Quick Links

Contact Us

Publications:

Artificial Intelligence-derived Measurements of Myosteatosis from Coronary Artery Calcium CT Scans to Predict COPD: The Multi-Et

Authors: Amir Azimi|||Kyle Atlas|||Anthony P Reeves|||Chenyu Zhang|||Jakob Wasserthal|||Seyed Reza Mirjalili|||Thomas Atlas|||Claudia I Henschke|||David F Yankelevitz|||Javier J Zulueta|||Juan P de-Torres|||Luis M Seijo|||Jeffrey I Mechanick|||Andrea Branch|||Ning Ma|||Rowena Yip|||Wenjun Fan|||Sion K Roy|||Khurram Nasir|||Sabee Molloi|||Zahi A Fayad|||Michael V McConnell|||Ioannis A Kakadiaris|||George S Abela|||Rozemarijn Vliegenthart|||David J Maron|||Jagat Narula|||Kim A Williams|||Prediman K Shah|||Matthew J Budoff|||Daniel Levy|||Emelia J Benjamin|||Roxana Mehran|||Robert A Kloner|||Nathan D Wong|||Morteza Naghavi

Journal: Radiology. Cardiothoracic imaging

Publication Type: Journal Article

Date: 2026

DOI: 10.1148/ryct.250205

ID: 41609478

Affiliations:

Affiliations

    HeartLung.AI, 2450 Holcombe Blvd, Houston, TX 77021.|||HeartLung.AI, 2450 Holcombe Blvd, Houston, TX 77021.|||Department of Electrical and Computer Engineering, Cornell University, Ithaca, NY.|||HeartLung.AI, 2450 Holcombe Blvd, Houston, TX 77021.|||Clinic of Radiology and Nuclear Medicine, University of Basel, Basel, Switzerland.|||HeartLung.AI, 2450 Holcombe Blvd, Houston, TX 77021.|||Tustin Teleradiology, Tustin, Calif.|||Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.|||Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.|||Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.|||Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain.|||Clínica Universitaria de Navarra, Pamplona, Spain.|||Kravis Center for Clinical Cardiovascular Health, Mount Sinai Fuster Heart Hospital, New York, NY.|||Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.|||Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.|||Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.|||Department of Radiology, University of California Irvine, Irvine, Calif.|||The Lundquist Institute, Torrance, Calif.|||Health Equity and Disparities Research, Division of Cardiovascular Prevention and Wellness, and Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist Hospital, Houston, Tex.|||Department of Radiology, University of California Irvine, Irvine, Calif.|||Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.|||Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, Calif.|||University of Houston, Houston, Tex.|||Division of Cardiology, Michigan State University, East Lansing, Mich.|||Department of Radiology, University Medical Center Groningen, Groningen, the Netherlands.|||Health Equity and Disparities Research, Division of Cardiovascular Prevention and Wellness, and Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist Hospital, Houston, Tex.|||University of Houston, Houston, Tex.|||University of Louisville, Louisville, Ky.|||Cedars-Sinai Medical Center, Los Angeles, Calif.|||The Lundquist Institute, Torrance, Calif.|||Department of Radiology, University Medical Center Groningen, Groningen, the Netherlands.|||School of Public Health, Boston University, Boston, Mass.|||Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.|||Department of Cardiovascular Medicine, Huntington Medical Research Institutes, Pasadena, Calif.|||Heart Disease Prevention Program, Mary and Steve Wen Cardiovascular Division, University of California Irvine, Irvine, Calif.|||HeartLung.AI, 2450 Holcombe Blvd, Houston, TX 77021.

Abstract

Purpose To evaluate the predictive value of myosteatosis as an opportunistic finding in coronary artery calcium (CAC) CT scans for clinically diagnosed chronic obstructive pulmonary disease (COPD) and compare it with an artificial intelligence (AI)-measured biomarker of emphysema derived from the same scans. Materials and Methods In this prospective study, baseline CAC CT scans and 20-year follow-up data were analyzed. Myosteatosis was defined as the lowest quartile of thoracic skeletal muscle mean attenuation (males < 33.5 HU, females < 27.0 HU). The emphysema-like lung biomarker was quantified as the percentage of lung voxels below -950 HU in CAC CT scans. COPD was identified using the , and diagnostic codes from hospital discharge records. Hazard ratios (HRs) for COPD were calculated using proportional hazard regression models, comparing the bottom versus top quartiles of myosteatosis and emphysema-like lung measurements. Results Among 5535 participants in the Multi-Ethnic Study of Atherosclerosis (mean age ± SD, 62.2 years ± 10.3, 47.6% males), 396 (7.1%) were diagnosed with COPD over the 20-year follow-up period. Myosteatosis showed a stronger association with COPD than emphysema (unadjusted HRs, 5.98 [95% CI: 4.14, 8.63] and 2.12 [95% CI: 1.61, 2.78], respectively [ < .001]). After adjusting for covariates (age, sex, smoking status, body mass index, race, asthma, physical activity, inflammatory markers, and insulin resistance), the HRs were reduced to 2.74 (95% CI: 1.81, 4.16) and 1.50 (95% CI: 1.12, 2.00), respectively ( = .02). Conclusion AI-measured myosteatosis in CAC CT scans strongly predicted future diagnosed COPD independently of known risk factors. Applications-CT, Pulmonary, Thorax, Adipose Tissue (Obesity Studies), Chronic Obstructive Pulmonary Disease, Metabolic Disorders, Myosteatosis, Coronary Artery Calcium Scan, Emphysema, AI-CVD ClinicalTrials.gov: NCT00005487 © The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license.