Regional epicardial fat measurement: computational methods for cardiac CT imaging

Epicardial fat, as other visceral fat localizations, is correlated with cardiovascular disease, cardiovascular risk factors and metabolic syndrome. However, many concerns remain about the method for mea- suring epicardial fat, its regional distribution on the myocardium and the accuracy and reproducibility of the measurements. Actually two techniques appear suitable for these tasks, Magnetic Resonance Imag- ing (MRI) and Computed Tomography (CT). Unfortunately, evaluating epicardial fat by direct user interaction is a long and tedious task prone to strong inter- and intra-observer variability. As a matter of fact, accu- rate and reproducible measurements on reasonably large populations is heavily hampered. The aim of this work is to introduce and design image processing methods suitable for the effective quantitative analysis of the epicardial fat from the data obtained by cardiac CT and to start investigating its regional distribution. In order to achieve adequate measurement reproducibility, minimization of user intervention is a ma jor design requirement. Single- frame 3D images obtained by standard acquisition protocols used for coronary calcium scoring and coronary CT angiography are considered. Preliminary results are reported.