Advanced body composition assessment: from body mass index to body composition profiling

Magnus Borga, Janne West, Jimmy D Bell, Nicholas C Harvey, Thobias Romu, Steven B Heymsfield, Olof Dahlqvist Leinhard, Magnus Borga, Janne West, Jimmy D Bell, Nicholas C Harvey, Thobias Romu, Steven B Heymsfield, Olof Dahlqvist Leinhard

Abstract

This paper gives a brief overview of common non-invasive techniques for body composition analysis and a more in-depth review of a body composition assessment method based on fat-referenced quantitative MRI. Earlier published studies of this method are summarized, and a previously unpublished validation study, based on 4753 subjects from the UK Biobank imaging cohort, comparing the quantitative MRI method with dual-energy X-ray absorptiometry (DXA) is presented. For whole-body measurements of adipose tissue (AT) or fat and lean tissue (LT), DXA and quantitative MRIs show excellent agreement with linear correlation of 0.99 and 0.97, and coefficient of variation (CV) of 4.5 and 4.6 per cent for fat (computed from AT) and LT, respectively, but the agreement was found significantly lower for visceral adipose tissue, with a CV of >20 per cent. The additional ability of MRI to also measure muscle volumes, muscle AT infiltration and ectopic fat, in combination with rapid scanning protocols and efficient image analysis tools, makes quantitative MRI a powerful tool for advanced body composition assessment.

Keywords: body composition; magnetic resonance imaging.

Conflict of interest statement

Competing interests: MB, JW, TR and ODL are employees and stockholders of AMRA Medical AB.

© American Federation for Medical Research (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Example of segmentation of abdominal subcutaneous AT (ASAT), visceral AT (VAT) and 10 muscle groups from fat water separated MRI using fat-referenced MRI and multi-atlas image segmentation. To the left is the fat image with ASAT (blue) and VAT (red), and to the right is the water image with the different muscle groups colored. Reproduced with permission from AMRA Medical AB.
Figure 2
Figure 2
(A) The definition of lean and adipose tissue measured by MRI from the bottom of the thigh muscles to top of vertebrae T9 marked in blue color in the water (left) and fat (right) image. (B) An example of a dual-energy X-ray absorptiometry (DXA) image from the study cohort. DXA image copyright UK Biobank. Reprinted with permission.
Figure 3
Figure 3
Correlation plots (upper row) between dual-energy X-ray absorptiometry (DXA) and corresponding measurement predicted from MRI using a linear transformation for body fat (left) and body lean tissue (right). The bottom row shows Bland-Altman plots of the agreement between DXA and corresponding measures predicted from MRI.
Figure 4
Figure 4
Correlation between visceral adipose tissue (VAT) predicted by dual-energy X-ray absorptiometry (DXA) and VAT measured by MRI (left) and Bland-Altman plot showing the agreement (liters) between the methods (right).

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