Automated Cardiac Adipose Tissue Segmentation in Computed Tomography: A Literature Review

This review provides an overview of recent advancements in automated segmentation methods on Computed Tomography (CT) for two types of cardiac fat: Epicardial adipose Tissue (EAT) and Pericardial Adipose Tissue (PAT). These fat deposits, separated by the pericardium, have been linked to various cardiovascular diseases, with EAT receiving the most research attention. Their complex anatomical context makes manual quantification highly time-consuming and prone to considerable inter-observer variability. Automated methods effectively address these complications, offering a more efficient and consistent solution. This study encompasses a broad range of methods, spanning AI as well as non-AI approaches. Additionally, it presents the remaining challenges, including the need for larger annotated public datasets and optimized attenuation thresholds for contrast-enhanced CT. It is demonstrated that automated methods are able to achieve segmentation results comparable to the quality of human annotation, proving their potential as a clinical tool for discovering new biomarkers and enhancing patient outcomes.