Antti Tolonen1, Tomppa Pakarinen2, Antti Sassi2, Jere Kyttä3, William Cancino4, Irina Rinta-Kiikka2, Said Pertuz4, Otso Arponen2. 1. Faculty of Medicine and Health Sciences, Tampere University, Kauppi Campus, Arvo Ylpön katu 34, 33520 Tampere, Finland. Electronic address: antti.h.tolonen@tuni.fi. 2. Faculty of Medicine and Health Sciences, Tampere University, Kauppi Campus, Arvo Ylpön katu 34, 33520 Tampere, Finland; Department of Radiology, Tampere University Hospital, Elämänaukio, Kuntokatu 2, 33520 Tampere, Finland. 3. Faculty of Medicine and Health Sciences, Tampere University, Kauppi Campus, Arvo Ylpön katu 34, 33520 Tampere, Finland. 4. Connectivity and Signal Processing Group, Universidad Industrial de Santander, Cl. 9 #Cra 27, Bucaramanga, Colombia.
Abstract
PURPOSE OF THE REVIEW: We aim to review the methods, current research evidence, and future directions in body composition analysis (BCA) with CT imaging. RECENT FINDINGS: CT images can be used to evaluate muscle tissue, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) compartments. Manual and semiautomatic segmentation methods are still the gold standards. The segmentation of skeletal muscle tissue and VAT and SAT compartments is most often performed at the level of the 3rd lumbar vertebra. A decreased amount of CT-determined skeletal muscle mass is a marker of impaired survival in many patient populations, including patients with most types of cancer, some surgical patients, and those admitted to the intensive care unit (ICU). Patients with increased VAT are more susceptible to impaired survival / worse outcomes; however, those patients who are critically ill or admitted to the ICU or who will undergo surgery appear to be exceptions. The independent significance of SAT is less well established. Recently, the roles of the CT-determined decrease of muscle mass and increased VAT area and epicardial adipose tissue (EAT) volume have been shown to predict a more debilitating course of illness in patients suffering from severe acute respiratory syndrome coronavirus 2 (COVID-19) infection. SUMMARY: The field of CT-based body composition analysis is rapidly evolving and shows great potential for clinical implementation.
PURPOSE OF THE REVIEW: We aim to review the methods, current research evidence, and future directions in body composition analysis (BCA) with CT imaging. RECENT FINDINGS: CT images can be used to evaluate muscle tissue, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) compartments. Manual and semiautomatic segmentation methods are still the gold standards. The segmentation of skeletal muscle tissue and VAT and SAT compartments is most often performed at the level of the 3rd lumbar vertebra. A decreased amount of CT-determined skeletal muscle mass is a marker of impaired survival in many patient populations, including patients with most types of cancer, some surgical patients, and those admitted to the intensive care unit (ICU). Patients with increased VAT are more susceptible to impaired survival / worse outcomes; however, those patients who are critically ill or admitted to the ICU or who will undergo surgery appear to be exceptions. The independent significance of SAT is less well established. Recently, the roles of the CT-determined decrease of muscle mass and increased VAT area and epicardial adipose tissue (EAT) volume have been shown to predict a more debilitating course of illness in patients suffering from severe acute respiratory syndrome coronavirus 2 (COVID-19) infection. SUMMARY: The field of CT-based body composition analysis is rapidly evolving and shows great potential for clinical implementation.
Authors: Arved Weimann; Wolfgang H Hartl; Michael Adolph; Matthias Angstwurm; Frank M Brunkhorst; Andreas Edel; Geraldine de Heer; Thomas W Felbinger; Christiane Goeters; Aileen Hill; K Georg Kreymann; Konstantin Mayer; Johann Ockenga; Sirak Petros; Andreas Rümelin; Stefan J Schaller; Andrea Schneider; Christian Stoppe; Gunnar Elke Journal: Med Klin Intensivmed Notfmed Date: 2022-04-28 Impact factor: 1.552
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