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Automated AI Fat Measurement on Abdominal CT Images Predicts Future Heart Attack or Stroke Risk Better Than BMI

By MedImaging International staff writers
Posted on 07 Jan 2021

Image: Example of body composition analysis of an abdominal CT slice with subcutaneous fat in green, skeletal muscle in red, and visceral fat in yellow (Photo courtesy of UCSF)

An automated artificial intelligence (AI) measurement of visceral fat area on abdominal CT images predicts future heart attack or stroke risk better than overall weight or body mass index (BMI).

In a study presented at the annual meeting of the Radiological Society of North America (RSNA), researchers from the University of California San Francisco (San Francisco, CA, USA) have suggested that automated deep learning analysis of abdominal CT images produces a more precise measurement of body composition and predicts major cardiovascular events, such as heart attack and stroke, better than overall weight or BMI. Unlike BMI, which is based on height and weight, a single axial CT slice of the abdomen visualizes the volume of subcutaneous fat area, visceral fat area and skeletal muscle area. However, manually measuring these individual areas is time intensive and costly.

A multidisciplinary team of researchers, including radiologists, a data scientist and biostatistician, developed a fully automated method using deep learning - a type of AI - to determine body composition metrics from abdominal CT images. The study cohort was derived from the 33,182 abdominal CT outpatient exams performed on 23,136 patients in 2012. The researchers identified 12,128 patients who were free of major cardiovascular and cancer diagnoses at the time of imaging. Mean age of the patients was 52 years, and 57% of patients were women. The researchers selected the L3 CT slice (from the third lumbar spine vertebra) and calculated body composition areas for each patient. Patients were then divided into four quartiles based on the normalized values of subcutaneous fat area, visceral fat area and skeletal muscle area.

In this retrospective study, it was determined which of these 12,128 patients had a myocardial infarction (heart attack) or stroke within five years after their index abdominal CT scan. The researchers found 1,560 myocardial infarctions and 938 strokes occurred in this study group. Statistical analysis demonstrated that visceral fat area was independently associated with future heart attack and stroke. BMI was not associated with heart attack or stroke. The researchers believe that this work demonstrates that fully automated and normalized body composition analysis could now be applied to large-scale research projects.

“This work shows the promise of AI systems to add value to clinical care by extracting new information from existing imaging data,” said Kirti Magudia, M.D., Ph.D., an abdominal imaging and ultrasound fellow at the University of California San Francisco. “The deployment of AI systems would allow radiologists, cardiologists and primary care doctors to provide better care to patients at minimal incremental cost to the health care system.”

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69 (71.048736572266): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=217 ORDER BY `ordering`

70 (389.09912109375): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294786461 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (288.00964355469): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294786461 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 15462.875366211): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (93.936920166016): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (53.167343139648): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (746.01173400879): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (66.995620727539): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (!!!!! 3554.105758667): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (84.877014160156): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (118.97087097168): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (67.949295043945): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (47.206878662109): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (!!!!! 3664.9703979492): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (104.18891906738): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (80.108642578125): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294786461 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (43.869018554688): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294786461 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (37.908554077148): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (87.02278137207): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (66.995620727539): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (40.769577026367): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 4679.9182891846): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

105 (211.00044250488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

106 (732.1834564209): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294786461 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (630.85556030273): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294786461 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (113.96408081055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

109 (70.810317993164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

110 (636.10076904297): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294786461 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (627.99453735352): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294786461 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (874.99618530273): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (779.15191650391): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (117.06352233887): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

115 (79.870223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

116 (104.90417480469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

117 (90.837478637695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

118 (94.175338745117): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

119 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

120 (323.05717468262): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 79201.936721802): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (99.18212890625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

123 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

124 (422.95455932617): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294786461 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294786461 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1414080.1429749): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (95.129013061523): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (280.85708618164): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (769.13833618164): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (326.87187194824): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (!!!!! 2048.9692687988): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (367.87986755371): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (!!!!! 2363.2049560547): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (267.02880859375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (205.99365234375): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (101.08947753906): SELECT name FROM jos_deeppockets WHERE id=217

136 (81.062316894531): SELECT name FROM jos_deeppockets WHERE id=217

137 (447.98851013184): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))217((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (345.94535827637): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))217((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

140 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

141 (!!!!! 10333.061218262): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 3221.0350036621): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294786461 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (123.97766113281): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294786461 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (447.03483581543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

147 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

148 (!!!!! 1126.0509490967): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

150 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

151 (308.99047851562): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294786461 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294786461 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (!!!!! 1951.9329071045): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=217 or channel_id is null)

153 (35.04753112793): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=217 or channel_id is null)

154 (30.040740966797): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 2754.9266815186): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

156 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294786461 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294786461 AND published='1' LIMIT 1

157 (158.78677368164): select jos_twitters.link from jos_twitters where cat=10

158 (52.928924560547): select jos_facebook.link from jos_facebook where cat=10

159 (48.87580871582): select jos_google_plus.link from jos_google_plus where cat=10

160 (72.002410888672): select jos_linkedin.link from jos_linkedin where cat=10

161 (324.01084899902): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 7493.0191040039): insert into jos_banners_delta values (14615,'2025-04-29 20:27:47','18.189.13.48','view'),(14202,'2025-04-29 20:27:47','18.189.13.48','view'),(14203,'2025-04-29 20:27:47','18.189.13.48','view')

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