Intermuscular Adipose Tissue as a Quantitative Imaging Biomarker

Quantitative imaging of intermuscular adipose tissue (IMAT) using CT, MRI, ultrasound, and PET provides complementary risk information beyond muscle mass alone. Evidence strongest in oncology for predicting poorer survival and treatment toxicity. Standardization needed.

• IMAT is an inflammatory fat depot within muscle that impairs function and metabolism, linked to frailty and insulin resistance.
• CT, MRI, ultrasound, and PET enable noninvasive quantification, with deep learning improving reproducibility across anatomical regions.
• In oncology, elevated IMAT is associated with worse survival and treatment tolerance, aiding risk-stratification beyond BMI or muscle size.

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