3D-segmentation and characterization of visceral and abdominal subcutaneous adipose tissue on CT: influence of contrast medium and contrast phase

Quantitative Imaging in Medicine and Surgery

article

Robin F. Gohmann¹  Sebastian Gottschling¹  Patrick Seitz¹  Batuhan Temiz²  Christian Krieghoff¹  Christian Lücke¹  Matthias Horn¹  Matthias Gutberlet¹ 

[1] Department of Diagnostic and Interventional Radiology, Heart Center Leipzig;Medical Faculty, University of Leipzig

关键词: Body composition;    segmentation;    adipose tissue;    contrast media;    computed tomography;   

DOI  :  10.21037/qims-20-907

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: Adipose tissue as part of body composition analysis may serve as a powerful biomarker. Validation of segmented adipose tissue and correlation to clinical data has been performed on non-enhanced scans (NES). As many patients require a contrast enhanced scan (CES) for other aspects of clinical decision making, the utility of CES for body composition analysis would be most useful. Therefore, we analyzed the influence of iodinated contrast medium (ICM) and contrast phase on the characterization and segmentation of adipose tissue. Methods: Exams of 31 patients undergoing multi-phasic CT at identical scan settings containing an NES were retrospectively included. In addition to NES, patients received an arterial (ART) (n=23), portal-venous (PVN) (n=10), and/or venous scan (VEN) (n=31) after intravenous injection of 90 mL ICM. Density and volume of adipose tissue were quantified semi-automatically with thresholds between −190 HU and −30 HU and recorded separately for visceral (VAT) and subcutaneous adipose tissue (SAT). Density and volume of total adipose tissue (TAT) were computed. For conversion of values from CES into those of NES regression analyses were performed and tested. Results: Density of adipose tissue increased after application of ICM more on later scans (VEN ≈ PVN > ART) and more markedly in VAT than SAT (VAT > TAT > SAT). Except in SAT on ART, all changes were significant (P ART) (P TAT) on all CES (P<0.05). Density and volume in CES correlate extremely well with NES and may be calculated from one another [root-mean-square error (RMSE): <6 HU; <0.85 dm 3 ]. Conclusions: Density and volume of segmented adipose tissue are altered by the injection of ICM in differing degrees between compartments and contrast phases. However, as the effect of ICM is fairly constant for a given compartment and contrast phase, values may be converted into those of NES with relative precession. This conversion allows body composition analysis to be carried out also in contrast enhanced CT examinations, e.g., for risk stratification and the comparison of the obtained results to previous studies.

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