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• Clinical Article •
Analysis of the fat fraction histogram of the brown adipose depot in the supraclavicular region of patients with colorectal cancer based on magnetic resonance mDIXON technology
CHEN Xuemin  YANG Ou  LI Feixiang  SUN Yun  HUANG Gang 

DOI:10.12015/issn.1674-8034.2026.07.010.


[Abstract] Objective To quantitatively explore changes in the fat fraction (FF) of the supraclavicular fat depot in patients with colorectal cancer using the MRI multi-echo DIXON (mDIXON) technique.Materials and Methods Newly diagnosed colorectal cancer patients (n = 60) were prospectively recruited and underwent neck MRI mDIXON. Neck mDIXON images from healthy volunteers (n = 60) during the same period were collected as controls. Representative region of interest for brown adipose tissue (BAT) in the supraclavicular fat depot and region of interest for white adipose tissue (WAT) in the dorsal subcutaneous fat at the same level were manually delineated on the mDIXON-FF images of both groups, avoiding blood vessels, nerves, and edge areas. Histogram features were extracted. Two independent samples t-tests (for normal parameters) or Mann-Whitney U tests (for non-normal parameters) were used to compare the FF histogram features between the two groups. Colorectal cancer patients were further subdivided based on pathological or clinical characteristics (such as tumor staging, whether there is lymph node metastasis, etc.). Propensity score matching was used to control for confounding factors like age, gender, and body mass index, and the FF histogram features were compared between the matched subgroups. In addition, 10 healthy volunteers were recruited. MRI mDIXON images of their necks were collected before and after a 30-day interval to evaluate the measurement stability of BAT in the supraclavicular fossa and subcutaneous WAT. The manual delineation of the ROI was also tested for its repeatability. Finally, the consistency of delineating BAT ROIs on the left and right sides of the supraclavicular fat depot was verified.Results Histogram analysis of the supraclavicular fat depot revealed that three features representing FF magnitude [10th Percentile (85.69 vs. 82.59, P < 0.001), Mean (90.24 vs. 86.92, P < 0.001), and Minimum (83.22 vs. 79.71, P < 0.001)] were all significantly higher in the colorectal cancer group compared to the control group. None of the histogram features for subcutaneous white adipose tissue showed statistically significant differences between the two groups. After internal grouping of colorectal cancer patients based on characteristics like lymph node metastasis, significant differences were observed between the lymph node metastasis-negative and positive groups for three features: InterquartileRange (5.27 vs. 3.55, P = 0.048), MeanAbsoluteDeviation (2.83 vs. 1.99, P = 0.029), and RobustMeanAbsoluteDeviation (2.20 vs. 1.45, P = 0.013). No statistically significant differences were observed in other features between the other subgroups. The reproducibility test of manual ROI delineation showed that all the above six features had good consistency [intra-class correlation coefficient (ICC) ≥ 0.75]. The self-control before and after showed that the FF histogram features of supraclavicular BAT and subcutaneous WAT obtained by scanning after 30 days had good stability. There was no significant statistical difference in delineating BAT ROI from the left and right supraclavicular fat depots respectively.Conclusions In patients with colorectal cancer, the relative content of supraclavicular brown adipose tissue (BAT) is decreased and the FF is elevated, suggesting that the reduction in BAT proportion may be accompanied by a decrease in BAT content, and its changes are correlated with disease progression indicators such as lymph node metastasis. Furthermore, the histogram analysis method based on mDIXON-FF provides a non-invasive and stable new approach for assessing brown adipose tissue, showing future potential as an imaging biomarker for metabolic evaluation and prognosis prediction in colorectal cancer.
[Keywords] brown adipose tissue；colorectal cancer；magnetic resonance imaging；multi-echo DIXON；fat fraction；histogram features

CHEN Xuemin1   YANG Ou1   LI Feixiang1   SUN Yun1   HUANG Gang2*  

1 The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou 730000, China

2 Department of Radiology, Gansu Provincial Hospital, Lanzhou 730000, China

Corresponding author: HUANG G, E-mail: huang_g2024@163.com

Conflicts of interest   None.

Received  2025-12-30
Accepted  2026-06-09
DOI: 10.12015/issn.1674-8034.2026.07.010
DOI:10.12015/issn.1674-8034.2026.07.010.

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