Automated three-dimensional body composition analysis identifies visceral adipose tissue radiodensity as a predictor of mortality and recurrence in colorectal cancer
1St Mark's Hospital and Academic Institute, St Mark's The National Bowel Hospital, Central Middlesex Hospital, Acton Ln, NW10 7NS, London, United Kingdom; Department of Surgery and Cancer, Imperial College London, United Kingdom.
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Summary
Three-dimensional body composition analysis using artificial intelligence reveals that sarcopenia, myosteatosis, and visceral obesity predict poorer colorectal cancer survival. Elevated visceral adipose tissue radiodensity is a novel predictor of mortality and recurrence in CRC patients.
Area of Science:
- Medical Imaging
- Oncology
- Artificial Intelligence
Background:
- Artificial intelligence (AI) enables advanced three-dimensional (3D) volumetric body composition (BC) analysis from computed tomography (CT) scans.
- Traditional BC analysis often relies on single L3 vertebral slices, limiting comprehensive assessment.
- This study investigates the utility of 3D BC analysis in predicting colorectal cancer (CRC) outcomes.
Purpose of the Study:
- To identify relationships between 3D body composition parameters and postoperative outcomes in colorectal cancer (CRC) patients.
- To explore the predictive value of sarcopenia, myosteatosis, visceral obesity, and adipose tissue radiodensity for CRC survival and recurrence.
- To assess the association between elevated visceral adipose tissue radiodensity and tumor characteristics.
Main Methods:
- Quantitative analysis of abdominopelvic skeletal muscle (SM), subcutaneous, and visceral adipose tissue volume and radiodensity from preoperative CT scans of 750 CRC patients.
- Size-adjusted indices for BC parameters were calculated using abdominopelvic length and height.
- Multivariate Cox regression models were employed to evaluate overall survival and disease-free survival, with sex-specific cut-offs for BC parameters.
Main Results:
- Sarcopenia, myosteatosis, visceral obesity, subcutaneous adipose tissue depletion, and elevated visceral adipose tissue radiodensity were significant predictors of poorer overall survival.
- Sarcopenia and elevated visceral adipose tissue radiodensity predicted disease recurrence.
- Elevated visceral adipose tissue radiodensity was associated with advanced T4 tumor stage and lymphovascular invasion.
Conclusions:
- Three-dimensional body composition analysis, including sarcopenia and myosteatosis, effectively predicts CRC survival outcomes, consistent with L3 slice studies.
- Elevated abdominopelvic visceral adipose tissue radiodensity emerges as a potentially novel predictor of both CRC mortality and recurrence.
- This novel predictor is linked to a more aggressive tumor phenotype, suggesting its clinical significance in CRC management.