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We investigated the influence of body composition and pulmonary fat attenuation volume (CTpfav) on overall survival (OS) in NSIP patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this retrospective single-center study, 71 NSIP patients with a median age of 65 years (interquartile range 21.5), 39 females (55%), who had a computed tomography from August 2009 to February 2018, were included, of whom 38 (54%) died during follow-up. Body composition analysis was performed using an open-source nnU-Net-based framework. Features were combined into: Sarcopenia (muscle\/bone); Fat (total adipose tissue\/bone); Myosteatosis (inter-\/intra-muscular adipose tissue\/total adipose tissue); Mediastinal (mediastinal adipose tissue\/bone); and Pulmonary fat index (CTpfav\/lung volume). Kaplan\u2013Meier analysis with a log-rank test and multivariate Cox regression were used for survival analyses.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Patients with a higher (&gt;\u2009median) Sarcopenia and lower (&lt;\u2009median) Mediastinal Fat index had a significantly better survival probability (2-year survival rate: 83% <jats:italic>versus<\/jats:italic> 71% for high <jats:italic>versus<\/jats:italic> low Sarcopenia index, <jats:italic>p<\/jats:italic>\u2009=\u20090.023; 83% <jats:italic>versus<\/jats:italic> 72% for low <jats:italic>versus<\/jats:italic> high Mediastinal fat index, <jats:italic>p<\/jats:italic>\u2009=\u20090.006). In univariate analysis, individuals with a higher Pulmonary fat index exhibited significantly worse survival probability (2-year survival rate: 61% <jats:italic>versus<\/jats:italic> 94% for high <jats:italic>versus<\/jats:italic> low, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). Additionally, it was an independent risk predictor for death (hazard ratio 2.37, 95% confidence interval 1.03\u20135.48, <jats:italic>p<\/jats:italic>\u2009=\u20090.043).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Fully automated body composition analysis offers interesting perspectives in patients with NSIP. Pulmonary fat index was an independent predictor of OS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Relevance statement<\/jats:title>\n                <jats:p>The Pulmonary fat index is an independent predictor of OS in patients with NSIP and demonstrates the potential of fully automated, deep-learning-driven body composition analysis as a biomarker for prognosis estimation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p><jats:list list-type=\"bullet\">\n                  <jats:list-item>\n                    <jats:p>This is the first study assessing the potential of CT-based body composition analysis in patients with non-specific interstitial pneumonia (NSIP).<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>A single-center analysis of 71 patients with board-certified diagnosis of NSIP is presented<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>Indices related to muscle, mediastinal fat, and pulmonary fat attenuation volume were significantly associated with survival at univariate analysis.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>CT pulmonary fat attenuation volume, normalized by lung volume, resulted as an independent predictor for death.<\/jats:p>\n                  <\/jats:list-item>\n                <\/jats:list><\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1186\/s41747-024-00519-0","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T10:02:44Z","timestamp":1728900164000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["CT-based body composition analysis and pulmonary fat attenuation volume as biomarkers to predict overall survival in patients with non-specific interstitial pneumonia"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5376-3154","authenticated-orcid":false,"given":"Luca","family":"Salh\u00f6fer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Bonella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Meetschen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lale","family":"Umutlu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Forsting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt M.","family":"Schaarschmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Opitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolas","family":"Beck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Zensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Hosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Parmar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Nensa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Haubold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,14]]},"reference":[{"key":"519_CR1","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1164\/rccm.201308-1483ST","volume":"188","author":"WD Travis","year":"2013","unstructured":"Travis WD, Costabel U, Hansell DM et al (2013) An official American Thoracic Society\/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. 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