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Review
. 2022 Sep-Oct;55(5):305-311.
doi: 10.1590/0100-3984.2021.0155-en.

Assessment of body composition by whole-body densitometry: what radiologists should know

Lucas Gabriel Cruz de Menezes Chaves  1 , Thiago José Martins Gonçalves  1 , Almir Galvão Vieira Bitencourt  1   2 , Ricardo Arroyo Rstom  1 , Talita Rombaldi Pereira  1 , Silvio Fontana Velludo  1
Affiliations
Review

Assessment of body composition by whole-body densitometry: what radiologists should know

Lucas Gabriel Cruz de Menezes Chaves et al. Radiol Bras. 2022 Sep-Oct.

Abstract
in English, Portuguese

The analysis of body composition is a fundamental part of a nutritional status assessment, and the use of diagnostic imaging methods has been increasingly required for an adequate characterization of the lean body mass and fat mass. Body composition measurements are useful in evaluating the effectiveness of nutritional interventions and monitoring changes associated with aging and chronic diseases. Whole-body densitometry using dual-energy X-ray absorptiometry (DEXA) is one of the most widely used methods in clinical practice, allowing highly accurate assessment of the bone mineral content, lean body mass, and fat mass. Although a DEXA examination provides a lot of information, there is still no universal standardization of the parameters to be included in radiology reports. The aim of this study was to review the most relevant information for assessing body composition by whole-body densitometry.

A análise da composição corporal é parte fundamental de uma avaliação nutricional, em que a utilização de métodos diagnósticos por imagem tem sido cada vez mais requisitada para uma adequada caracterização da massa magra e massa gorda corporal. Medidas de composição corporal são úteis em avaliar a eficácia das intervenções nutricionais e monitorar as mudanças associadas ao envelhecimento e condições de doenças crônicas. A densitometria de corpo inteiro utilizando a técnica de absorciometria de dupla energia (DEXA) é um dos métodos mais utilizados na prática clínica, que permite avaliação com elevada acurácia do conteúdo mineral ósseo, da gordura corporal e da massa magra. Este exame fornece grande quantidade de informações, no entanto, ainda não existe uma padronização universal de quais parâmetros devem ser incluídos nos relatórios radiológicos. O objetivo deste trabalho é revisar as informações mais relevantes para avaliação da composição corporal fornecidas pela densitometria de corpo inteiro.

Keywords: Body composition; Body fat distribution; Densitometry; Sarcopenia.

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Figures

Figure 1
Figure 1
Patient positioned for whole-body densitometry to assess body composition.
Figure 2
Figure 2
Example of DEXA performed to assess body composition, with proper positioning of the reference lines separating the regions of the body: head, trunk, pelvis, arms, and legs.
Figure 3
Figure 3
Example of DEXA in a 79-year-old male patient with a low body mass index (22.7 kg/m2; weight: 61 kg ; height: 1.64 cm). Body fat analysis revealed a fat mass of 21.9 kg (body fat: 35.8%), with a FMI of 8.1 kg/m2 (consistent with overweight), a VAT area of 240 cm2 (normal range, ≤ 100 cm2), an android/gynoid (A/G) fat ratio of 1.72 (predominance of android fat), and an ALMI of 5.8 kg/m2 (ALM: 15.7 kg, which is considered low).
Figure 4
Figure 4
Example of DEXA in a 70-year-old female patient with a low body mass index (21.9 kg/m2; weight: 61 kg; height: 1.67 cm). Body fat analysis revealed a fat mass of 32.2 kg (body fat: 39.6%), with a FMI of 11.5 kg/m2 (consistent with overweight), a VAT area of 211 cm2 (normal range, ≤ 100 cm2), an android/gynoid (A/G) fat ratio of 0.94 (predominance of gynoid fat), and an ALMI of 7.4 kg/m2 (ALM: 20.5 kg, which is considered normal).
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