ArticleEuropean radiology2023
Inter-software and inter-scan variability in measurement of epicardial adipose tissue: a three-way comparison of a research-specific, a freeware and a coronary application software platform.
Article in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Standardized MRI-Based Quantification of Epicardial Adipose Tissue Volume: Reproducibility and Agreement With Cardiac Computed Tomography.Journal of magnetic resonance imaging : JMRI · 2026Article
- Reply to 'Bedside epicardial adipose tissue assessment in the era of advanced adipose phenotyping'.Nature reviews. Cardiology · 2026Article
- Role of systemic and epicardial adipose tissue in cardiometabolic disease.Nature reviews. Cardiology · 2026Review
- Epicardial adipose tissue in type 1 diabetes mellitus: a systematic review and meta-analysis.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025Review
- Refining the link between obesity and heart failure: insights from GLP-1 receptor agonist trials and studies adopting direct adiposity measures.Cardiovascular diabetology · 2025Review
- Predictive value of pericoronary fat attenuation index for graft occlusion after coronary artery bypass grafting.Japanese journal of radiology · 2025Article
- Deep learning for opportunistic, end-to-end automated assessment of epicardial adipose tissue in pre-interventional, ECG-gated spiral computed tomography.Insights into imaging · 2024Article
- The change of epicardial adipose tissue characteristics and vulnerability for atrial fibrillation upon drastic weight loss.Adipocyte · 2024Article
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Authors and funding
11 authors.
Funding
Abstract
objectivesEpicardial adipose tissue (EAT) is a proposed marker of cardiovascular risk; however, clinical application may be limited by variability in post-processing software platforms. We assessed inter-vendor agreement of EAT volume (EATv) and attenuation on both contrast-enhanced (CE) and non-contrast CT (NCT) using a standard coronary CT reporting software (Vitrea), an EAT research-specific software (QFAT) and a freeware imaging software (OsiriX).
methodsSeventy-six consecutive patients undergoing simultaneous CE and NCT had complete volumetric EAT measurement. Between-software, within-software NCT vs. CE, and inter- and intra-observer agreement were evaluated with analysis by ANOVA (with post hoc adjustment), Bland-Altman with 95% levels of agreement (LoA) and intraclass correlation coefficient (ICC).
resultsMean EATv (freeware 53 ± 31 mL vs. research 93 ± 43 mL vs. coronary 157 ± 64 mL) and attenuation (freeware - 72 ± 25 HU vs. research - 75 ± 3 HU vs. coronary - 61 ± 10 HU) were significantly different between all vendors (ANOVA p < 0.001). EATv was consistently higher in NCT vs. CE for all software packages, with most reproducibility found in research software (bias 26 mL, 95% LoA: 2 to 56 mL), compared to freeware (bias 11 mL 95% LoA: - 46 mL to 69 mL) and coronary software (bias 10 mL 95% LoA: - 127 to 147 mL). Research software had more comparable NCT vs. CE attenuation (- 75 vs. - 72 HU) compared to freeware (- 72 vs. - 57 HU) and coronary (- 61 vs. - 39 HU). Excellent inter-observer agreement was seen with research (ICC 0.98) compared to freeware (ICC 0.73) and coronary software (ICC 0.75) with narrow LoA on Bland-Altman analysis.
conclusionThere are significant inter-vendor differences in EAT assessment. Our study suggests that research-specific software has better agreement and reproducibility compared to freeware or coronary software platforms. KEY POINTS: • There are significant differences between EAT volume and attenuation values between software platforms, regardless of scan type. • Non-contrast scans routinely have higher mean EAT volume and attenuation; however, this finding is only consistently seen with research-specific software. • Of the three analyzed packages, research-specific software demonstrates the highest reproducibility, agreement, and reliability for both inter-scan and inter-observer agreement.
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