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Evaluating Epicardial Fat Density Using ROI-Based Analysis: A Feasibility Study
Giovanni Lorusso1, Nicola Maggialetti1, Luca De Marco1
1Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.
Journal of Cardiovascular Development and Disease
|March 26, 2025
Summary
Epicardial fat density (EFD) varies significantly by heart region. Region-specific measurements using coronary CT may not accurately represent overall EFD, impacting cardiovascular disease assessment.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Biomedical Engineering
Background:
- Epicardial fat density (EFD) is a marker for cardiovascular disease risk.
- Accurate EFD measurement is crucial for risk stratification.
- Understanding regional EFD variability is essential for precise assessment.
Purpose of the Study:
- To investigate regional differences in epicardial fat density (EFD) using coronary computed tomography (CCT).
- To assess the utility of region-of-interest (ROI)-based EFD measurements compared to global segmentation.
- To determine if ROI measurements can reliably represent overall EFD.
Main Methods:
- Retrospective analysis of 171 patients undergoing CCT.
- Global EFD measured via semi-automated segmentation (3D Slicer).
- Regional EFD measured manually in the aortic bulb, right posterolateral wall, and cardiac apex.
Main Results:
- Global EFD averaged -83.92 ± 5.19 HU.
- Significant regional EFD variability observed: aortic bulb (-97.54 HU), apex (-93.42 HU), right posterolateral wall (-94.99 HU).
- Statistically significant differences (p < 0.000) between global and regional EFD values.
Conclusions:
- Epicardial fat density exhibits significant regional heterogeneity.
- ROI-based EFD measurements may not accurately reflect global EFD.
- Current ROI methods might be insufficient for comprehensive cardiovascular risk assessment based on EFD.
