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Quantification of abdominal fat from computed tomography using deep learning and its association with electronic health records in an academic biobank
Authors:Matthew T MacLean  Qasim Jehangir  Marijana Vujkovic  Yi-An Ko  Harold Litt  Arijitt Borthakur  Hersh Sagreiya  Mark Rosen  David A Mankoff  Mitchell D Schnall  Haochang Shou  Julio Chirinos  Scott M Damrauer  Drew A Torigian  Rotonya Carr  Daniel J Rader  Walter R Witschey
Abstract:ObjectiveThe objective was to develop a fully automated algorithm for abdominal fat segmentation and to deploy this method at scale in an academic biobank.Materials and MethodsWe built a fully automated image curation and labeling technique using deep learning and distributive computing to identify subcutaneous and visceral abdominal fat compartments from 52,844 computed tomography scans in 13,502 patients in the Penn Medicine Biobank (PMBB). A classification network identified the inferior and superior borders of the abdomen, and a segmentation network differentiated visceral and subcutaneous fat. Following technical evaluation of our method, we conducted studies to validate known relationships with visceral and subcutaneous fat.ResultsWhen compared with 100 manually annotated cases, the classification network was on average within one 5-mm slice for both the superior (0.4 ± 1.1 slice) and inferior (0.4 ± 0.6 slice) borders. The segmentation network also demonstrated excellent performance with intraclass correlation coefficients of 1.00 (P < 2 × 10-16) for subcutaneous and 1.00 (P < 2 × 10-16) for visceral fat on 100 testing cases. We performed integrative analyses of abdominal fat with the phenome extracted from the electronic health record and found highly significant associations with diabetes mellitus, hypertension, and renal failure, among other phenotypes.ConclusionsThis work presents a fully automated and highly accurate method for the quantification of abdominal fat that can be applied to routine clinical imaging studies to fuel translational scientific discovery.
Keywords:deep learning  subcutaneous fat  machine learning  Penn Medicine biobank  visceral fat  body mass index
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