Epicardial fat volume assessment in cardiac CT

Epicardial fat, as other visceral fat localizations, is correlated with car- diovascular disease, cardiovascular risk factors and metabolic syndrome. However, many concerns remain about the method for measuring epi- cardial fat, its regional distribution on the myocardium, as well as the accuracy and reproducibility of such measurements. At present, dedi- cated software procedures to assess epicardial fat are lacking. On the other hand, manual fat segmentation requires a huge and tedious operator intervention, which is expected to cause inaccuracy and large observer- dependent variability. The aim of this study was twofold: (1) the devel- opment of a procedure devoted to assess the volume of epicardial fat, (2) the evaluation of the related intra and inter-observer variability in CT scans, both with and without contrast medium injection.