An accurate and robust method for unsupervised assessment of abdominal fat by MRI

Positano, Vincenzo; Gastaldelli, Amalia; Sironi, Anna Maria; Santarelli, Maria Filomena; Lombardi, Massimo; Landini, Luigi

doi:10.1002/jmri.20167

Cited by 143 publications

(173 citation statements)

References 19 publications

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“…This issue has been noted previously . 18 Even in the case of heavier subjects with large amounts of visceral adipose tissue, the automated contours for the visceral compartment appeared to exclude some of the adipose tissue from the subsequent analysis, perhaps because of varying intensity of the VAT signal across a single image, or poor resolution of the boundary between the abdominal wall and the visceral compartment. If the signal intensity for VAT is low in a region, the automated VAT contour may not detect it, and the VAT level may be underestimated.…”

Section: Discussionmentioning

confidence: 99%

“…Subjects in the present analysis were imaged on a 1.5 T scanner using a standard body coil with a T1-weighted fastspin-echo pulse sequence -a fairly standard protocol for the acquisition of abdominal VAT data in existing studies and similar to the protocol used to initially test the Hippo Fatt method. 18 Better resolution images may improve the ability of Hippo Fatt to generate accurate estimates of VAT without manual editing.…”

Section: Discussionmentioning

confidence: 99%

“…18,31 The FCM algorithm results in a roughly bimodal distribution of pixel intensities in the visceral compartment for each axial image. A Gaussian distribution (with a mean value equal to the representative adipose tissue value and a height equal to the number of pixels with that range of values) is then fit to the peak that corresponds to adipose tissue to estimate SAT and VAT areas.…”

Section: Hippo Fatt Analysismentioning

confidence: 99%

“…Positano et al 18 recently introduced Hippo Fatt, an IDL Virtual Machine 6.1-based freeware designed to quantify adipose tissue areas from MR images automatically, without user supervision or manual editing. 19 Given the considerable time and research cost associated with manual tagging of VAT, an automated image analysis system is highly desirable, especially for large-scale studies.…”

Section: Introductionmentioning

confidence: 99%

“…19 Given the considerable time and research cost associated with manual tagging of VAT, an automated image analysis system is highly desirable, especially for large-scale studies. Compared to a free-hand method of contour fitting, 20 Hippo Fatt produced comparable results in less time, 18 but Hippo Fatt has yet to be independently compared to image analysis software currently in use in clinical and epidemiological studies. slice-O-matict (slice-O-matic version 4.2, Tomovision, Montreal, Canada) has been used to estimate visceral adipose tissue volumes in over 200 peer-reviewed scientific publications since 1991.…”

Section: Introductionmentioning

confidence: 99%

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Validity of a new automated software program for visceral adipose tissue estimation

et al. 2006

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Introduction: Given the considerable time and research cost of analyzing biomedical images to quantify adipose tissue volumes, automated image analysis methods are highly desirable. Hippo Fatt is a new software program designed to automatically quantify adipose tissue areas from magnetic resonance images without user inputs. Hippo Fatt has yet to be independently validated against commonly used image analysis software programs. Objective: Our aim was to compare estimates of VAT (visceral adipose tissue) and SAT (subcutaneous adipose tissue) using the new Hippo Fatt software against those from a widely used, validated, computer-assisted manual method (slice-O-matic version 4.2, Tomovision, Montreal, CA, USA) to assess its potential utility for large-scale studies. Methods: A Siemens Magnetom Vision 1.5-T whole-body scanner and a T1-weighted fast-spin echo pulse sequence were used to collect multiple, contiguous axial images of the abdomen from a sample of 40 healthy adults (20 men) aged 18-77 years of age, with mean body mass index of 29 kg/m 2 (range ¼ 19-43 kg/m 2 ). Results: Hippo Fatt provided estimates of VAT and SAT that were highly correlated with estimates using slice-O-matic (R 2 40.9). Average VAT was 9.4% lower and average SAT was 3.7% higher using Hippo Fatt compared to slice-O-matic; the overestimation of SAT tended to be greater among individuals with greater adiposity. Individual-level differences for VAT were also substantial; Hippo Fatt gave estimates of VAT ranging from 1184 cm 3 less to 566 cm 3 more than estimates for the same person using slice-O-matic. Conclusion: Hippo Fatt provides a rapid method of quantifying total VAT, although the method does not provide estimates that are interchangeable with slice-O-matic at either the group (mean) or individual level.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Hippo Fatt Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Validity of a new automated software program for visceral adipose tissue estimation

et al. 2006

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Automated quantification of abdominal adiposity by magnetic resonance imaging

Sun

Freeland‐Graves

2016

American J Hum Biol

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Objectives To develop a fully-automated algorithm to process axial magnetic resonance imaging (MRI) slices for quantifying abdominal visceral, subcutaneous and total adipose tissues, i.e. VAT, SAT and TAT, without human intervention or prior knowledge. Materials and Methods Fat regions in single MRI slice or sequence (20 slices) were identified with image processing techniques including region-growing, inhomogeneity correction, fuzzy c-means clustering, and active contours segmentation. The MR images of 85 subjects (60 males and 25 females), whose body mass index (BMI) values ranged from 19.96 to 40.35 kg/m2, were analyzed using the fully-automated algorithm—the automatic method developed in the research and the widely used semi-automated software (sliceOmatic® Tomovision, Inc.)—the reference method. Results The proposed automated method showed good performance against the reference method to quantify adipose tissues in both single umbilical slice and MRI sequence. The square of the Pearson correlation coefficients (R2) based on the results generated from the two methods for VAT/SAT/TAT were 0.977/0.998/0.997 for single slice data and 0.995/0.999/0.999 for volumetric data. The intra-class correlation of VAT between the three operators was 0.939 in the reference method, which was improved to 0.999 in the automatic method. The adipose tissue measurements in the slice at Lumbar 3 vertebra have the highest correlation with the total fat volumes across the entire abdomen. Conclusion The fully-automated algorithm presented in the paper provides an accurate and reliable assessment of abdominal fat without human intervention.

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Visceral fat

Poorten¹,

Milner²,

Hui³

et al. 2008

Hepatology

523

360

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Visceral obesity is intimately associated with metabolic disease and adverse health outcomes. However, a direct association between increasing amounts of visceral fat and end-organ inflammation and scarring has not been demonstrated. We examined the association between visceral fat and liver inflammation in patients with nonalcoholic fatty liver disease (NAFLD) to delineate the importance of visceral fat to progressive steatohepatitis and hence the inflammatory pathogenesis of the metabolic syndrome. We undertook a cross-sectional, proof of concept study in 38 consecutive adults with NAFLD at a tertiary liver clinic. All subjects had a complete physical examination, anthropometric assessment, and fasting blood tests on the day of liver biopsy. Abdominal fat volumes were assessed by magnetic resonance imaging within 2 weeks of liver biopsy. The extent of hepatic inflammation and fibrosis augmented incrementally with increases in visceral fat (P < 0.01). For each 1% increase in visceral fat, the odds ratio for increasing liver inflammation and fibrosis was 2.4 (confidence interval [CI]: 1.3-4.2) and 3.5 (CI: 1.7-7.1), respectively. Visceral fat remained an independent predictor of advanced steatohepatitis (odds ratio [OR] 2.1, CI: 1.1-4.2, P ‫؍‬ 0.05) and fibrosis (OR 2.9, CI: 1.4-6.3, P ‫؍‬ 0.006) even when controlled for insulin resistance and hepatic steatosis. Interleukin-6 (IL-6) levels, which correlated with visceral fat, also independently predicted increasing liver inflammation. Visceral fat was associated with all components of the metabolic syndrome. Conclusion: Visceral fat is directly associated with liver inflammation and fibrosis independent of insulin resistance and hepatic steatosis. Visceral fat should therefore be a central target for future interventions in nonalcoholic steatohepatitis and indeed all metabolic disease. (HEPATOLOGY 2008;48:449-457.)

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An accurate and robust method for unsupervised assessment of abdominal fat by MRI

Cited by 143 publications

References 19 publications

Validity of a new automated software program for visceral adipose tissue estimation

Validity of a new automated software program for visceral adipose tissue estimation

Automated quantification of abdominal adiposity by magnetic resonance imaging

Visceral fat

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