title: CT-based compartmental quantification of adipose tissue versus body metrics in colorectal cancer patients.
abstract: OBJECTIVE
  While obesity is considered a prognostic factor in colorectal cancer (CRC), there is increasing evidence that not simply body mass index (BMI) alone but specifically abdominal fat distribution is what matters. As part of the ColoCare study, this study measured the distribution of adipose tissue compartments in CRC patients and aimed to identify the body metric that best correlates with these measurements as a useful proxy for adipose tissue distribution.
  
  
  METHODS
  In 120 newly-diagnosed CRC patients who underwent multidetector computed tomography (CT), densitometric quantification of total (TFA), visceral (VFA), intraperitoneal (IFA), retroperitoneal (RFA), and subcutaneous fat area (SFA), as well as the M. erector spinae and psoas was performed to test the association with gender, age, tumor stage, metabolic equivalents, BMI, waist-to-height (WHtR) and waist-to-hip ratio (WHR).
  
  
  RESULTS
  VFA was 28.8 % higher in men (pVFA<0.0001) and 30.5 % higher in patients older than 61 years (pVFA<0.0001). WHtR correlated best with all adipose tissue compartments (rVFA=0.69, rTFA=0.84, p<0.0001) and visceral-to-subcutaneous-fat-ratio (VFR, rVFR=0.22, p=<0.05). Patients with tumor stages III/IV showed significantly lower overall adipose tissue than I/II. Increased M. erector spinae mass was inversely correlated with all compartments.
  
  
  CONCLUSIONS
  Densitometric quantification on CT is a highly reproducible and reliable method to show fat distribution across adipose tissue compartments. This distribution might be best reflected by WHtR, rather than by BMI or WHR.
  
  
  CONCLUSIONS
  • Densitometric quantification of adipose tissue on CT is highly reproducible and reliable. • Waist-to-height ratio better correlates with adipose tissue compartments and VFR than BMI or waist-to-hip ratio. • Men have higher a higher visceral fat area than women. • Patients older than 61 years have higher visceral fat area. • Patients with tumor stages III/IV have significantly lower adipose tissue than those in stages I/II.
authors: Department of Diagnostic and Interventional Radiology, University Hospital, Heidelberg, Germany. Johanna.nattenmueller@med.uni-heidelberg.de.
authors: Johanna
authors: http://orcid.org/0000-0003-4032-378X
authors: J
authors: Nattenmueller
authors: Department of Diagnostic and Interventional Radiology, University Hospital, Heidelberg, Germany.
authors: Hanna
authors: H
authors: Hoegenauer
authors: Department of Population Health Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA.
authors: Juergen
authors: J
authors: Boehm
authors: Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany.
authors: Dominique
authors: D
authors: Scherer
authors: Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany.
authors: Michael
authors: M
authors: Paskow
authors: Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany.
authors: Biljana
authors: B
authors: Gigic
authors: Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany.
authors: Petra
authors: P
authors: Schrotz-King
authors: Department of Diagnostic and Interventional Radiology, University Hospital, Heidelberg, Germany.
authors: Lars
authors: L
authors: Grenacher
authors: Department of Population Health Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA.
authors: Cornelia
authors: C
authors: Ulrich
authors: Department of Diagnostic and Interventional Radiology, University Hospital, Heidelberg, Germany.
authors: Hans-Ulrich
authors: HU
authors: Kauczor
mesh_terms: D050153:Abdominal Fat / Q000000981:diagnostic imaging; D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000378:metabolism; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D009765:Obesity / Q000000981:diagnostic imaging; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D049629:Waist-Hip Ratio
keywords: Body mass index; Colorectal neoplasms; Multidetector computed tomography; Obesity; Waist-to-height ratio