Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
, 94 (45), e1991

Anthropometric Assessment of Neck Adipose Tissue and Airway Volume Using Multidetector Computed Tomography: An Imaging Approach and Association With Overall Mortality

Affiliations
Observational Study

Anthropometric Assessment of Neck Adipose Tissue and Airway Volume Using Multidetector Computed Tomography: An Imaging Approach and Association With Overall Mortality

Hillel S Maresky et al. Medicine (Baltimore).

Abstract

Neck adiposity tissue volume (NATV) accumulation is an indicator for metabolic syndrome and cardiovascular disease (CVD). Neck circumference is a poor measure of NATV, and a quantifier for this entity has not yet been established. To evaluate volumetric quantification by multidetector computed tomography (MDCT) as a reproducible anthropometric tool to measure NATV and airway volume (AWV). A total of 519 patients, including a subset of 70 random patients who underwent head and neck CT scanning in our hospital within 1 year (2013), were studied. Included patients were all those undergoing nonenhanced CT (NECT) or CT angiography (CTA). Neck cross-sectional areas (NCSA) were measured at 2 separate levels of the neck, and 3D postprocessing tissue reconstruction was performed, and NATV and AWVs were quantified volumetrically for all patients within the year. The average NCSA at the level of the soft palate and thyroid cartilage was 22,579 and 14,500 mm, respectively. NATV when compared to the upper and lower levels of NCSA showed correlations of 0.64 and 0.79, respectively (P < 0.001). Interobserver analysis showed mean deviations of 0.46% and 0.32% for NATV and AWV, respectively. A strong correlation between NATV and body mass index (BMI) was found (r = 0.658, P < 0.001), and the top quartile of NATV:AWV patients (out of 519 patients) displayed a statistically significant mortality rate during 670 days of follow-up (d = 7.5%, P = 0.032). After adjustment for age and gender, the association between NATV:AWV and mortality was close to significant (P = 0.072). Volumetric quantification of NATV and AWV is a reproducible and prognostic anthropometric tool, as a high NATV:AWV demonstrated a significant risk factor for mortality; future research may further advance our understanding of this phenomenon.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Computed tomography (CT) margins obtained from the scout view: from the roof of the bony orbits cranially, to the sternal angle of lewis inferiorly, and from the mid-clavicular interspace laterally.
FIGURE 2
FIGURE 2
Manual tracing of neck adipose tissue (NAT) compartments at several axial levels.
FIGURE 3
FIGURE 3
Two levels of neck cross-sectional surface areas (NCSAs): at the level of the soft palate superiorly, and the level of the thyroid cartilage inferiorly. Axial cross-sectional areas were traced semiautomatically, ear cartilage was excluded manually, and expressed in mm2.
FIGURE 4
FIGURE 4
Bland–Altman plots for interobserver NATV and AWV. AWV = airway volume, NATV = neck adipose tissue volume.
FIGURE 5
FIGURE 5
NATV distribution according to WHO BMI categories. BMI = body mass index, NATV = neck adipose tissue volume, WHO = World Health Organisation.
FIGURE 7
FIGURE 7
Cumulative 670 days survival follow-up through NATV:AWV quartiles. AWV = airway volume, NATV = neck adipose tissue volume.
FIGURE 6
FIGURE 6
Illustration of NATV (A) and AWV (B) reconstructed 3-dimensionally. AWV = airway volume, NATV = neck adipose tissue volume.

Similar articles

See all similar articles

Cited by 2 PubMed Central articles

References

    1. Ogden CL, Carroll MD, Kit BK, et al. Prevalence of Childhood and Adult Obesity in the United States, 2011–2012. JAMA 2014; 311:806–814. - PMC - PubMed
    1. Keinan-Boker Lital, et al. “Overweight and obesity prevalence in Israel: findings of the first national health and nutrition survey (MABAT).” The Israel Medical Association journal: IMAJ 7.4 (2005): 219–223. - PubMed
    1. Smith, Sidney C, et al. Our time: a call to save preventable death from cardiovascular disease (heart disease and stroke). Eur Heart J 2012; ehs313. - PubMed
    1. McGee, Daniel L., and Diverse Populations Collaboration. “Body mass index and mortality: a meta-analysis based on person-level data from twenty-six observational studies.” Annals of epidemiology 15.2 (2005): 87–97. - PubMed
    1. Ford ES, Maynard LM, Li C. Trends in mean waist circumference and abdominal obesity among US adults, 1999–2012. JAMA 2014; 312:1151–1153. - PMC - PubMed

Publication types

Feedback