Share:
Share this content in WeChat
X
Review
Advances in the application of fat quantification techniques based on CT and MRI in general population cohorts
HUANG Shengqian  ZHANG Daming  WANG Qin  XUE Huadan  JIN Zhengyu 

DOI:10.12015/issn.1674-8034.2026.02.034.


[Abstract] Adipose tissue is widely distributed throughout the human body and plays a crucial role in the regulation of metabolism. Basic anthropometric indicators such as body mass index are insufficient for precisely assessing fat distribution. CT- and MRI-based fat quantification techniques enable accurate measurement of adipose tissue in specific depots, including subcutaneous fat, visceral fat, liver fat, and muscle fat, which has been widely applied in large-scale general population cohorts. Previous studies have comprehensively revealed the associations between the distribution patterns of different adipose tissue depots and various diseases, such as metabolic and cardiovascular diseases, thereby broadening our understanding of the heterogeneity of fat distribution and its health implications. Existing reviews on fat quantification often focus on a specific technique or a particular disease, lacking an integrated perspective from population studies that synthesizes recent advances. This article introduces the principles of CT- and MRI-based fat quantification techniques, reviews their application in quantifying major fat depots within large general population cohorts, discusses current limitations and future directions, and aims to provide new insights for the application of fat quantification techniques in population-based research.
[Keywords] body composition;fat quantification;computed tomography;magnetic resonance imaging;general population cohort

HUANG Shengqian   ZHANG Daming   WANG Qin   XUE Huadan*   JIN Zhengyu  

Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Corresponding author: XUE H D, E-mail: bjdanna95@163.com

Conflicts of interest   None.

Received  2025-10-27
Accepted  2025-12-30
DOI: 10.12015/issn.1674-8034.2026.02.034
DOI:10.12015/issn.1674-8034.2026.02.034.

[1]
LECOUTRE S, REBIÈRE C, MAQDASY S, et al. Enhancing adipose tissue plasticity: progenitor cell roles in metabolic health[J]. Nat Rev Endocrinol, 2025, 21(5): 272-288. DOI: 10.1038/s41574-024-01071-y.
[2]
LUO J Q, WANG Y, MAO J X, et al. Features, functions, and associated diseases of visceral and ectopic fat: a comprehensive review[J]. Obesity, 2025, 33(5): 825-838. DOI: 10.1002/oby.24239.
[3]
LIU H H, LIU L Y, ROSEN C J. Bone marrow adipocytes as novel regulators of metabolic homeostasis: clinical consequences of bone marrow adiposity[J/OL]. Curr Obes Rep, 2025, 14(1): 9 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/39808256/. DOI: 10.1007/s13679-024-00594-9.
[4]
YAN S Y, YANG Y W, JIANG X Y, et al. Fat quantification: Imaging methods and clinical applications in cancer[J/OL]. Eur J Radiol, 2023, 164: 110851 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/37148843/. DOI: 10.1016/j.ejrad.2023.110851.
[5]
WU H, ZHOU T H, LI Y B, et al. Quantitative evaluation of abdominal fat distribution and visceral fat in young people based on mLIVE sequence[J]. Chin J Magn Reson Imaging, 2023, 14(1): 77-81. DOI: 10.12015/issn.1674-8034.2023.01.014.
[6]
MA M Y, WANG J Y, LI X B, et al. Research progress and applications of fat quantification with magnetic resonance imaging[J]. Chin J Magn Reson Imaging, 2023, 14(7): 197-202. DOI: 10.12015/issn.1674-8034.2023.07.036.
[7]
ANDERSSON C, NAYOR M, TSAO C W, et al. Framingham heart study: JACC focus seminar, 1/8[J]. J Am Coll Cardiol, 2021, 77(21): 2680-2692. DOI: 10.1016/j.jacc.2021.01.059.
[8]
ALLEN N E, LACEY B, LAWLOR D A, et al. Prospective study design and data analysis in UK Biobank[J/OL]. Sci Transl Med, 2024, 16(729): eadf4428 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/38198570/. DOI: 10.1126/scitranslmed.adf4428.
[9]
Tordjman M, Fayad Z A, Benzinger T L S, et al. Imaging in patients with obesity: challenges, applications and future directions[J]. Nat Rev Endocrinol, 2025, 21(10): 588-590. DOI: 10.1038/s41574-025-01166-0.
[10]
WANG L, YUAN H S, CHENG X G. Promoting actively the clinical application of quantitative CT[J]. Chin J Radiol, 2021, 55(4): 337-339. DOI: 10.3760/cma.j.cn112149-20210214-00120.
[11]
TAO Z Z, JI Q. Recent advances in MRI for fat quantifying in type 2 diabetes mellitus patients[J]. Chin J Radiol, 2021, 55(5): 565-568. DOI: 10.3760/cma.j.cn112149-20200512-00676.
[12]
FAN J L, ZUO L P, YU D X. Advances in evaluating the biological behavior of renal cell carcinoma through radiographic quantitative analysis of abdominal fat[J]. Chin J Radiol, 2023, 57(2): 226-230. DOI: 10.3760/cma.j.cn112149-20211229-01163.
[13]
TROSCHEL A S, TROSCHEL F M, FUCHS G, et al. Significance of acquisition parameters for adipose tissue segmentation on CT images[J]. AJR Am J Roentgenol, 2021, 217(1): 177-185. DOI: 10.2214/AJR.20.23280.
[14]
WESTON A D, KORFIATIS P, KLINE T L, et al. Automated abdominal segmentation of CT scans for body composition analysis using deep learning[J]. Radiology, 2019, 290(3): 669-679. DOI: 10.1148/radiol.2018181432.
[15]
STAREKOVA J, HERNANDO D, PICKHARDT P J, et al. Quantification of liver fat content with CT and MRI: state of the art[J]. Radiology, 2021, 301(2): 250-262. DOI: 10.1148/radiol.2021204288.
[16]
ENGELKE K, MUSEYKO O, WANG L, et al. Quantitative analysis of skeletal muscle by computed tomography imaging-State of the art[J/OL]. J Orthop Translat, 2018, 15: 91-103 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/30533385/. DOI: 10.1016/j.jot.2018.10.004.
[17]
XU J J, BOESEN M R, HANSEN S L, et al. Assessment of liver fat: dual-energy CT versus conventional CT with and without contrast[J/OL]. Diagnostics, 2022, 12(3): 708 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/35328261/. DOI: 10.3390/diagnostics12030708.
[18]
LIN H M, XU X X, DENG R, et al. Photon-counting detector CT for liver fat quantification: validation across protocols in metabolic dysfunction-associated steatotic liver disease[J/OL]. Radiology, 2024, 312(3): e240038 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/39315897/. DOI: 10.1148/radiol.240038.
[19]
JUNG M, RAGHU V K, REISERT M, et al. Deep learning-based body composition analysis from whole-body magnetic resonance imaging to predict all-cause mortality in a large western population[J/OL]. EBioMedicine, 2024, 110: 105467 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/39622188/. DOI: 10.1016/j.ebiom.2024.105467.
[20]
HAUEISE T, SCHICK F, STEFAN N, et al. Comparison of the accuracy of commercial two-point and multi-echo Dixon MRI for quantification of fat in liver, paravertebral muscles, and vertebral bone marrow[J/OL]. Eur J Radiol, 2024, 172: 111359 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/38325186/. DOI: 10.1016/j.ejrad.2024.111359.
[21]
YANG C, YU S H, XU F P, et al. Application of magnetic resonance imaging-proton density fat fraction in liver fat quantification[J]. J Clin Hepatol, 2024, 40(3): 600-605. DOI: 10.12449/JCH240327.
[22]
YU Q L, ZHOU B B, ZHANG X R, et al. Quantitative assessment of skeletal muscle fat content in type 2 diabetic patients by magnetic resonance multi-echo DIXON technique[J]. Chin J Magn Reson Imaging, 2024, 15(1): 145-151. DOI: 10.12015/issn.1674-8034.2024.01.023.
[23]
GONG F Y, HU W J. Adipose tissue: an endocrine and immune organ with high heterogeneity and plasticity[J]. Chin J Diabetes Mellit, 2022, 14(12): 1469-1474. DOI: 10.3760/cma.j.cn115791-20220908-00464.
[24]
GÓMEZ-AMBROSI J, CATALÁN V, FRÜHBECK G. The evolution of the understanding of obesity over the last 100 years[J]. Int J Obes, 2025, 49(2): 168-176. DOI: 10.1038/s41366-024-01668-3.
[25]
LI J J. Risk factors related to cardiovascular metabolism are the key to prevention and control of cardiovascular diseases[J]. Chin Circ J, 2022, 37(10): 969-973. DOI: 10.3969/j.issn.1000-3614.2022.10.001.
[26]
FOX C S, MASSARO J M, HOFFMANN U, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study[J]. Circulation, 2007, 116(1): 39-48. DOI: 10.1161/CIRCULATIONAHA.106.675355.
[27]
PORTER S A, MASSARO J M, HOFFMANN U, et al. Abdominal subcutaneous adipose tissue: a protective fat depot [J]. Diabetes Care, 2009, 32(6): 1068-1075. DOI: 10.2337/dc08-2280.
[28]
ABRAHAM T M, PEDLEY A, MASSARO J M, et al. Association between visceral and subcutaneous adipose depots and incident cardiovascular disease risk factors[J]. Circulation, 2015, 132(17): 1639-1647. DOI: 10.1161/CIRCULATIONAHA.114.015000.
[29]
LEE J J, PEDLEY A, HOFFMANN U, et al. Association of changes in abdominal fat quantity and quality with incident cardiovascular disease risk factors[J]. J Am Coll Cardiol, 2016, 68(14): 1509-1521. DOI: 10.1016/j.jacc.2016.06.067.
[30]
HUANG J H, GUO L X. Research progress in the correlation between visceral fat and type 2 diabetes mellitus[J]. Chin J Diabetes Mellit, 2024, 16(10): 1147-1151. DOI: 10.3760/cma.j.cn115791-20240418-00184.
[31]
BRITTON K A, MASSARO J M, MURABITO J M, et al. Body fat distribution, incident cardiovascular disease, cancer, and all-cause mortality[J]. J Am Coll Cardiol, 2013, 62(10): 921-925. DOI: 10.1016/j.jacc.2013.06.027.
[32]
NEELAND I J, TURER A T, AYERS C R, et al. Body fat distribution and incident cardiovascular disease in obese adults[J]. J Am Coll Cardiol, 2015, 65(19): 2150-2151. DOI: 10.1016/j.jacc.2015.01.061.
[33]
AGRAWAL S, KLARQVIST M D R, DIAMANT N, et al. BMI-adjusted adipose tissue volumes exhibit depot-specific and divergent associations with cardiometabolic diseases[J/OL]. Nat Commun, 2023, 14(1): 266 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/36650173/. DOI: 10.1038/s41467-022-35704-5.
[34]
AGRAWAL S, WANG M X, KLARQVIST M D R, et al. Inherited basis of visceral, abdominal subcutaneous and gluteofemoral fat depots[J/OL]. Nat Commun, 2022, 13(1): 3771 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/35773277/. DOI: 10.1038/s41467-022-30931-2.
[35]
PATI S, IRFAN W, JAMEEL A, et al. Obesity and cancer: a current overview of epidemiology, pathogenesis, outcomes, and management[J/OL]. Cancers, 2023, 15(2): 485 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/36672434/. DOI: 10.3390/cancers15020485.
[36]
MARTIN-PEREZ M, URDIROZ-URRICELQUI U, BIGAS C, et al. The role of lipids in cancer progression and metastasis[J]. Cell Metab, 2022, 34(11): 1675-1699. DOI: 10.1016/j.cmet.2022.09.023.
[37]
KIM J M, CHUNG E, CHO E S, et al. Impact of subcutaneous and visceral fat adiposity in patients with colorectal cancer[J]. Clin Nutr, 2021, 40(11): 5631-5638. DOI: 10.1016/j.clnu.2021.10.001.
[38]
LI L Y, LI W Q, XU D S, et al. Association between visceral fat area and cancer prognosis: a population-based multicenter prospective study[J]. Am J Clin Nutr, 2023, 118(3): 507-517. DOI: 10.1016/j.ajcnut.2023.07.001.
[39]
ROSENQUIST K J, MASSARO J M, PEDLEY A, et al. Fat quality and incident cardiovascular disease, all-cause mortality, and cancer mortality[J]. J Clin Endocrinol Metab, 2015, 100(1): 227-234. DOI: 10.1210/jc.2013-4296.
[40]
RASK-ANDERSEN M, IVANSSON E, HÖGLUND J, et al. Adiposity and sex-specific cancer risk[J/OL]. Cancer Cell, 2023, 41(6): 1186-1197.e4 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/37311415/. DOI: 10.1016/j.ccell.2023.05.010.
[41]
ZHANG D, FU Y J, SHEN C Y, et al. Regional adiposity shapes brain and cognition in adults[J]. Nat Ment Health, 2025, 3(10): 1168-1180. DOI: 10.1038/s44220-025-00501-8.
[42]
MORAN C, HERSON J, THAN S, et al. Interactions between age, sex and visceral adipose tissue on brain ageing[J]. Diabetes Obes Metab, 2024, 26(9): 3821-3829. DOI: 10.1111/dom.15727.
[43]
JAELIM C, SEONGHO S, WOO-RAM K, et al. Association Between Visceral Fat and Brain Cortical Thickness in the Elderly: A Neuroimaging Study[J/OL]. Frontiers in aging neuroscience, 2021, 13 [2025-12-22]. https://pubmed.ncbi.nlm.nih.gov/34248609/. DOI: 10.3389/fnagi.2021.694629.
[44]
ANAND S S, FRIEDRICH M G, LEE D S, et al. Evaluation of adiposity and cognitive function in adults[J/OL]. JAMA Netw Open, 2022, 5(2): e2146324 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/35103790/. DOI: 10.1001/jamanetworkopen.2021.46324.
[45]
SONG Z H, LIU J, WANG X F, et al. Impact of ectopic fat on brain structure and cognitive function: a systematic review and meta-analysis from observational studies[J/OL]. Front Neuroendocrinol, 2023, 70: 101082 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/37414372/. DOI: 10.1016/j.yfrne.2023.101082.
[46]
RAJI C A, MEYSAMI S, HASHEMI S, et al. Visceral and subcutaneous abdominal fat predict brain volume loss at midlife in 10, 001 individuals[J]. Aging Dis, 2024, 15(4): 1831-1842. DOI: 10.14336/AD.2023.0820.
[47]
WOLFF L, BOS D, MURAD S D, et al. Liver fat is related to cardiovascular risk factors and subclinical vascular disease: the Rotterdam Study[J]. Eur Heart J Cardiovasc Imaging, 2016, 17(12): 1361-1367. DOI: 10.1093/ehjci/jew174.
[48]
LV Z, FU Y Z, MA Y, et al. Associations between visceral and liver fat and cardiac structure and function: a UK biobank study[J/OL]. J Clin Endocrinol Metab, 2025, 110(6): e1856-e1865 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/39288024/. DOI: 10.1210/clinem/dgae639.
[49]
TEJANI S, MCCOY C, AYERS C R, et al. Cardiometabolic health outcomes associated with discordant visceral and liver fat phenotypes: insights from the Dallas heart study and UK biobank[J]. Mayo Clin Proc, 2022, 97(2): 225-237. DOI: 10.1016/j.mayocp.2021.08.021.
[50]
HAAS M E, PIRRUCCELLO J P, FRIEDMAN S N, et al. Machine learning enables new insights into genetic contributions to liver fat accumulation[J/OL]. Cell Genom, 2021, 1(3): 100066 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/34957434/. DOI: 10.1016/j.xgen.2021.100066.
[51]
XIA T Y, DU M L, LI H Q, et al. Association between liver MRI proton density fat fraction and liver disease risk[J/OL]. Radiology, 2023, 309(1): e231007 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/37874242/. DOI: 10.1148/radiol.231007.
[52]
GUO Z, BLAKE G M, LI K, et al. Liver fat content measurement with quantitative CT validated against MRI proton density fat fraction: a prospective study of 400 healthy volunteers[J]. Radiology, 2020, 294(1): 89-97. DOI: 10.1148/radiol.2019190467.
[53]
NORRIS A M, PALZKILL V R, APPU A B, et al. Intramuscular adipose tissue restricts functional muscle recovery[J/OL]. Cell Rep, 2025, 44(8): 116021 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/40668672/. DOI: 10.1016/j.celrep.2025.116021.
[54]
GOODPASTER B H, BERGMAN B C, BRENNAN A M, et al. Intermuscular adipose tissue in metabolic disease[J]. Nat Rev Endocrinol, 2023, 19(5): 285-298. DOI: 10.1038/s41574-022-00784-2.
[55]
CARBONE S. Intramuscular and intermuscular adipose tissue in older adults: noncardiac body composition depots and HF risk[J]. JACC Heart Fail, 2022, 10(7): 494-497. DOI: 10.1016/j.jchf.2022.05.003.
[56]
MILJKOVIC I, VELLA C A, ALLISON M. Computed tomography-derived myosteatosis and metabolic disorders[J]. Diabetes Metab J, 2021, 45(4): 482-491. DOI: 10.4093/dmj.2020.0277.
[57]
THERKELSEN K E, PEDLEY A, SPELIOTES E K, et al. Intramuscular fat and associations with metabolic risk factors in the Framingham Heart Study[J]. Arterioscler Thromb Vasc Biol, 2013, 33(4): 863-870. DOI: 10.1161/ATVBAHA.112.301009.
[58]
WANG D Y, MORTON J I, MAGLIANO D J, et al. Comparison of subcutaneous, visceral, liver and muscle fat depots in relation to prevalent and incident diabetes[J]. Diabetes Obes Metab, 2025, 27(11): 6304-6313. DOI: 10.1111/dom.70021.
[59]
GRANADOS A, GEBREMARIAM A, GIDDING S S, et al. Association of abdominal muscle composition with prediabetes and diabetes: The CARDIA study[J]. Diabetes Obes Metab, 2019, 21(2): 267-275. DOI: 10.1111/dom.13513.
[60]
LARSEN B, BELLETTIERE J, ALLISON M, et al. Associations of abdominal muscle density and area and incident cardiovascular disease, coronary heart disease, and stroke: the multi-ethnic study of atherosclerosis[J/OL]. J Am Heart Assoc, 2024, 13(4): e032014 [2025-10-26]. https://pubmed.ncbi.nlm.nih.gov/38348808/. DOI: 10.1161/JAHA.123.032014.
[61]
HUYNH K, AYERS C, BUTLER J, et al. Association between thigh muscle fat infiltration and incident heart failure: the health ABC study[J]. JACC Heart Fail, 2022, 10(7): 485-493. DOI: 10.1016/j.jchf.2022.04.012.

PREV Application and prospects of deep learning-based MRI motion artifact correction technology
NEXT Advances in the application of fat quantification techniques based on CT and MRI in general population cohorts
  



Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn