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Objectives CT-based body composition analysis (BCA) provides imaging biomarkers, including muscle volume and surrogates of muscle quality. Concerns over the comparability of Non-contrast and contrast-enhanced CT scans have limited their clinical application. This study aims to assess the influence of various contrast phases on a volumetric CT-based BCA. Materials and methods 20 Göttingen minipigs were subjected to a Non-contrast (NC) and five contrast-enhanced Early Arterial, Late Arterial, Vascular Portal Venous, Parenchymal Portal Venous (PPV), Late CT scans. 114 tri-phasic (Non-Contrast, Arterial, Venous) CT scans were analyzed for human validation. A volumetric BCA network Body and Organ Analysis (BOA) extracted muscle radiodensity and the following features as volumes: Muscle, Subcutaneous Adipose Tissue (SAT), Inter- and Intramuscular Adipose Tissue (IMAT), Visceral Adipose Tissue (VAT), and Total Adipose Tissue (TAT). Significance was assessed by a one-way ANOVA with Tukey's multiple comparisons test. Results In the animal model, there was a tendency toward reduced IMAT volumes after CM injection NC = 245 ml (±105 ml), e.g., PPV = 241 ml (±105 ml). Muscle radiodensity was significantly higher following CM administration Non-contrast: 51.1 HU (±1.9 HU), e.g., Late: 56.6 HU (±2.4 HU), p 0.001. The human validation analysis showed similar tendencies for the IMAT volume Non-contrast: 1750ml (±729 ml), Venous: 1,552 ml (±696 ml), p = 0.10 and significantly higher muscle radiodensity Venous: 39.2 HU (±9.1 HU), Non-contrast: 35.6 HU (±7.8), p = 0.007. Conclusion Myosteatosis surrogates, such as muscle radiodensity or IMAT, are susceptible to interference by CM, while quantification of muscle tissue and extramuscular fat remains robust.
Salhöfer et al. (Fri,) studied this question.