Effects of Computed Tomography Technical Parameters on Body-Composition Analysis

Body-composition analysis (BCA) is gaining increasing clinical importance, because abnormalities in muscle and fat distribution are closely associated with patient outcomes for various diseases. Although several methods for assessing body composition are available, including bioelectrical impedance analysis, dual-energy X-ray absorptiometry, and magnetic resonance imaging, computed tomography (CT) has emerged as the most widely used imaging modality owing to its accuracy, accessibility, and artificial intelligence-driven automated analytical capabilities. CT-based BCA enables the precise quantification of skeletal muscle and adipose tissues, but its measurements can be influenced by various technical factors, such as the contrast phase, tube current and voltage, slice thickness, reconstruction algorithm, and scanner type. These parameters particularly affect attenuation-based metrics such as muscle density. Recent technological advancements, such as iterative reconstruction, dual-energy CT, and photon-counting CT, have resulted in new capabilities but may further introduce variability. This review summarizes the effects of CT parameters on BCA results and underscores the need for awareness and consistency when performing CT-based BCA. A better understanding of these factors may improve measurement reproducibility and support broader clinical and research applications.