Key result
Deep learning applied to whole-body MRI discriminated diabetes with an AUC-ROC of 0.87 and prediabetes with an AUC-ROC of 0.68, showing superior classification to conventional models.
Why the study?
Body fat distribution patterns influence insulin resistance in T2D, but hitherto unknown features of fat distribution that additionally contribute to the disease remained to be identified.
Does a deep learning model using whole-body MRI improve the detection of diabetes compared to conventional models?
Cross-Sectional (n=2,371)
Does a deep learning model using whole-body MRI improve the detection of diabetes compared to conventional models?
Effect estimate: AUC-ROC 0.87
Deep learning applied to whole-body MRI can accurately detect diabetes (AUC-ROC 0.87) without blood glucose measurements, identifying lower visceral abdominal fat as a critical region.
May support noninvasive diabetes detection via MRI; leaves open need for prospective validation before clinical adoption.
Obesity is one of the main drivers of the globally rising prevalence of type 2 diabetes (T2D). Yet, obesity is not uniformly associated with metabolic consequences. The location of fat accumulation is critical for metabolic health. Specific patterns of body fat distribution, such as an increased ratio of visceral to subcutaneous fat, are closely related to insulin resistance which is crucial in the pathogenesis of T2D. There might be further, hitherto unknown features of body fat distribution which could additionally contribute to the disease. We used a machine learning approach with dense convolutional neural networks (DCNN) to detect diabetes related variables from 2371 T1-weighted whole-body magnetic resonance image (MRI) data sets. Each single measurement was labelled by sex, age, BMI, insulin sensitivity, HbA1c and prediabetes or incident diabetes. The result was compared to conventional models using segmented body fat compartment volumes. Anatomical labels were assigned to locations in the DCNN gradient heatmaps that are critical for discrimination. The AUC-ROC was 0.87 for the discrimination of diabetes and 0.68 for prediabetes. Classification performance was superior to conventional models. Mean absolute regression errors were comparable to those of the conventional models. Heatmaps clearly showed that lower visceral abdominal regions were most critical in diabetes classification, while other significant areas comprised upper legs, arms and the neck region.Our results show that diabetes is detectable from whole-body MRI without any blood glucose measurement. Our technique of heatmap visualization unravels plausible anatomical regions and highlights the leading role of fat accumulation in the lower abdomen in the pathogenesis of T2D. Disclosure R. Wagner: Advisory Panel; Self; Novo Nordisk A/S. Speaker’s Bureau; Self; Novo Nordisk A/S. Other Relationship; Self; Eli Lilly and Company. B. Dietz: None. J. Machann: None. P. Schwab: Employee; Self; Roche Pharma. J.K. Dienes: Advisory Panel; Spouse/Partner; Novo Nordisk A/S. Speaker’s Bureau; Spouse/Partner; Novo Nordisk A/S. Other Relationship; Spouse/Partner; Eli Lilly and Company. S. Reichert: Other Relationship; Self; Lilly Diabetes. A.L. Birkenfeld: None. H. Haering: None. F. Schick: None. N. Stefan: None. M. Heni: Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Sanofi. Speaker’s Bureau; Self; Novo Nordisk A/S. H. Preissl: None. B. Schölkopf: None. S. Bauer: None. A. Fritsche: None. Funding German Federal Ministry of Education and Research (01GI0925)
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Wágner et al. (2020) conducted a cross-sectional in Type 2 diabetes (n=2,371). Deep learning (DCNN) on whole-body MRI vs. Conventional models using segmented body fat compartment volumes was evaluated on Discrimination of diabetes (AUC-ROC 0.87). Deep learning applied to whole-body MRI discriminated diabetes with an AUC-ROC of 0.87 and prediabetes with an AUC-ROC of 0.68, showing superior classification to conventional models.
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