipose tissue volume, and colorectal adenomas were estimated with adjusted odds ratios and 95% confidence intervals (CIs). In addition, the association between characteristics of colorectal adenomas and visceral adipose tissue volume was evaluated. RESULTS Compared with participants who had visceral adipose tissue volume of less than 500 cm(3), the odds ratio for colorectal adenoma was 1.09 (95% CI, 0.87-1.36) for a volume of 500 to 999 cm(3), 1.33 (95% CI, 1.04-1.69) for a volume of 1000 to 1499 cm(3), and 1.43 (95% CI, 1.06-1.94) for a volume of 1500 cm(3) or greater. The risk of colorectal adenomas increased with increasing visceral adipose tissue volume in both sexes (P trend = .004 in men and .009 in women). Waist circumference was associated with colorectal adenomas in men (P trend = .02), but not in women. High volume of visceral adipose tissue (>or=1000 cm(3)) had a positive association with larger adenomas (>or=10 mm) and multiple adenomas. CONCLUSIONS Abdominal visceral adipose tissue volume can contribute to the development and growth of colorectal adenomas, and it was a better predictor for risk of colorectal adenomas than body mass index or waist circumference in both sexes.
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Affiliation(s)
- Su Youn Nam
- Center for Cancer Prevention and Detection, National Cancer Center, Goyang, Korea.
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Association between single-slice measurements of visceral and abdominal subcutaneous adipose tissue with volumetric measurements: the Framingham Heart Study. Int J Obes (Lond) 2010; 34:781-7. [PMID: 20065971 DOI: 10.1038/ijo.2009.279] [Citation(s) in RCA: 145] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Volumetric visceral abdominal adipose tissue (VAT) and subcutaneous abdominal adipose tissue (SAT) as measured by computed tomography (CT) are associated with metabolic risk factors. We sought to identify the correlations of VAT and SAT between area-based measures at different anatomic locations with volumetric measurements to identify the optimal anatomic site, and to relate measurements at this site with metabolic risk factors. METHODS We measured SAT and VAT volumes across the total imaging volume, whereas we measured SAT and VAT area at seven predefined anatomic landmarks in 200 participants from the Framingham Heart Study (mean age 54 years, 50% women) who underwent abdominal multi-detector CT. Correlation coefficients were used to assess the association between area measurements and volumes as well as metabolic risk factors stratified by gender. RESULTS Area-based measurements of SAT and VAT obtained at all anatomic landmarks were strongly associated with SAT and VAT volumes (all r>0.93, P<0.0001 and r>0.87, P<0.0001, for women and men; respectively). Consistently, area-based measurements of SAT and VAT obtained at L(3/4) were most strongly associated with volumetric measured VAT and SAT independent of age (both r=0.99 in men, r=0.96 for SAT and r=0.99 for VAT in women, all P-value <0.0001) and were similarly correlated with risk factors compared with SAT and VAT volumes (all P<0.05 for fasting plasma glucose, triglycerides, high-density lipoprotein, systolic blood pressure). CONCLUSION Among area-based measurements of SAT and VAT, those obtained at the level of L(3/4) were strongly associated with SAT and VAT volumes and cardio-metabolic risk factors in both men and women.
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Haug JT, Haug C, Maas A, Fayers SR, Trewin NH, Waloszek D. Simple 3D images from fossil and recent micromaterial using light microscopy. J Microsc 2009; 233:93-101. [PMID: 19196416 DOI: 10.1111/j.1365-2818.2008.03100.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Abstract We present a technique for extracting 3D information from small-scale fossil and Recent material and give a summary of other contemporary techniques for 3D methods of investigation. The only hardware needed for the here-presented technique is a microscope that can perform dark field and/or differential interference contrast with a mounted digital camera and a computer. Serial images are taken while the focus is successively shifted from the uppermost end of the specimen to the lowermost end, resulting in about 200 photographs. The data are then processed almost completely automatically by successive use of three freely available programs. Firstly, the stack of images is aligned by the use of CombineZM, which is used to produce a combined image with a high depth of field. Secondly, the aligned images are cropped and sharp edges extracted with the aid of ImageJ. Thirdly, although ImageJ is also capable of producing 3D representations, we preferred to process the image stack further using osirix as it has the facility to export various formats. One of the interesting export formats is a virtual Quicktime movie file (QTVR), which can be used for documentation, and stereo images can also be produced from this Quicktime VR. This method is easy to apply and can be used for documenting specimens in 3D (at least some aspects) without having to prepare them. Therefore, it is particularly useful as a safe method for documenting limited material, before using methods that may destroy the specimen of interest, or to investigate type material that cannot be treated with any preparatory technique. As light microscopes are available in most labs and free computer programs are easily accessible, this method can be readily applied.
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Affiliation(s)
- J T Haug
- Biosystematic Documentation, University of Ulm, Helmholtzstrasse 20, D-89081 Ulm, Germany.
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