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Updated: Jul 17, 2026
Fat-Water Phantoms for Magnetic Resonance Imaging Validation: A Flexible and Scalable Protocol
Published on: September 7, 2018
Approximation of total visceral adipose tissue with a single magnetic resonance image
Ellen W Demerath1, Wei Shen, Miryoung Lee
1Lifespan Health Research Center, Department of Community Health, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA. ellen.demerath@wright.edu
Background:
A single axial image measured between the 4th and 5th lumbar vertebrae (L4-L5) is most frequently chosen to approximate total abdominal visceral adipose tissue (VAT) volume, but growing evidence suggests that this measurement site is not ideal.
Objective:
The objective was to determine the single magnetic resonance (MR) image that best approximates the total VAT volume in a biracial sample of healthy subjects.
Design:
We used contiguous abdominal MR images to measure VAT area and summed them to determine total VAT volume. The sample included 820 healthy men and women (n = 692 whites, 128 blacks) aged 18-88 y.
Results:
A range of MR images had equally high correlations with total VAT in each race and sex group. The image 6 cm above L4-L5 (L4-L5 + 6) was within the best equivalent range for all race and sex groups. The L4-L5 + 6 image crossed the L3 vertebra in 85% of subjects and crossed the L2-L3 intervertebral space or the L2 vertebra for 15% of subjects. Linear regression models indicated that the L4-L5 + 6 image explained 97% of the variance in total abdominal VAT volume, and additional covariates did not increase the R(2) value significantly. The L4-L5 image explained 83% of the variance in VAT volume, and the covariates accounted for an additional 7% of the variance. Rank-order values for VAT can change if total VAT volume is approximated by a single image area. Whereas 25% of subjects changed rank by >or=10% with the L4-L5 image, only 3% changed rank to that degree with the L4-L5 + 6 image.
Conclusions:
A single MR image located approximately at the L3 vertebra can accurately estimate total VAT volume in blacks and whites of both sexes.
