Correlation of visceral adipose tissue measured by Lunar Prodigy dual X-ray absorptiometry with MRI and CT in older men

Abstract

Quantification of abdominal visceral adipose tissue (VAT) is important to understand obesity-related comorbidities. We hypothesized that dual X-ray absorptiometry (DXA) measurements of VAT would correlate with traditional gold standards of magnetic resonance imaging (MRI) and computed tomography (CT) in older men. Deming regression and Bland-Altman plots were used to assess the agreement between VAT measured simultaneously by DXA and MRI (n=95) in a cohort of older males participating in a randomized trial of testosterone replacement for diabetes. We also correlated DXA with single-slice CT (n=102) in a cohort of older males undergoing testosterone deprivation for prostate cancer. Lunar Prodigy DXA scanners using enCORE software was used to measure VAT. DXA VAT volume strongly correlated with MRI VAT volume (r=0.90, P<0.0001) and CT VAT area (r=0.83, P<0.0001). As DXA assesses VAT volume in a smaller compartment than MRI, Bland-Altman analysis demonstrated DXA systematically underestimated VAT by an approximately 30% proportional bias. DXA VAT volume measured by Lunar Prodigy DXA scanners correlate well with gold standard MRI and CT quantification methods, and provides a low radiation, efficient, cost-effective option. Future clinical studies examining the effects of interventions on body composition and regional fat distribution may find DXA an appropriate volumetric method to quantify VAT.

Relationships between insulin resistance and frailty with body composition and testosterone in men undergoing androgen deprivation therapy for prostate cancer

“…Previous studies reporting VAT changes with ADT, using areal measurements by singleslice CT, have demonstrated conflicting reports (5,24). One explanation may be that this study used DXAbased volume measurements, which may be somewhat more precise than an areal measurement (18). There has been some suggestion that single-slice CT is associated with significant intra-subject and intra-scan variability which limits longitudinal analysis (25).…”

“…Appendicular skeletal muscle mass (ASMM) was calculated from the sum of the fat-free and bone mineral content-free mass in both arms and legs and used as a surrogate for total-body skeletal muscle mass (16). Visceral adipose tissue (VAT) mass and volume was quantitated using enCore software (version 16, GE Healthcare) algorithm for DXA, which correlates well with gold standard MRI volumetric measurements (17,18). Repeated measure by subject was added as a random effect.…”

Central Obesity and Visceral Adipose Tissue Are Not Associated With Incident Atherosclerotic Cardiovascular Disease Events in Older Men

“…We cannot rule out the possibility that measures of VAT using CT or magnetic resonance imaging are associated with incident ASCVD in older men. However, we think that is unlikely since DXA‐VAT is highly correlated with both CT34, 35, 36, 37 and magnetic resonance imaging34, 38 measures of VAT, and since DXA‐VAT is as strongly associated with cardiometabolic ASCVD risk factors as CT‐VAT in older men 10. Finally, we ascertained prior diagnoses of comorbid conditions at baseline by self‐report, and did not have medical records available to confirm self‐reported diagnoses.…”

Muscle, fat and performance during androgen deprivation for prostate cancer

“…Although, these results must be interpreted with caution given the use of DXA, which despite being shown to highly correlate (r=0.83) with CT-derived visceral fat CSA in overweight older men (mean age, 66 years; mean BMI, 29.7 kg/m 2 ) [120] , only provided an estimate of visceral and subcutaneous fat mass within this region of interest.…”

“…Alternatively, DXA can measure total body and regional fat mass with high precision (CV of 0.9-4.4%) [118] and correlation compared to MRI (r=0.990) and CT (r=0.979) at the same sites [119] . [120] . [119] , which may be further confounded by previously reported limitations of total body assessments in obese participants [121] and inter-and intramanufacturer variations in DXA scanners and algorithms [122,123] ; thus highlighting the importance of using a singular DXA scanner when possible and strictly adhering to manufacturer guidelines when analysing scans (e.g.…”