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A radiographic examination was carried out using a digital radiography system (Leonardo DR System). Radiographic imaging of the thorax, spine, and tympanic bullae was carried out in accordance with the standardized protocols. Radiographs were analyzed using a DICOM PACS DXR X-Ray (CareRay Version: 6.0.61-186) Acquisition Software workstation.
The abdominal ultrasound was carried out using a mikrokonvex 3–9 MHz probe and a linear 10–12 MHz probe (EsaoteMyLab Twice). During the examination, the animals were laid in dorsal recumbency.
All animals were sedated for the tomography examination with inhalation anesthesia (isoflurane), and laid in sternal recumbency. Tomography was performed using a Philips MX-16 slice unit CT scanner at a 120 kV tube voltage and 120 mA, with a slice thickness of 1 mm. The postcontrast examination was carried out following the intravenous administration of the contrast agent at a dose of 600 mgI/kg iohexol (Omnipaque 300 mgI/mL; GE Healthcare, Oslo, Norway). The raw data were reconstructed in soft tissue (window level, 40 HU; window width 350 HU), brain (window level, 40 HU; window width, 120 HU), and bone (window level, 500 HU; window width, 1600 HU) algorithms. Tomographic images were reviewed and analyzed on a DICOM PACS Acquisition Software workstation (Philips IntelliSpace Portal, Philips Medical Systems Nederland B.V., Bests, The Netherlands).

CT scans were performed on one of two multislice (MS) CT scanners at our institution: the 128-MSCT Siemens AS+ (Siemens Healthcare, Erlangen, Germany) or 64-MSCT Philips Brilliance (Philips Healthcare, Best, The Netherlands). The scanner used for each of the patients was determined randomly.
The patients were examined in the supine position with their arms adducted and lying on the belly, and the patients were stabilized with a strap around the body.
The CT scans were performed with the standard CT protocol for the shoulders used at the institution, with a slice thickness of 1 mm and 0.7 mm increments with reformations in the axial and paracoronal planes of 2/2 mm.
Muscle volumes were calculated using the postprocessing software program Philips IntelliSpace Portal (Radiology DICOM image processing application software Version 8.0 LOT 8.0.3.30150, 2016-10-17, Philips Medical Systems Nederland B.V).

Plasma was collected from whole venous blood (K₂EDTA) obtained from participant donors following informed written consent. Experiments were performed under institutional review board approved protocols from Vanderbilt University Medical Center (IRB#170046 and #101615). Participants underwent noncontrast coronary CT examination to identify the presence of calcified coronary atheroma and measure the CAC score (68 (link), 69 (link)). Women who were pregnant or potentially pregnant were excluded from the CT examination. Image acquisition was performed using a 64-slice multi-detector CT scanner (Brilliance 64, Philips Healthcare). Technical parameters included 120 KVp, 150 mAs, and ECG-gating of image acquisition in late diastole. CAC was measured on 3.0 mm thick slices using the Food and Drug Administration–approved calcium scoring software (Philips IntelliSpace Portal, Philips Healthcare) and reported as the Agatston score (70 (link)) for minimum lesion volume of 0.5 mm3 and an attenuation threshold of ≥130 Hounsfield units. Subject characteristics are presented in Table S1. Plasma lipoprotein cholesterol and plasma triglyceride levels were quantified using an Ace Axcel clinical chemistry system (Alfa Wassermann). These studies abide by the Declaration of Helsinki principles.

In all cases, MRI was performed with a 1.5-T MR scanner (Aera, Siemens Healthcare, Erlangen, Germany) with a standardised protocol including axial DWI, and fat-saturated contrast-enhanced T1w-images. All patients were administered a standard dose of 1 mmol/mL Gadovist (Gadobutrol, Bayer HealthCare Pharmaceuticals, Berlin, Germany) as an intravenous injection at a flow rate of 1–2 mL/s, followed by a 20 mL saline flush.
Axial DWI-images were acquired with either b-values of 50, 400, and 800 s/mm² (n = 21, 2.5% of all patients) or 50, 400, and 1000 s/mm² (n = 19, 47.5% of all patients).
The computed higher b-values of 1000, 2000, 3000, 4000, and 5000 s/mm² were generated with the postprocessing software “Philips IntelliSpace Portal” (version 11; Philips, Amsterdam, The Netherlands) using the application “MR Advanced Diffusion Analysis” (Philips Health System, Hamburg, Germany). This tool employs a mono-exponential model to generate images with high b-values. The MRI protocol parameters are described in Table 1.

Evaluation of cardiac CTA images was performed offline by 22 cardiologist and radiologist experts. In case of any uncertainty, the images were reviewed and re-evaluated. Coronary artery status was analyzed using commercially available semi-automated software (HeartBeat-CS, Philips IntelliSpace Portal, Philips Healthcare). Stenosis severity was qualitatively reported according to the current Society of Cardiovascular Computed Tomography Guidelines: normal: absence of plaque and no luminal stenosis; minimal: 1–25% stenosis; mild: 25–49% stenosis; moderate: 50–69% stenosis; severe: 70–99% stenosis; occluded: 100% stenosis. In this current analysis, we defined obstructive CAD as a lesion with ≥50% stenosis [15 (link)]. In case of the presence of multiple lesions, the most severe stenosis was considered. Furthermore, total CACS was determined as well.

An expert panel, consisting of four nuclear medicine physicians and one radiologist, all with more than 10 years of experience in PET and CT, examined the images and graded lesions. Two experts (JF and KH) graded lesions using only standard [¹⁸F]FDG PET/CT SUV images, while two other experts (AD and LCG) graded lesions using both standard SUV and parametric images (MR_FDG and DV_FDG). Furthermore, a specialist in radiology (ALJ) inspected the contrast enhanced CT scans.
[¹⁸F]FDG PET/CT images (parametric and standard) were inspected using Hermes Gold Client v.2.5.0 (Hermes Medical Solution AB, Stockholm, Sweden). While Philips IntelliSpace Portal (Philips Medical Systems, Amsterdam, Netherlands) was used by the radiologist to examine CT scans. Each lesion was graded according to a certainty score of 1–5, where a score of 5 was given when the physician was confident that the lesion was malignant, 4 when the lesion was most likely malignant, 3 when it could be malignant as well as benign, 2 when it was most likely benign, and 1 when definitely benign. All scans were pseudonymized and readers were not allowed to consults others on image interpretation. Information about clinical stage and pathological results were disclosed to readers prior to inspection of the scans.

Axial conventional images with a 2.00 mm slice thickness were reconstructed from contributions of both detector layers using the proprietary iDose4 reconstruction algorithm.
Spectral database images (SBI) were automatically generated in order to obtain post-processing reconstructions through a dedicated dl-DECT WorkStation (IntelliSpace Portal (vv. 8.0.2), Philips Healthcare, Best, Netherlands).
SBI data were exploited to create VNC image series starting from the cortico-medullary and nephrographic phases (Figure 2).