Cardiac Adipose Tissue, Imaging Segmentation, and Quantification for Cardio-Vascular Disease Assessment – A survey

Adipose tissue plays a complex role in cardiovascular health. Cardiac adipose tissue (CAT) has been correlated with several diseases that affect the structure and function of the heart. Examples include heart failure (HF), where the heart muscle (myocardium) is affected, coronary artery disease (CAD), where these main heart vessels are affected by the amount of fat around the heart, and cardiac steatosis or fatty heart disease, where infiltration or accumulation of fat within the heart’s muscle inhibits proper function. This review explores the different types of fat deposits surrounding the heart, focusing on the potential contribution of CAT to cardiovascular disease (CVD). Three main imaging modalities for assessing cardiac fat are discussed, including magnetic resonance imaging (MRI), computed tomography (CT), and echocardiography. The segmentation and quantification of the fat for each imaging modality is also presented, correlating these measurements with CVD risk. Each imaging modality offers distinct advantages and limitations in segmenting and quantifying fat. While advancements have been made, challenges persist in accurately measuring and interpreting the fat distribution around the heart. Future research should focus on refining segmentation techniques, establishing standardized protocols, and elucidating the specific mechanisms linking adipose tissue to CVD risk. By overcoming these limitations, cardiac fat imaging can be a powerful tool for improved risk stratification, personalized treatment strategies, and ultimately, better cardiovascular health outcomes.