Vincent Chow

Varun Akella, Razeyeh Bagherinasab, Jia Ming Li et al.

Body composition analysis is vital in assessing health conditions such as obesity, sarcopenia, and metabolic syndromes. MRI provides detailed images of skeletal muscle (SKM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT), but their manual segmentation is labor-intensive and limits clinical applicability. This study validates an automated tool for MRI-based 2D body composition analysis- (Data Analysis Facilitation Suite (DAFS) Express), comparing its automated measurements with expert manual segmentations using UK Biobank data. A cohort of 399 participants from the UK Biobank dataset was selected, yielding 423 single L3 slices for analysis. DAFS Express performed automated segmentations of SKM, VAT, and SAT, which were then manually corrected by expert raters for validation. Evaluation metrics included Jaccard coefficients, Dice scores, Intraclass Correlation Coefficients (ICCs), and Bland-Altman Plots to assess segmentation agreement and reliability. High agreements were observed between automated and manual segmentations with mean Jaccard scores: SKM 99.03%, VAT 95.25%, and SAT 99.57%; and mean Dice scores: SKM 99.51%, VAT 97.41%, and SAT 99.78%. Cross-sectional area comparisons showed consistent measurements with automated methods closely matching manual measurements for SKM and SAT, and slightly higher values for VAT (SKM: Auto 132.51 cm^2, Manual 132.36 cm^2; VAT: Auto 137.07 cm^2, Manual 134.46 cm^2; SAT: Auto 203.39 cm^2, Manual 202.85 cm^2). ICCs confirmed strong reliability (SKM: 0.998, VAT: 0.994, SAT: 0.994). Bland-Altman plots revealed minimal biases, and boxplots illustrated distribution similarities across SKM, VAT, and SAT areas. On average DAFS Express took 18 seconds per DICOM. This underscores its potential to streamline image analysis processes in research and clinical settings, enhancing diagnostic accuracy and efficiency.

Da Ma, Vincent Chow, Karteek Popuri et al.

The latest advances in computer-assisted precision medicine are making it feasible to move from population-wide models that are useful to discover aggregate patterns that hold for group-based analysis to patient-specific models that can drive patient-specific decisions with regard to treatment choices, and predictions of outcomes of treatment. Body Composition is recognized as an important driver and risk factor for a wide variety of diseases, as well as a predictor of individual patient-specific clinical outcomes to treatment choices or surgical interventions. 3D CT images are routinely acquired in the oncological worklows and deliver accurate rendering of internal anatomy and therefore can be used opportunistically to assess the amount of skeletal muscle and adipose tissue compartments. Powerful tools of artificial intelligence such as deep learning are making it feasible now to segment the entire 3D image and generate accurate measurements of all internal anatomy. These will enable the overcoming of the severe bottleneck that existed previously, namely, the need for manual segmentation, which was prohibitive to scale to the hundreds of 2D axial slices that made up a 3D volumetric image. Automated tools such as presented here will now enable harvesting whole-body measurements from 3D CT or MRI images, leading to a new era of discovery of the drivers of various diseases based on individual tissue, organ volume, shape, and functional status. These measurements were hitherto unavailable thereby limiting the field to a very small and limited subset. These discoveries and the potential to perform individual image segmentation with high speed and accuracy are likely to lead to the incorporation of these 3D measures into individual specific treatment planning models related to nutrition, aging, chemotoxicity, surgery and survival after the onset of a major disease such as cancer.