Automated body weight measurement using computed tomography

Computed tomography (CT) images provide detailed information on tissue composition and density. Body weight estimation from CT can be highly relevant in emergency and forensic contexts where conventional weighing is impractical or unavailable-for example, due to unconscious or immobilized patients, lack of appropriate equipment, or the necessity to preserve forensic trace evidence. An automated method for body weight estimation using antemortem and postmortem CT data from clinical scanners was evaluated. Two retrospective cohorts were included: 30 forensic postmortem whole-body CT scans and 66 clinical torso CT scans. Tissue segmentation applied predefined Hounsfield Unit thresholds for fat, muscle, and bone, with voxel volumes multiplied by corresponding tissue densities to calculate weight. In forensic cases, CT-derived weights differed by - 1.26 ± 2.58 kg (median: - 1.15 kg) from measured weights. In clinical cases, torso weight was extrapolated to total body weight using a corrected scaling factor that accounted for body and scan length, resulting in an average difference of 0.53 ± 4.62 kg (median: 0.23 kg). Linear regression demonstrated strong correlations (R² = 0.97/0.96 forensic/clinical). These findings indicate that routinely acquired CT scans enable accurate, automated, and retrospective body weight estimation, providing a non-invasive alternative when direct measurement is not feasible while simultaneously allowing body composition analysis.