Fully automated waist circumference measurement on abdominal CT: Comparison with manual measurements and potential value for identifying overweight and obesity as an adjunct output of CT scan

• Published in: PloS one Vol. 16; no. 7; p. e0254704
• Main Authors: Joo, Ijin, Kwak, Min-Sun, Park, Dae Hyun, Yoon, Soon Ho
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 19.07.2021; Public Library of Science (PLoS)
• Subjects: Abdomen; Adults; Algorithms; Analysis; Anthropometry; Auroral kilometric radiation; Automation; Biology and Life Sciences; Body composition; Body mass; Body mass index; Body measurements; Body size; Body weight; Computed tomography; Computer and Information Sciences; Correlation analysis; CT imaging; Deep learning; Diagnosis; Engineering and Technology; Evaluation; Hospitals; Image segmentation; Machine learning; Medical imaging; Medicine and Health Sciences; Men; Obesity; Overweight; Performance evaluation; Radiation; Radiation measurement; Research and Analysis Methods; Skin; Women; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0254704

Waist circumference (WC) is a widely accepted anthropometric parameter of central obesity. We investigated a fully automated body segmentation algorithm for measuring WC on abdominal computed tomography (CT) in comparison to manual WC measurements (WC-manual) and evaluated the performance of CT-measured WC for identifying overweight/obesity. This retrospective study included consecutive adults who underwent both abdominal CT scans and manual WC measurements at a health check-up between January 2013 and November 2019. Mid-waist WCs were automatically measured on noncontrast axial CT images using a deep learning-based body segmentation algorithm. The associations between CT-measured WC and WC-manual was assessed by Pearson correlation analysis and their agreement was assessed through Bland-Altman analysis. The performance of these WC measurements for identifying overweight/obesity (i.e., body mass index [BMI] [greater than or equal to]25 kg/m.sup.2) was evaluated using receiver operating characteristics (ROC) curve analysis. Among 763 subjects whose abdominal CT scans were analyzed using a fully automated body segmentation algorithm, CT-measured WCs were successfully obtained in 757 adults (326 women; mean age, 54.3 years; 64 women and 182 men with overweight/obesity). CT-measured WC was strongly correlated with WC-manual (r = 0.919, p < 0.001), and showed a mean difference of 6.1 cm with limits of agreement between -1.8 cm and 14.0 cm in comparison to WC-manual. For identifying overweight/obesity, CT-measured WC showed excellent performance, with areas under the ROC curve (AUCs) of 0.960 (95% CI, 0.933-0.979) in women and 0.909 (95% CI, 0.878-0.935) in men, which were comparable to WC-manual (AUCs of 0.965 [95% CI, 0.938-0.982] and 0.916 [95% CI, 0.886-0.941]; p = 0.735 and 0.437, respectively). CT-measured WC using a fully automated body segmentation algorithm was closely correlated with manually-measured WC. While radiation issue may limit its general use, it can serve as an adjunctive output of abdominal CT scans to identify overweight/obesity.