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The present study aimed to determine whether the EAT volume (EV) and mean EAT attenuation (mEA) measured by non-contrast routine chest CT (RCCT) could be more consistent with those measured by coronary CT angiography (CCTA) by adjusting the threshold of fatty attenuation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In total, 83 subjects who simultaneously underwent CCTA and RCCT were enrolled. EV and mEA were quantified by CCTA using a threshold of (N30) (\u2212\u2009190 HU,\u2009\u2212\u200930 HU) as a reference and measured by RCCT using thresholds of N30, N40 (\u2212\u2009190 HU,\u2009\u2212\u200940 HU), and N45 (\u2212\u2009190 HU,\u2009\u2212\u200945 HU). The correlation and agreement of EAT metrics between the two imaging modalities and differences between patients with coronary plaques (plaque (\u2009+)) and without plaques (plaque (\u2009\u2212)) were analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>EV obtained from RCCT showed very strong correlation with the reference (r\u2009=\u20090.974, 0.976, 0.972 (N30, N40, N45), <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), whereas mEA showed a moderate correlation (r\u2009=\u20090.516, 0.500, 0.477 (N30, N40, N45), <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Threshold adjustment was able to reduce the bias of EV, while increase the bias of mEA. Data obtained by CCTA and RCCT both demonstrated a significantly larger EV in the plaque (\u2009+) group than in the plaque (\u2009\u2212) group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). A significant difference in mEA was shown only by RCCT using a threshold of N30 (plaque (\u2009+) vs (\u2009\u2212):\u2009\u2212\u200980.0\u2009\u00b1\u20094.4 HU vs\u2009\u2212\u200978.0\u2009\u00b1\u20094.0 HU, <jats:italic>P<\/jats:italic>\u2009=\u20090.030). The mEA measured on RCCT using threshold of N40 and N45 showed no significant statistical difference between the two groups (<jats:italic>P<\/jats:italic>\u2009=\u20090.092 and 0.075), which was consistent with the result obtained on CCTA (<jats:italic>P<\/jats:italic>\u2009=\u20090.204).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Applying more negative threshold, the consistency of EV measurements between the two techniques improves and a consistent result can be obtained when comparing EF measurements between groups, although the bias of mEA increases. Threshold adjustment is necessary when measuring EF with non-contrast RCCT.\n<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12880-022-00840-3","type":"journal-article","created":{"date-parts":[[2022,6,25]],"date-time":"2022-06-25T08:03:09Z","timestamp":1656144189000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Measurement of epicardial adipose tissue using non-contrast routine chest-CT: a consideration of threshold adjustment for fatty attenuation"],"prefix":"10.1186","volume":"22","author":[{"given":"Lekang","family":"Yin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shijie","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenwei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengsu","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,6,25]]},"reference":[{"issue":"6","key":"840_CR1","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. 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The requirements for consent to participate and written informed consent were waived by the Institutional Review Board. We confirm that all methods were performed in accordance with the relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no conflicts of interest to report.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"114"}}