CT-derived epicardial adipose tissue density: Systematic review and meta-analysis

Area of Science:

• Cardiology
• Radiology
• Biomedical Imaging

Background:

• Epicardial adipose tissue (EAT) is metabolically active and linked to cardiovascular disease.
• Accurate measurement of EAT density using computed tomography (CT) is crucial for risk stratification.
• Variability in EAT density measurements may stem from technical and clinical factors.

Purpose of the Study:

• To systematically review and meta-analyze epicardial adipose tissue (EAT) density values from existing literature.
• To assess the correlation between EAT density and segmentation thresholds.
• To investigate the influence of technical and clinical variables on EAT density.

Main Methods:

• Systematic literature search for studies reporting EAT density in Hounsfield Units (HU) from chest CT scans.
• Inclusion of studies reporting mean and standard deviation of EAT density.
• Extraction of technical, clinical, and EAT data, with subgroup analysis based on clinical conditions.
• Pooled density analysis and meta-regression to evaluate influencing factors.

Main Results:

• Included 13 studies with 7683 subjects.
• Overall pooled EAT density was -85.86 HU.
• EAT density was lower in healthy subjects (-86.40 HU) compared to coronary artery disease patients (-80.71 HU).
• EAT volume and segmentation thresholds (lower and higher) significantly correlated with EAT density.

Conclusions:

• Coronary artery disease patients exhibit higher EAT density.
• Significant correlations highlight the need for standardized EAT segmentation thresholds.
• Consistent methodology is essential for reliable EAT density assessment in clinical practice.