Is visceral obesity associated with colorectal cancer? The first volumetric study using all CT slices

The Effect of Falsely Highlighted Intestinal Intraluminal Areas and the Fat in Paraspinal Muscles on Abdominal Adipose Tissue Measurements Using Computed Tomography

“…Similarly, several previous studies have included FPM in SAT measurement (7,8). However, Hung et al, Delivanis et al, and Akay et al have excluded FPM in their studies (9)(10)(11). In this study, a statistically significant difference was obtained between including and excluding FPM in SAT measurements.…”

“…Lastly and recently, Akay et al have used an oral contrast agent to prevent any intestinal involvement in the automated VAT measurement process and also excluded the remnant intestinal involvement manually, if any (11). In contrast, a majority of studies measuring VAT have not excluded FHIIAs (2,7,(8)(9)(10)(11)(12)(13)(14)(15). This methodological approach indicates that the effect of FHIIAs on the abdominal fat measurement is an underestimated problem in the literature, thus enhancing the importance of this study.…”

“…One minor limitation of this study was performing two-dimensional fat measurements on a single slice selected at a specific level rather than using three-dimensional measurements as the volume was measured across several slices. However, several studies have revealed that measuring VAT on a single CT or magnetic resonance imaging slice is a reliable method (2,8,11,15,16,(18)(19)(20). Given the limitation of obtaining twodimensional measurements in a three-dimensional patient, the validity of this method has been previously established by comparing the two-dimensional and three-dimensional VAT measurements in a different patient population (21).…”

“…Therefore, whether to include or exclude FHIIAs while performing VAT measurements is unclear. A similar confusion also exists with the fat within paraspinal muscles (FPM) while performing SAT measurements, as some of the studies in the literature include FPM, and some exclude them (7)(8)(9)(10)(11). The fatty infiltration of the FPM, secondary to muscle atrophy, obesity, or other reasons, is another drawback of the current CT quantification technique.…”

The Relationship Between Colorectal Cancer and Abdominal Adipose Tissue Distribution

“…In these studies, different results were found depending on the method used or the selected patient populations and their different clinical characteristics. [5,[10][11][12][22][23][24][25] Lee et al [12] found that VFA is positively associated with the prevalence of colorectal cancer. Although they could not comment on causality, they stated that visceral fat may be associated with the risk of colorectal cancer.…”