Anthropometer3D: Automatic Multi-Slice Segmentation Software for the Measurement of Anthropometric Parameters from CT of PET/CT

Anthropometric parameters like muscle body mass (MBM), fat body mass (FBM), lean body mass (LBM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) are used in oncology. Our aim was to develop and evaluate the software Anthropometer3D measuring these anthropometric parameters on the CT of PET/CT. This software performs a multi-atlas segmentation of CT of PET/CT with extrapolation coefficients for the body parts beyond the usual acquisition range (from the ischia to the eyes). The multi-atlas database is composed of 30 truncated CTs manually segmented to isolate three types of voxels (muscle, fat, and visceral fat). To evaluate Anthropomer3D, a leave-one-out cross-validation was performed to measure MBM, FBM, LBM, VAT, and SAT. The reference standard was based on the manual segmentation of the corresponding whole-body CT. A manual segmentation of one CT slice at level L3 was also used. Correlations were analyzed using Dice coefficient, intra-class coefficient correlation (ICC), and Bland–Altman plot. The population was heterogeneous (sex ratio 1:1; mean age 57 years old [min 23; max 74]; mean BMI 27 kg/m2 [min 18; max 40]). Dice coefficients between reference standard and Anthropometer3D were excellent (mean+/-SD): muscle 0.95 ± 0.02, fat 1.00 ± 0.01, and visceral fat 0.97 ± 0.02. The ICC was almost perfect (minimal value of 95% CI of 0.97). All Bland–Altman plot values (mean difference, 95% CI and slopes) were better for Anthropometer3D compared to L3 level segmentation. Anthropometer3D allows multiple anthropometric measurements based on an automatic multi-slice segmentation. It is more precise than estimates using L3 level segmentation.