Deep learning-enabled MRI phenotyping uncovers regional body composition heterogeneity and disease associations in two European population cohorts

medRxiv

Abstract

Abstract Body mass index (BMI) does not account for substantial inter-individual differences in regional fat and muscle compartments, which are relevant for the prevalence of cardiometabolic and cancer conditions. We applied a validated deep learning pipeline for automated segmentation of whole-body MRI scans in 45,851 adults from the UK Biobank and German National Cohort, enabling harmonized quantification of visceral (VAT), gluteofemoral (GFAT), and abdominal subcutaneous adipose tissue (ASAT), liver fat fraction (LFF), and trunk muscle volume. Associations with clinical conditions were evaluated using compartment measures adjusted for age, sex, height, and BMI. Our analysis demonstrates that regional adiposity and muscle volume show distinct associations with cardiometabolic and cancer prevalence, and that substantial disease heterogeneity exists within BMI strata. The analytic framework and reference data presented here will support future risk stratification efforts and facilitate the integration of automated MRI phenotyping into large-scale population and clinical research.

Authors 35

1. Christian J. Mertens

   TUM Klinikum · Technical University of Munich

   Affiliation as printed

   Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany.;

   Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany

2. Hartmut Häntze

   Radboud University Nijmegen · TUM Klinikum · Radboud University Medical Center · Technical University of Munich

   Affiliation as printed

   Diagnostic Image Analysis Group , Department of Medical Imaging , Radboud University Medical Center , Nijmegen , The Netherlands

   Institute for Diagnostic and Interventional Radiology , School of Medicine and Health , TUM Klinikum , Technical University of Munich (TUM) , Munich , Germany

   Diagnostic Image Analysis Group, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands

   Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany

3. Sebastian Ziegelmayer

   TUM Klinikum · Technical University of Munich

   Affiliation as printed

   Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany.;

   Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany

4. Jakob Nikolas Kather

   Heidelberg University · University Hospital Heidelberg · National Center for Tumor Diseases · University Hospital Carl Gustav Carus · Else Kröner Fresenius Center for Digital Health · Technische Universität Dresden

   Affiliation as printed

   Else Kroener Fresenius Center for Digital Health, Dresden University of Technology, Dresden, Germany.; Department of Medicine I, University Hospital Dresden, Dresden, Germany.; Medical Oncology, National Center for Tumour Diseases (NCT), University Hospit;

   Department of Medicine I, University Hospital Dresden, Dresden, Germany

   Else Kroener Fresenius Center for Digital Health, Dresden University of Technology, Dresden, Germany

   Medical Oncology, National Center for Tumour Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany

5. Daniel Truhn Aachen Department for Diagnostic and Interventional Radiology

   Universitätsklinikum Aachen

   Affiliation as printed

   Department for Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany.;

   Department for Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany

6. Su Hwan Kim

   TUM Klinikum · Technical University of Munich

   Affiliation as printed

   Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany.;

   Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany

7. Felix Busch

   TUM Klinikum · Technical University of Munich

   Affiliation as printed

   Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany.;

   Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany

8. Benedikt Wiestler

   TUM Klinikum · Technical University of Munich

   Affiliation as printed

   Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, TUM Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.;

   Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, TUM Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany

9. Markus M. Graf

   TUM Klinikum · Technical University of Munich

   Affiliation as printed

   Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany.;

   Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany

10. Fabian Bamberg

    University of Freiburg · University Medical Center Freiburg

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany.;

    Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany

11. Christopher L. Schlett

    University of Freiburg · University Medical Center Freiburg

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany.;

    Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany

12. Jakob Weiss

    University of Freiburg · University Medical Center Freiburg

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany.;

    Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany

13. Steffen Ringhof

    University of Freiburg · University Medical Center Freiburg

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany.;

    Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany

14. Elif Can

    University of Freiburg · University Medical Center Freiburg

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany.;

    Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany

15. Jeanette Schulz‐Menger

    Max Delbrück Center · Humboldt-Universität zu Berlin · German Centre for Cardiovascular Research · Helios Hospital Berlin-Buch · Charité - Universitätsmedizin Berlin

    Affiliation as printed

    Charite - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, ECRC Experimental and Clinical Research Center, Berlin, Germany.; Working Group on CMR, Experimental and Clinical Research Center, a;

    Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, ECRC Experimental and Clinical Research Center, Berlin, Germany

    DZHK (German Centre for Cardiovascular Research), Berlin, Germany

    Department of Cardiology and Nephrology, Helios Hospital Berlin-Buch, Berlin, Germany

    Working Group on CMR, Experimental and Clinical Research Center, a Joint Cooperation Between the Max-Delbrück-Center for Molecular Medicine and the Charité - Universitätsmedizin Berlin, Berlin, Germany

16. Thoralf Niendorf

    Max Delbrück Center · Charité - Universitätsmedizin Berlin

    Affiliation as printed

    Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility (B.U.F.F.), 13125 Berlin, Germany.; Experimental and Clinical Research Center (ECRC), Charite-Universitaetsmedizin Berlin, A Joint Cooperation;

    Experimental and Clinical Research Center (ECRC), Charité-Universitätsmedizin Berlin, A Joint Cooperation Between the Charité Medical Faculty and The Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, 13125 Berlin, Germany

17. Jacqueline Lammert

    TUM Klinikum · Technical University of Munich

    Affiliation as printed

    Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Technical University of Munich (TUM), School of Medicine and Health, Klinikum rechts der Isar, TUM University Hospital, Munich, Germany.;

    Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Technical University of Munich (TUM), School of Medicine and Health, Klinikum rechts der Isar, TUM University Hospital, Munich, Germany

18. Isabel Molwitz

    University Medical Center Hamburg-Eppendorf

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.;

    Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

19. Avan Kader

    TUM Klinikum · Technical University of Munich

    Affiliation as printed

    Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany.;

    Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany

20. Alessa Hering

    Radboud University Nijmegen · Radboud University Medical Center

    Affiliation as printed

    Diagnostic Image Analysis Group, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.;

    Diagnostic Image Analysis Group, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands

21. Aymen Meddeb

    Stiftung Charité · Charité - Universitätsmedizin Berlin

    Affiliation as printed

    Department of Neuroradiology, Charite Universitaetsmedizin Berlin, Berlin, Germany.;

    Department of Neuroradiology, Charité Universitätsmedizin Berlin, Berlin, Germany

22. Jawed Nawabi

    Stiftung Charité · Charité - Universitätsmedizin Berlin

    Affiliation as printed

    Department of Neuroradiology, Charite Universitaetsmedizin Berlin, Berlin, Germany.;

    Department of Neuroradiology, Charité Universitätsmedizin Berlin, Berlin, Germany

23. Matthias Bernd Schulze

    University of Potsdam · German Institute of Human Nutrition

    Affiliation as printed

    Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.; Institute of Nutrition Science, University of Potsdam, Nuthetal, Germany.;

    Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany

    Institute of Nutrition Science, University of Potsdam, Nuthetal, Germany

24. Thomas Keil

    Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin

    Affiliation as printed

    Institute of Social Medicine, Epidemiology and Health Economics, Charite - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin, Germany.;

    Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany

25. Stefan N. Willich

    Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin

    Affiliation as printed

    Institute of Social Medicine, Epidemiology and Health Economics, Charite - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin, Germany.;

    Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany

26. Lilian Krist

    Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin

    Affiliation as printed

    Institute of Social Medicine, Epidemiology and Health Economics, Charite - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin and Humboldt-Universitaet zu Berlin, Berlin, Germany.;

    Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany

27. Martin Hadamitzky

    Deutsches Herzzentrum München · Technical University of Munich

    Affiliation as printed

    Department of Cardiovascular Radiology and Nuclear Medicine, German Heart Center Munich, TUM University Hospital, Institute for Cardiovascular Radiology and Nuclear Medicine, Lazarettstrasse 36, 80636, Munich, Germany.;

    Department of Cardiovascular Radiology and Nuclear Medicine, German Heart Center Munich, TUM University Hospital, Institute for Cardiovascular Radiology and Nuclear Medicine, Lazarettstrasse 36, 80636, Munich, Germany

28. Anke Hannemann

    Universitätsmedizin Greifswald · Universität Greifswald

    Affiliation as printed

    Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany.;

    Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany

29. Florian C. Bassermann

    TUM Klinikum · Technical University of Munich

    Affiliation as printed

    Department of Medicine III, Technical University of Munich, TUM School of Medicine and Health, Munich, Germany.; Center for Translational Cancer Research (TranslaTUM), Technical University of Munich, TUM School of Medicine and Health, Munich, Germany.;

    Center for Translational Cancer Research (TranslaTUM), Technical University of Munich, TUM School of Medicine and Health, Munich, Germany

30. Daniel Rueckert

    TUM Klinikum · Munich Center for Machine Learning · Imperial College London · Technical University of Munich

    Affiliation as printed

    Munich Center for Machine Learning (MCML), Munich, Germany.; Chair of AI in Healthcare and Medicine, Technical University of Munich (TUM) and TUM University Hospital, Munich, Germany.; Department of Computing, Imperial College London, London, UK.;

    Chair of AI in Healthcare and Medicine, Technical University of Munich (TUM) and TUM University Hospital, Munich, Germany

    Department of Computing, Imperial College London, London, UK

    Munich Center for Machine Learning (MCML), Munich, Germany

31. Tobias Pischon

    Max Delbrück Center · Humboldt-Universität zu Berlin · Freie Universität Berlin · Charité - Universitätsmedizin Berlin

    Affiliation as printed

    Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.; Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, G;

    Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany

    Molecular Epidemiology Research Group, Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany

32. Alexander Hapfelmeier

    TUM Klinikum · Technical University of Munich

    Affiliation as printed

    Technische Universitaet of Munich, School of Medicine and Health, TUM University Hospital Rechts der Isar, Institute of AI and Informatics in Medicine, Munich, Germany; Technische Universitaet of Munich, School of Medicine and Health, TUM University Hospi;

    Technische Universität of Munich, School of Medicine and Health, TUM University Hospital Rechts der Isar, Institute of AI and Informatics in Medicine, Munich, Germany

33. Marcus R. Makowski

    TUM Klinikum · Technical University of Munich

    Affiliation as printed

    Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany.;

    Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany

34. Keno K. Bressem corresponding

    TUM Klinikum · Deutsches Herzzentrum München · Technical University of Munich

    Affiliation as printed

    Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany.; Department of Cardiovascular Radiology and Nuclear Medicine, German Heart Center Munich, TUM Univer

    Department of Cardiovascular Radiology and Nuclear Medicine, German Heart Center Munich, TUM University Hospital, Institute for Cardiovascular Radiology and Nuclear Medicine, Lazarettstrasse 36, 80636, Munich, Germany

    Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany

35. Lisa C. Adams

    TUM Klinikum · Technical University of Munich

    Affiliation as printed

    Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany.;

    Institute for Diagnostic and Interventional Radiology, School of Medicine and Health, TUM Klinikum, Technical University of Munich (TUM), Munich, Germany