Abdominal fat was detected using 64-multidetector CT (Brilliance 64; Philips, Best, the Netherlands).4 (link) In summary, contiguous 5-mm slices were acquired, and fat volume was calculated using 20 slices covering 100 mm located 50 mm above to 50 mm below the umbilicus. Abdominal fat compartments were manually traced in each image, segmentation of the 20 slices was automatically reconstructed, and volume (cm3) was estimated using software (Extended Brilliance Workspace version 3.5; Philips) that electronically determined area by setting attenuation values for a region of interest within a range of 25 to −175 Hounsfield units. Visceral fat was defined as intra-abdominal fat bound by parietal peritoneum or transversalis fascia, excluding the vertebral column and paraspinal muscles. The subcutaneous fat volume was acquired by subtracting visceral fat volume from total adipose tissue volume.
Extended brilliance workspace version 3
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Abdominal Fat Quantification Protocol
Abdominal fat was detected using 64-multidetector CT (Brilliance 64; Philips, Best, the Netherlands).4 (link) In summary, contiguous 5-mm slices were acquired, and fat volume was calculated using 20 slices covering 100 mm located 50 mm above to 50 mm below the umbilicus. Abdominal fat compartments were manually traced in each image, segmentation of the 20 slices was automatically reconstructed, and volume (cm3) was estimated using software (Extended Brilliance Workspace version 3.5; Philips) that electronically determined area by setting attenuation values for a region of interest within a range of 25 to −175 Hounsfield units. Visceral fat was defined as intra-abdominal fat bound by parietal peritoneum or transversalis fascia, excluding the vertebral column and paraspinal muscles. The subcutaneous fat volume was acquired by subtracting visceral fat volume from total adipose tissue volume.
Quantifying Metabolic Activity in Inflammatory Conditions
To measure the metabolic activity of PM, the boundary of PM was identified by CT images at L4 spine level, as previously described [23 (link)]. Next, ROIs were manually placed on both right and left PM and their corresponding area and maximum SUV (SUVmax) were obtained. Representative PM area was defined as the average value of right and left PM area. Representative PM SUVmax, was defined as the average value of right and left PM SUVmax. Metabolic activities of spleen and bone-marrow (BM) assessed by 18F-FDG PET/CT could reflect the elevated myeloid activity arising from systemic inflammation, thereby being known for systemic inflammation surrogate markers [24 (link),25 (link)]. To measure the metabolic activity of the spleen and BM, ROIs were located on the spleen and spinal BM at the level of L3 to L5 from all axial slices. Averaged SUVmax from those ROIs were used as representative spleen SUVmax and BM SUVmax, respectively [24 (link)].
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