Relationship Between Dual-Energy X-Ray Absorptiometry Volumetric Assessment and X-ray Computed Tomography–Derived Single-Slice Measurement of Visceral Fat

Abstract

To reduce radiation exposure and cost, visceral adipose tissue (VAT) measurement on X-ray computed tomography (CT) has been limited to a single slice. Recently, the US Food and Drug Administration has approved a dual-energy X-ray absorptiometry (DXA) application validated against CT to measure VAT volume. The purpose of this study was to develop an algorithm to compute single-slice area values on DXA at 2 common landmarks, L2/3 and L4/5, from an automated volumetrically derived measurement of VAT. Volumetric CT and total body DXA were measured in 55 males (age: 21–77 yr; body mass index [BMI]: 21.1–37.9) and 60 females (age: 21–85 yr; BMI: 20.0–39.7). Equations were developed by applying the relationship of CT single-slice area and volume measurements of VAT to the DXA VAT volume measure as well as validating these against the CT single-slice measurements. Correlation coefficients between DXA estimate of single-slice area and CT were 0.94 for L2/3 and 0.96 for L4/5. The mean difference between DXA estimate of single-slice area and CT was 5 cm2 at L2/3 and 3.8 cm2 at L4/5. Bland-Altman analysis showed a fairly constant difference across the single-slice range in this study, and the 95% limits of agreement for the 2 methods were −44.6 to +54.6 cm2 for L2/3 and −47.3 to +54.9 cm2 for L4/5. In conclusion, a volumetric measurement of VAT by DXA can be used to estimate single-slice measurements at the L2/3 and the L4/5 landmarks.