Visceral adipose tissue (VAT) is a key marker of both metabolic health and habitual physical activity (PA). Excess VAT is highly correlated with type 2 diabetes and insulin resistance. The mechanistic basis for this pathophysiology relates to overloading the liver with fatty acids. VAT is also a highly labile fat depot, with increased turnover stimulated by catecholamines during exercise. VAT can be measured with sophisticated imaging technologies, but can also be inferred directly from PA. We tested this relationship using National Health and Nutrition Examination Survey (NHANES) data from 2011-2014, for individuals aged 20-60 years with 7 days of accelerometry data (n=2,456 men; 2,427 women) [1]. Two approaches were used for estimating VAT from activity. The first used engineered features based on movements during gait and sleep, and then ridge regression to map summary statistics of these features into a VAT estimate. The second approach used deep neural networks trained on 24 hours of continuous accelerometry. A foundation model first mapped each 10s frame into a high-dimensional feature vector. A transformer model then mapped each day's feature vector time series into a VAT estimate, which were averaged over multiple days. For both approaches, the most accurate estimates were obtained with the addition of covariate information about subject demographics and body measurements. The best performance was obtained by combining the two approaches, resulting in VAT estimates with correlations of r=0.86. These findings demonstrate a strong relationship between PA and VAT and, by extension, between PA and metabolic health risks.

-- Accurate segmentation of abdominal adipose tissue, including subcutaneous (SA T) and visceral adipose tissue (V A T), along with liver segmentation, is essential for understanding body composition and associated health risks such as type 2 diabetes and cardiovascular disease. This study proposes Attention GhostUNet++, a novel deep learning model incorporating Channel, Spatial, and Depth Attention mechanisms into the Ghost UNet++ bottleneck for automated, precise segmentation. Evaluated on the AA TTCT -IDS and LiTS datasets, the model achieved Dice coefficients of 0.9430 for V A T, 0.9639 for SA T, and 0.9652 for liver segmentation, surpassing baseline models. Despite minor limitations in boundary detail segmentation, the proposed model significantly enhances feature refinement, contextual understanding, and computational efficiency, offering a robust solution for body composition analysis. Clinical relevance -- The Attention GhostUNet++ model offers a significant advancement in the automated segmentation of adipose tissue and liver regions from CT images.

Epicardial adipose tissue (EAT) is a type of visceral fat that can secrete large amounts of adipokines to affect the myocardium and coronary arteries. EAT volume and density can be used as independent risk markers measurement of volume by noninvasive magnetic resonance images is the best method of assessing EAT. However, segmenting EAT is challenging due to the low contrast between EAT and pericardial effusion and the presence of motion artifacts. we propose a novel feature latent space multilevel supervision network (SPDNet) with uncertainty-driven and adversarial calibration learning to enhance segmentation for more accurate EAT volume estimation. The network first addresses the blurring of EAT edges due to the medical images in the open medical environments with low quality or out-of-distribution by modeling the uncertainty as a Gaussian distribution in the feature latent space, which using its Bayesian estimation as a regularization constraint to optimize SwinUNETR. Second, an adversarial training strategy is introduced to calibrate the segmentation feature map and consider the multi-scale feature differences between the uncertainty-guided predictive segmentation and the ground truth segmentation, synthesizing the multi-scale adversarial loss directly improves the ability to discriminate the similarity between organizations. Experiments on both the cardiac public MRI dataset (ACDC) and the real-world clinical cohort EAT dataset show that the proposed network outperforms mainstream models, validating that uncertainty-driven and adversarial calibration learning can be used to provide additional information for modeling multi-scale ambiguities.

Department of Radiology, Case Western Reserve University, Cleveland, OH, 44106, USA Abstract Background: Recent studies have used basic epicardial adipose tissue (EAT) assessments (e.g., volume and mean HU) to predict risk of atherosclerosis-related, major adverse cardiovascular events (MACE). Objectives: Create novel, hand-crafted EAT features, "fat-omics", to capture the pathophysiology of EAT and improve MACE prediction. We extracted 148 radiomic features (morphological, spatial, and intensity) and used Cox elastic-net for feature reduction and prediction of MACE. Results: Traditional fat features gave marginal prediction (EAT-volume/EAT-mean-HU/ BMI gave C-index 0.53/0.55/0.57, Significant improvement was obtained with 15 fat-omics features (C-index=0.69, Other high-risk features include kurtosis-of-EAT-thickness, reflecting the heterogeneity of thicknesses, and EATvolume-in-the-top-25%-of-the-heart, emphasizing adipose near the proximal coronary arteries. Kaplan-Meyer plots of Cox-identified, high-and low-risk patients were well separated with the median of the fat-omics risk, while high-risk group having HR 2.4 times that of the low-risk group (P<0.001). Conclusion: Preliminary findings indicate an opportunity to use more finely tuned, explainable assessments on EAT for improved cardiovascular risk prediction. Introduction Cardiovascular disease is a major cause of morbidity and mortality worldwide (1), leading to 17.9 million deaths globally each year (2). Numerous risk score methodologies have been developed to predict risks from cardiovascular disease, but these methods often lack sufficient discrimination (3). Accurate explainable risk prediction models will provide useful information to patients and physicians for more personalized medications and interventions. Previous studies have determined the usefulness of coronary calcification Agatston score as obtained from CT calcium score (CTCS) images for cardiovascular risk prediction.

The clinical management of breast cancer depends on an accurate understanding of the tumor and its anatomical context to adjacent tissues and landmark structures. This context may be provided by semantic segmentation methods; however, previous works have been largely limited to a singular focus on the tumor alone and rarely other tissue types. In contrast, we present a method that exploits tissue-tissue interactions to accurately segment every major tissue type in the breast including: chest wall, skin, adipose tissue, fibroglandular tissue, vasculature and tumor via standard-of-care Dynamic Contrast Enhanced MRI. Comparing our method to prior state-of-the-art, we achieved a superior Dice score on tumor segmentation while maintaining competitive performance on other studied tissues across multiple institutions. Briefly, our method proceeds by localizing the tumor using 2D object detectors, then segmenting the tumor and surrounding tissues independently using two 3D U-nets, and finally integrating these results while mitigating false positives by checking for anatomically plausible tissue-tissue contacts. The object detection models were pre-trained on ImageNet and COCO, and operated on MIP (maximum intensity projection) images in the axial and sagittal planes, establishing a 3D tumor bounding box. By integrating multiple relevant peri-tumoral tissues, our work enables clinical applications in breast cancer staging, prognosis and surgical planning.

Methods: In this study, a benchmark \emph{Abdominal Adipose Tissue CT Image Dataset} (AATTCT-IDS) containing 300 subjects is prepared and published. AATTCT-IDS publics 13,732 raw CT slices, and the researchers individually annotate the subcutaneous and visceral adipose tissue regions of 3,213 of those slices that have the same slice distance to validate denoising methods, train semantic segmentation models, and study radiomics. For different tasks, this paper compares and analyzes the performance of various methods on AATTCT-IDS by combining the visualization results and evaluation data. Thus, verify the research potential of this data set in the above three types of tasks. Results: In the comparative study of image denoising, algorithms using a smoothing strategy suppress mixed noise at the expense of image details and obtain better evaluation data. Methods such as BM3D preserve the original image structure better, although the evaluation data are slightly lower. The results show significant differences among them. In the comparative study of semantic segmentation of abdominal adipose tissue, the segmentation results of adipose tissue by each model show different structural characteristics. Among them, BiSeNet obtains segmentation results only slightly inferior to U-Net with the shortest training time and effectively separates small and isolated adipose tissue. In addition, the radiomics study based on AATTCT-IDS reveals three adipose distributions in the subject population. Conclusion: AATTCT-IDS contains the ground truth of adipose tissue regions in abdominal CT slices. This open-source dataset can attract researchers to explore the multi-dimensional characteristics of abdominal adipose tissue and thus help physicians and patients in clinical practice. AATCT-IDS is freely published for non-commercial purpose at: \url{https://figshare.com/articles/dataset/AATTCT-IDS/23807256}.

To incorporate spatial (neighborhood) and bidirectional hierarchical relationships as well as features and priors of the samples into their classification, we formulated the classification problem on three variants of multiresolution neighborhood graphs and the graph of a hierarchical conditional random field. Each of these graphs was weighted and undirected and could thus incorporate the spatial or hierarchical relationships in all directions. In addition, each variant of the proposed neighborhood graphs was composed of a spatial feature-based subgraph and an aspatial prior-based subgraph. It expanded on a random walker graph by using novel mechanisms to derive the edge weights of its spatial feature-based subgraph. These mechanisms included implicit and explicit edge detection to enhance detection of weak boundaries between different classes in spatial domain. The implicit edge detection relied on the outlier detection capability of the Tukey's function and the classification reliabilities of the samples estimated by a hierarchical random forest classifier. Similar mechanism was used to derive the edge weights and thus the energy function of the hierarchical conditional random field. This way, the classification problem boiled down to a system of linear equations and a minimization of the energy function which could be done via fast and efficient techniques.

Computed tomography (CT) is routinely used in clinical practice to evaluate a wide variety of medical conditions. While CT scans provide diagnoses, they also offer the ability to extract quantitative body composition metrics to analyze tissue volume and quality. Extracting quantitative body composition measures manually from CT scans is a cumbersome and time-consuming task. Proprietary software has been developed recently to automate this process, but the closed-source nature impedes widespread use. There is a growing need for fully automated body composition software that is more accessible and easier to use, especially for clinicians and researchers who are not experts in medical image processing. To this end, we have built Comp2Comp, an open-source Python package for rapid and automated body composition analysis of CT scans. This package offers models, post-processing heuristics, body composition metrics, automated batching, and polychromatic visualizations. Comp2Comp currently computes body composition measures for bone, skeletal muscle, visceral adipose tissue, and subcutaneous adipose tissue on CT scans of the abdomen. We have created two pipelines for this purpose. The first pipeline computes vertebral measures, as well as muscle and adipose tissue measures, at the T12 - L5 vertebral levels from abdominal CT scans. The second pipeline computes muscle and adipose tissue measures on user-specified 2D axial slices. In this guide, we discuss the architecture of the Comp2Comp pipelines, provide usage instructions, and report internal and external validation results to measure the quality of segmentations and body composition measures. Comp2Comp can be found at https://github.com/StanfordMIMI/Comp2Comp.

This work proposes the use of Genetic Algorithms (GA) in tracing and recognizing the pericardium contour of the human heart using Computed Tomography (CT) images. We assume that each slice of the pericardium can be modelled by an ellipse, the parameters of which need to be optimally determined. An optimal ellipse would be one that closely follows the pericardium contour and, consequently, separates appropriately the epicardial and mediastinal fats of the human heart. Tracing and automatically identifying the pericardium contour aids in medical diagnosis. Usually, this process is done manually or not done at all due to the effort required. Besides, detecting the pericardium may improve previously proposed automated methodologies that separate the two types of fat associated to the human heart. Quantification of these fats provides important health risk marker information, as they are associated with the development of certain cardiovascular pathologies. Finally, we conclude that GA offers satisfiable solutions in a feasible amount of processing time.

Globally, the number of obese patients has doubled due to sedentary lifestyles and improper dieting. The tremendous increase altered human genetics, and health. According to the world health organization, Life expectancy dropped from 80 to 75 years, as obese people struggle with different chronic diseases. This report will address the problems of obesity in children and adults using ML datasets to feature, predict, and analyze the causes of obesity. By engaging neural ML networks, we will explore neural control using diffusion tensor imaging to consider body fats, BMI, waist \& hip ratio circumference of obese patients. To predict the present and future causes of obesity with ML, we will discuss ML techniques like decision trees, SVM, RF, GBM, LASSO, BN, and ANN and use datasets implement the stated algorithms. Different theoretical literature from experts ML \& Bioinformatics experiments will be outlined in this report while making recommendations on how to advance ML for predicting obesity and other chronic diseases.