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Imaging Methodology and Body Adiposity
The advent of imaging technologies for the direct assessment of body fat and muscle distribution and content has revolutionised body composition studies. CT and magnetic resonance imaging (MRI) quickly became the techniques of choice for research scientists and clinicians, with MRI becoming the gold-standard due to its non-invasive/non-radiation nature. However, these techniques were themselves not without issues, including availability and relatively high cost. This limited many studies to rather small cohorts (< 100 subjects). Attempts were initially made to cut down cost by reducing scanning time e.g. scanning of the abdominal area only or even the use of single-abdominal-slice to estimate visceral and ectopic fat. These approaches were again not sufficient to completely overcome variability between individuals.
More recently acquisition techniques have greatly improved, allowing whole-body scans, as well as determining liver and pancreas fat content and inflammatory/fibrotic status, in <10 minutes. The final stumbling block for large scale implementation, namely the slow and very time-consuming process of image analysis that requires extensive manual intervention from specialised personnel, has recently been overcome. The introduction of, for example, AMRA Profiler and LiverMultiScan has greatly enhanced our ability to phenotype almost any living individual. This has resulted in highly innovative and practical systems to mine large scale imaging resources such as the UK-Biobank (UKBB) and the German National Cohort (GNC). The future is likely to see imaging analysis taken a step further with the development of novel tools, which will translate measurements of body composition into a clearer picture of an individual’s overall health and metabolic risk.