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REVIEW article

Front. Imaging

Sec. Imaging Applications

This article is part of the Research TopicTransforming medical imaging with advanced deep learning techniquesView all articles

Cardiac Adipose Tissue, Imaging Segmentation, and Quantification for Cardiovascular Disease Assessment

Provisionally accepted
Julian  Rene Cuellar BuriticaJulian Rene Cuellar Buritica1*Mukul  BhattaraiMukul Bhattarai2Manjula  BurriManjula Burri3Pedro  CarrilloPedro Carrillo1Jon  David KlingensmithJon David Klingensmith1
  • 1Southern Illinois University Edwardsville, Edwardsville, United States
  • 2Southern Illinois University School of Medicine, Springfield, United States
  • 3Columbus Regional Hospital, Columbus, United States

The final, formatted version of the article will be published soon.

Cardiac adipose tissue (CAT) has emerged as a critical and clinically relevant factor in cardiovascular disease (CVD), yet its full impact remains largely overlooked. The amount of fat surrounding the heart can influence major blood vessels by promoting plaque formation. In conditions such as cardiac steatosis or fatty heart disease, fat infiltration or accumulation within the heart muscle compromises its function may play a role in heart failure (HF) and coronary artery disease (CAD). This review explores the different types of fat deposits surrounding the heart, focusing on the potential contribution of CAT to cardiovascular disease (CVD). Three main imaging modalities for assessing cardiac fat are discussed, including magnetic resonance imaging (MRI), computed tomography (CT), and echocardiography. The segmentation and quantification of the fat for each imaging modality are also presented, correlating these measurements with CVD risk. Each imaging modality offers distinct advantages and limitations in segmenting and quantifying fat. Despite its clinical significance, quantification and characterization of CAT remain challenging, requiring advanced imaging techniques for precise assessment. Future research should focus on unlocking the mechanistic pathways that link CAT to adverse cardiovascular outcomes, ultimately enhancing our ability to predict, prevent, and treat heart disease with greater precision. As imaging technology advances, there is a need for refined segmentation methods and consensus-driven guidelines to establish CAT as a key biomarker in CVD risk stratification.

Keywords: Cardiac adipose tissue, cardiovascular disease, ultrasound, MRI, CT, segmentation, quantification, deep learning

Received: 28 Aug 2025; Accepted: 04 Dec 2025.

Copyright: © 2025 Cuellar Buritica, Bhattarai, Burri, Carrillo and Klingensmith. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Julian Rene Cuellar Buritica

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