{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:27:12Z","timestamp":1784258832668,"version":"3.55.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T00:00:00Z","timestamp":1594684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T00:00:00Z","timestamp":1594684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2018-04164"],"award-info":[{"award-number":["2018-04164"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006310","name":"Medicinska Forskningsr\u00e5det","doi-asserted-by":"publisher","award":["2018-02779"],"award-info":[{"award-number":["2018-02779"]}],"id":[{"id":"10.13039\/501100006310","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20170440"],"award-info":[{"award-number":["20170440"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003749","name":"L\u00e4nsstyrelsen \u00d6sterg\u00f6tland","doi-asserted-by":"publisher","award":["LIO-797721"],"award-info":[{"award-number":["LIO-797721"]}],"id":[{"id":"10.13039\/501100003749","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is an increased interest in quantifying and characterizing epicardial fat which has been linked to various cardiovascular diseases such as coronary artery disease and atrial fibrillation. Recently, three-dimensional single-phase Dixon techniques have been used to depict the heart and to quantify the surrounding fat. The purpose of this study was to investigate the merits of a new high-resolution cine 3D Dixon technique for quantification of epicardial adipose tissue and compare it to single-phase 3D Dixon in patients with cardiovascular disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifteen patients referred for clinical CMR examination of known or suspected heart disease were scanned on a 1.5\u2009T scanner using single-phase Dixon and cine Dixon. Epicardial fat was segmented by three readers and intra- and inter-observer variability was calculated per slice. Cine Dixon segmentation was performed in the same cardiac phase as single-phase Dixon. Subjective image quality assessment of water and fat images were performed by three readers using a 4-point Likert scale (1\u2009=\u2009severe; 2\u2009=\u2009significant; 3\u2009=\u2009mild; 4\u2009=\u2009no blurring of cardiac structures).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Intra-observer variability was excellent for cine Dixon images (ICC\u2009=\u20090.96), and higher than single-phase Dixon (ICC\u2009=\u20090.92). Inter-observer variability was good for cine Dixon (ICC\u2009=\u20090.76) and moderate for single-phase Dixon (ICC\u2009=\u20090.63). The intra-observer measurement error (mean\u2009\u00b1\u2009standard deviation) per slice for cine was \u2212\u20090.02\u2009\u00b1\u20090.51\u2009ml (\u2212\u20090.08\u2009\u00b1\u20090.4%), and for single-phase 0.39\u2009\u00b1\u20090.72\u2009ml (0.18\u2009\u00b1\u20090.41%). Inter-observer measurement error for cine was 0.46\u2009\u00b1\u20090.98\u2009ml (0.11\u2009\u00b1\u20090.46%) and for single-phase 0.42\u2009\u00b1\u20091.53\u2009ml (0.17\u2009\u00b1\u20090.47%). Visual scoring of the water image yielded median of 2 (interquartile range\u2009=\u2009[Q3-Q1] 2\u20132) for cine and median of 3 (interquartile range\u2009=\u20093\u20132) for single-phase (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) while no significant difference was found for the fat images, both techniques yielding a median of 3 and interquartile range of 3\u20132.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cine Dixon can be used to quantify epicardial fat with lower intra- and inter-observer variability compared to standard single-phase Dixon. The time-resolved information provided by the cine acquisition appears to support the delineation of the epicardial adipose tissue depot.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12880-020-00478-z","type":"journal-article","created":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T09:38:34Z","timestamp":1594719514000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Quantification of epicardial fat using 3D cine Dixon MRI"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6142-3005","authenticated-orcid":false,"given":"Markus","family":"Henningsson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Brundin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Scheffel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Edin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Viola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl-Johan","family":"Carlh\u00e4ll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,7,14]]},"reference":[{"key":"478_CR1","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1161\/CIRCEP.110.957241","volume":"3","author":"O Batal","year":"2010","unstructured":"Batal O, Schoenhagen P, Shao M, et al. Left atrial epicardial adiposity and atrial fibrillation. Circ Arrhythm Electrophysiol. 2010;3:230\u20136.","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"478_CR2","doi-asserted-by":"crossref","unstructured":"Wong CX, Sun MT, Odutayo A, et al. Associations of Epicardial, Abdominal, and Overall Adiposity With Atrial Fibrillation. Circ Arrhythm Electrophysiol. 2016;9(12):e004378.","DOI":"10.1161\/CIRCEP.116.004378"},{"key":"478_CR3","doi-asserted-by":"crossref","unstructured":"Nakamori S, Nezafat M, Ngo LH, Manning WJ, Nezafat R. Left Atrial Epicardial Fat Volume Is Associated With Atrial Fibrillation: A Prospective Cardiovascular Magnetic Resonance 3D Dixon Study. J Am Heart Assoc 2018;7(6):e008232.","DOI":"10.1161\/JAHA.117.008232"},{"key":"478_CR4","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.atherosclerosis.2010.05.034","volume":"214","author":"SN Verhagen","year":"2011","unstructured":"Verhagen SN, Visseren FL. Perivascular adipose tissue as a cause of atherosclerosis. Atherosclerosis. 2011;214:3\u201310.","journal-title":"Atherosclerosis"},{"key":"478_CR5","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1016\/j.amjcard.2011.06.012","volume":"108","author":"K Harada","year":"2011","unstructured":"Harada K, Amano T, Uetani T, et al. Cardiac 64-multislice computed tomography reveals increased epicardial fat volume in patients with acute coronary syndrome. Am J Cardiol. 2011;108:1119\u201323.","journal-title":"Am J Cardiol"},{"key":"478_CR6","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.amjcard.2011.03.058","volume":"108","author":"T Khawaja","year":"2011","unstructured":"Khawaja T, Greer C, Chokshi A, et al. Epicardial fat volume in patients with left ventricular systolic dysfunction. Am J Cardiol. 2011;108:397\u2013401.","journal-title":"Am J Cardiol"},{"key":"478_CR7","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/j.amjcard.2018.10.020","volume":"123","author":"J Mancio","year":"2019","unstructured":"Mancio J, Azevedo D, Fragao-Marques M, et al. Meta-analysis of relation of Epicardial adipose tissue volume to left atrial dilation and to left ventricular hypertrophy and functions. Am J Cardiol. 2019;123:523\u201331.","journal-title":"Am J Cardiol"},{"key":"478_CR8","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.117.007372","volume":"11","author":"A Ng","year":"2018","unstructured":"Ng A, Strudwick M, van der Geest RJ, et al. Impact of epicardial adipose tissue, left ventricular myocardial fat content, and interstitial fibrosis on myocardial contractile function. Circ Cardiovasc Imaging. 2018;11:e007372.","journal-title":"Circ Cardiovasc Imaging"},{"key":"478_CR9","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.118.008002","volume":"12","author":"J Zhou","year":"2019","unstructured":"Zhou J, Chen Y, Zhang Y, et al. Epicardial fat volume improves the prediction of obstructive coronary artery disease above traditional risk factors and coronary calcium score. Circ Cardiovasc Imaging. 2019;12:e008002.","journal-title":"Circ Cardiovasc Imaging"},{"key":"478_CR10","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1007\/s12410-010-9012-1","volume":"3","author":"P Kellman","year":"2010","unstructured":"Kellman P, Hernando D, Arai AE. Myocardial fat imaging. Curr Cardiovasc Imaging Rep. 2010;3:83\u201391.","journal-title":"Curr Cardiovasc Imaging Rep"},{"key":"478_CR11","doi-asserted-by":"publisher","first-page":"1587","DOI":"10.1148\/rg.306105519","volume":"30","author":"F Kimura","year":"2010","unstructured":"Kimura F, Matsuo Y, Nakajima T, et al. Myocardial fat at cardiac imaging: how can we differentiate pathologic from physiologic fatty infiltration? Radiographics. 2010;30:1587\u2013602.","journal-title":"Radiographics"},{"key":"478_CR12","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1002\/mrm.24648","volume":"71","author":"P Bornert","year":"2014","unstructured":"Bornert P, Koken P, Nehrke K, Eggers H, Ostendorf P. Water\/fat-resolved whole-heart Dixon coronary MRA: an initial comparison. Magn Reson Med. 2014;71:156\u201363.","journal-title":"Magn Reson Med"},{"key":"478_CR13","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1007\/s10334-016-0550-7","volume":"29","author":"M Nezafat","year":"2016","unstructured":"Nezafat M, Henningsson M, Ripley DP, et al. Coronary MR angiography at 3T: fat suppression versus water-fat separation. MAGMA. 2016;29:733\u20138.","journal-title":"MAGMA"},{"key":"478_CR14","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1007\/s10554-015-0778-8","volume":"32","author":"R Homsi","year":"2016","unstructured":"Homsi R, Meier-Schroers M, Gieseke J, et al. 3D-Dixon MRI based volumetry of peri- and epicardial fat. Int J Cardiovasc Imaging. 2016;32:291\u20139.","journal-title":"Int J Cardiovasc Imaging"},{"key":"478_CR15","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1016\/j.ahj.2007.03.019","volume":"153","author":"HS Sacks","year":"2007","unstructured":"Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J. 2007;153:907\u201317.","journal-title":"Am Heart J"},{"key":"478_CR16","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.atherosclerosis.2016.05.033","volume":"251","author":"MT Lu","year":"2016","unstructured":"Lu MT, Park J, Ghemigian K, et al. Epicardial and paracardial adipose tissue volume and attenuation - association with high-risk coronary plaque on computed tomographic angiography in the ROMICAT II trial. Atherosclerosis. 2016;251:47\u201354.","journal-title":"Atherosclerosis"},{"key":"478_CR17","doi-asserted-by":"publisher","first-page":"984","DOI":"10.3945\/ajcn.117.157115","volume":"106","author":"G Tsaban","year":"2017","unstructured":"Tsaban G, Wolak A, Avni-Hassid H, et al. Dynamics of intrapericardial and extrapericardial fat tissues during long-term, dietary-induced, moderate weight loss. Am J Clin Nutr. 2017;106:984\u201395.","journal-title":"Am J Clin Nutr"},{"key":"478_CR18","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1177\/0284185117706201","volume":"59","author":"R Homsi","year":"2018","unstructured":"Homsi R, Sprinkart AM, Gieseke J, et al. Cardiac magnetic resonance based evaluation of aortic stiffness and epicardial fat volume in patients with hypertension, diabetes mellitus, and myocardial infarction. Acta Radiol. 2018;59:65\u201371.","journal-title":"Acta Radiol"},{"key":"478_CR19","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1016\/j.echo.2009.10.013","volume":"22","author":"G Iacobellis","year":"2009","unstructured":"Iacobellis G, Willens HJ. Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr. 2009;22:1311\u20139.","journal-title":"J Am Soc Echocardiogr"},{"key":"478_CR20","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","volume":"15","author":"TK Koo","year":"2016","unstructured":"Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficient for reliability research. J Chiropr Med. 2016;15:155\u201363.","journal-title":"J Chiropr Med"},{"key":"478_CR21","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1148\/radiol.11101659","volume":"260","author":"S Uribe","year":"2011","unstructured":"Uribe S, Hussain T, Valverde I, et al. Congenital heart disease in children: coronary MR angiography during systole and diastole with dual cardiac phase whole-heart imaging. Radiology. 2011;260:232\u201340.","journal-title":"Radiology"},{"key":"478_CR22","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1002\/mrm.10664","volume":"51","author":"AC Larson","year":"2004","unstructured":"Larson AC, White RD, Laub G, McVeigh ER, Li DB, Simonetti OP. Self-gated cardiac cine MRI. Magn Reson Med. 2004;51:93\u2013102.","journal-title":"Magn Reson Med"},{"key":"478_CR23","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.1002\/mrm.25523","volume":"74","author":"S Coppo","year":"2015","unstructured":"Coppo S, Piccini D, Bonanno G, Chaptinel J, Vincenti G, Feliciano H. Free-running 4D whole-heart self-navigated golden angle MRI: initial results. Magn Reson Med. 2015;74:1306\u201316.","journal-title":"Magn Reson Med"},{"key":"478_CR24","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1002\/mrm.25450","volume":"72","author":"JN Pang","year":"2014","unstructured":"Pang JN, Sharif B, Fan ZY, Bi XM, Arsanjani R, Berman DS, Li D. ECG and navigator-free four-dimensional whole-heart coronary MRA for simultaneous visualization of cardiac anatomy and function. Magn Reson Med. 2014;72:1208\u201317.","journal-title":"Magn Reson Med"},{"key":"478_CR25","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1002\/mrm.22306","volume":"63","author":"J Liu","year":"2010","unstructured":"Liu J, Spincemaille P, Codella NCF, Nguyen TD, Prince MR, Wang Y. Respiratory and cardiac self-gated free-breathing cardiac CINE imaging with multiecho 3D hybrid radial SSFP acquisition. Magn Reson Med. 2010;63:1230\u20137.","journal-title":"Magn Reson Med"},{"key":"478_CR26","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1016\/j.mri.2011.02.011","volume":"29","author":"P Spincemaille","year":"2011","unstructured":"Spincemaille P, Liu J, Nguyen T, Prince MR, Wang Y. Z intensity-weighted position self-respiratory gating method for free-breathing 3D cardiac CINE imaging. Magn Reson Imaging. 2011;29:861\u20138.","journal-title":"Magn Reson Imaging"},{"key":"478_CR27","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.mri.2016.12.021","volume":"38","author":"M Usman","year":"2017","unstructured":"Usman M, Ruijsink B, Nazir MS, Cruz G, Prieto C. Free breathing whole-heart 3D CINE MRI with self-gated Cartesian trajectory. Magn Reson Imaging. 2017;38:129\u201337.","journal-title":"Magn Reson Imaging"},{"key":"478_CR28","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1002\/mrm.27763","volume":"82","author":"R Zhou","year":"2019","unstructured":"Zhou R, Yang Y, Mathew RC, et al. Free breathing cine imaging with motion-corrected reconstruction at 3T using SPiral acquisition with respiratory correction and cardiac self-gating (SPARCS). Magn Reson Med. 2019;82:706\u201320.","journal-title":"Magn Reson Med"},{"key":"478_CR29","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1002\/mrm.27732","volume":"82","author":"C Munoz","year":"2019","unstructured":"Munoz C, Cruz G, Neji R, Botnar RM, Prieto C. Motion corrected water\/fat whole-heart coronary MR angiography with 100% respiratory efficiency. Magn Reson Med. 2019;82:732\u201342.","journal-title":"Magn Reson Med"},{"key":"478_CR30","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1002\/jmri.24931","volume":"42","author":"T Romu","year":"2015","unstructured":"Romu T, Elander L, Leinhard OD, et al. Characterization of brown adipose tissue by water-fat separated magnetic resonance imaging. J Magn Reson Imaging. 2015;42:1639\u201345.","journal-title":"J Magn Reson Imaging"},{"key":"478_CR31","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1007\/s40261-018-0674-9","volume":"38","author":"LJ Scott","year":"2018","unstructured":"Scott LJ. Gadobutrol. A review in contrast-enhanced MRI and MRA. Clin Drug Investig. 2018;38:773\u201384.","journal-title":"Clin Drug Investig"},{"issue":"1","key":"478_CR32","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1093\/eurheartj\/ehv625","volume":"38","author":"P Haemers","year":"2017","unstructured":"Haemers P, Hamdi H, Guedj K, et al. Atrial fibrillation is associated with the fibrotic remodelling of adipose tissue in the subepicardium of human and sheep atria. Eur Heart J. 2017;38(1):53\u201361.","journal-title":"Eur Heart J"},{"issue":"6","key":"478_CR33","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.1007\/s10554-013-0218-6","volume":"29","author":"MB Elming","year":"2013","unstructured":"Elming MB, L\u00f8nborg J, Rasmussen T, et al. Measurements of pericardial adipose tissue using contrast enhanced cardiac multidetector computed tomography--comparison with cardiac magnetic resonance imaging. Int J Cardiovasc Imaging. 2013;29(6):1401\u20137.","journal-title":"Int J Cardiovasc Imaging"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-020-00478-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-020-00478-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-020-00478-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T19:30:54Z","timestamp":1626204654000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedimaging.biomedcentral.com\/articles\/10.1186\/s12880-020-00478-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,14]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["478"],"URL":"https:\/\/doi.org\/10.1186\/s12880-020-00478-z","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-26979\/v2","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-26979\/v1","asserted-by":"object"}]},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,14]]},"assertion":[{"value":"29 April 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All patients provided written informed consent prior to participation and the study was approved by the local ethics committee (Link\u00f6ping Regional Ethics Committee, 2015\/396\u201331) and conducted according to the Declaration of Helsinki.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"No applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"80"}}