The added value of an AI-based body composition analysis in a lung cancer screening population: preliminary results

• Published in: Nutrition, metabolism, and cardiovascular diseases p. 103696
• Main Authors: Ledda, Roberta Eufrasia, Sabia, Federica, Valsecchi, Camilla, Suatoni, Paola, Milanese, Gianluca, Rolli, Luigi, Marchianò, Alfonso Vittorio, Pastorino, Ugo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 22-07-2024
• Subjects: Body composition; Lung cancer screening; Metabolic profiling; Ultra-low dose computed tomography; Metabolic profiling; Ultra-low dose computed tomography; Lung cancer screening; Body composition
• ISSN: 0939-4753; 1590-3729; 1590-3729
• DOI: 10.1016/j.numecd.2024.07.013

Body composition has been linked with clinical and prognostic outcomes in patients with cancer and cardiovascular diseases. Body composition analysis in lung cancer screening (LCS) is very limited. This study aimed at assessing the association of subcutaneous fat volume (SFV) and subcutaneous fat density (SFD), measured on chest ultra-low dose computed tomography (ultra-LDCT) images by a fully automated artificial intelligence (AI)-based software, with clinical and anthropometric characteristics in a LCS population.
Demographic, clinical, and dietary data were obtained from the written questionnaire completed by each participant at the first visit, when anthropometric measurements, blood sample collection and chest ultra-LDCT were performed. Images were analyzed for automated 3D segmentation of subcutaneous fat and muscle.
The analysis included 938 volunteers (372 females); men with a smoking history of ≥40 pack-years had higher SFV (p = 0.0009), while former smokers had lower SFD (p = 0.0019). In female participants, SFV and SFD differed significantly according to age. SFV increased with rising BMI, waist circumference, waist-hip ratio, and CRP levels ≥2 mg/L (p < 0.0001), whereas SFD decreased with rising BMI, waist circumference, waist-hip ratio, and CRP levels ≥2 mg/L (p < 0.001) in both sexes. SFV was associated with glycemia and triglycerides levels (p = 0.0067 and p=<0.0001 in males, p = 0.0074 and p < 0.0001 in females, respectively), while SFD with triglycerides levels (p < 0.0001).
We observed different associations of SFV and SFD with age and smoking history between men and women, whereas the association with anthropometric data, CRP, glycemia and triglycerides levels was similar in the two sexes.
•Fully automated AI-based body composition analysis is feasible on chest ultra-low dose CT imaging.•Subcutaneous fat volume (SFV) was significantly higher in men with pack-years ≥40 and in women aged ≥65.•Median SFV increased significantly with rising BMI, waist circumference and waist-hip ratio in both sexes.