Summary: Automated CT-based AI tools reveal distinct body composition changes in semaglutide-treated patients, with weight loss linked to favorable cardiometabolic shifts and weight gain associated with reduced muscle quality.
Key Takeaways
- Automated CT-based AI tools revealed distinct body composition changes in semaglutide-treated patients, going beyond standard clinical measures.
- Weight loss in patients was associated with favorable shifts in cardiometabolic risk markers, such as reductions in visceral fat and improved liver attenuation.
- Weight gain was linked to increases in fat and muscle areas but a decrease in muscle quality, as indicated by reduced muscle attenuation.
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Automated CT-based AI tools provide biomarkers of body composition changes in patients treated with semaglutides Ozempic, Wegovy, and Rybelsus—beyond what is evident by standard clinical measures, according to an accepted manuscript published in the American Journal of Roentgenology (AJR).
Semaglutide Patients Show Body Changes
“Patients using semaglutides, or glucagon-like peptide-1 (GLP-1) agonists, who lost versus gained weight demonstrated distinct patterns of changes in CT-based body composition measures,” writes corresponding author and former ARRS Scholar Perry Pickhardt, MD, from the radiology department at the University of Wisconsin School of Medicine & Public Health in Madison.
“Those with weight loss exhibited overall favorable shifts in measures related to cardiometabolic risk,” Pickhardt adds, also noting that decreased muscle attenuation in patients who gained weight was consistent with a decrease in muscle quality.
AI Detects Changes in Semaglutide Users
Pickhardt and his colleagues’ AJR study, one of the first of its kind in radiology, involved 241 patients (mean age 60.4 years; 151 women, 90 men) treated with semaglutide. Patients underwent abdominopelvic CT scans within 5 years before and after starting treatment (January 2016–November 2023). Researchers used validated AI tools to analyze pre- and post-treatment scans, measuring visceral (VAT) and subcutaneous (SAT) fat, skeletal muscle area, intermuscular fat (IMAT), liver volume, and bone mineral density.
In patients with ≥ 5-kg weight loss, there were reductions in VAT, SAT, muscle area, and liver volume, with an increase in liver attenuation. Patients with ≥ 5-kg weight gain showed increases in VAT, SAT, muscle area, IMAT, and a decrease in muscle attenuation (all p < .05).
Featured image: Patient underwent abdominopelvic CT for indication of abdominal pain 36 days before semaglutide initiation and for indication of epigastric pain 140 days after semaglutide initiation. Patient had stopped semaglutide use 36 days prior to post-semaglutide scan. Patients weight was 148.0 kg on pre-semaglutide scan and 176.0 kg on post-semaglutide scan. Patient was thus assigned to weight-gain group. (A) Coronal maximum-intensity projection (MIP) image from pre-semaglutide scan shows organ segmentations. (B) Axial image from pre-semaglutide scan at L3 level shows color-coded tissue segmentations. (C) Coronal MIP image from post-semaglutide scan shows organ segmentations. (D) Axial image from post-semaglutide scan at L3 level shows color-coded tissue segmentations. Segmented visceral adipose tissue (VAT) is colored yellow, subcutaneous adipose tissue (SAT) is colored blue, skeletal muscle is colored red, liver is colored red, and spleen (not evaluated in present investigation) is colored orange. On pre- and post-semaglutide scans, VAT area was 358.5 cm2 and 412.1 cm2, muscle area was 186.8 cm2 and 225.2 cm2, muscle attenuation was -5.2 HU and -11.0 HU, liver volume was 2579 and 3851 mL, and liver attenuation was 77.8 HU and 59.2 HU, respectively.
