title: Automated quantification of epicardial adipose tissue (EAT) in coronary CT angiography; comparison with manual assessment and correlation with coronary artery disease.
abstract: BACKGROUND
  Epicardial adipose tissue (EAT) is emerging as a risk factor for coronary artery disease (CAD).
  
  
  OBJECTIVE
  The aim of this study was to determine the applicability and efficiency of automated EAT quantification.
  
  
  METHODS
  EAT volume was assessed both manually and automatically in 157 patients undergoing coronary CT angiography. Manual assessment consisted of a short-axis-based manual measurement, whereas automated assessment on both contrast and non-contrast-enhanced data sets was achieved through novel prototype software. Duration of both quantification methods was recorded, and EAT volumes were compared with paired samples t test. Correlation of volumes was determined with intraclass correlation coefficient; agreement was tested with Bland-Altman analysis. The association between EAT and CAD was estimated with logistic regression.
  
  
  RESULTS
  Automated quantification was significantly less time consuming than automated quantification (17 ± 2 seconds vs 280 ± 78 seconds; P < .0001). Although manual EAT volume differed significantly from automated EAT volume (75 ± 33 cm(³) vs 95 ± 45 cm(³); P < .001), a good correlation between both assessments was found (r = 0.76; P < .001). For all methods, EAT volume was positively associated with the presence of CAD. Stronger predictive value for the severity of CAD was achieved through automated quantification on both contrast-enhanced and non-contrast-enhanced data sets.
  
  
  CONCLUSIONS
  Automated EAT quantification is a quick method to estimate EAT and may serve as a predictor for CAD presence and severity.
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, The Netherlands; CARIM, School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Casper
authors.initials: C
authors.lastname: Mihl
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, The Netherlands; CARIM, School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Daan
authors.initials: D
authors.lastname: Loeffen
authors.affiliation: Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Mathijs O
authors.initials: MO
authors.lastname: Versteylen
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Richard A P
authors.initials: RA
authors.lastname: Takx
authors.affiliation: Department of Epidemiology, University of Maastricht, Maastricht, The, Netherlands.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Nelemans
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Estelle C
authors.initials: EC
authors.lastname: Nijssen
authors.affiliation: Siemens AG Healthcare Sector, Computed Tomography, 91301 Forchheim, Germany.
authors.forename: Fernando
authors.initials: F
authors.lastname: Vega-Higuera
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, The Netherlands; CARIM, School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, The Netherlands; CARIM, School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands. Electronic address: m.das@mumc.nl.
authors.forename: Marco
authors.initials: M
authors.lastname: Das
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000473:pathology; D001331:Automation; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000473:pathology; D015203:Reproducibility of Results; D012984:Software; D054894:Spiral Cone-Beam Computed Tomography
keywords: Automated quantitative analysis; Coronary CT angiography; Coronary artery disease; Epicardial adipose tissue; Quantification