A standardized, comprehensive magnetic resonance imaging protocol for rapid and precise quantification of HIV-1-associated lipodystrophy.

ABSTRACT

OBJECTIVES: Although multiple methods have been proposed, there is no current gold standard for assessing HIV-1-associated lipodystrophy. METHODS: HIV-1-infected participants were randomly enrolled and surveyed about changes in the abdomen, thigh, cheek and neck areas. Magnetic resonance imaging (MRI) sequences of these sites were obtained. Participants were grouped according to survey results, and the MRI measurements were compared between groups. RESULTS: One hundred participants were included in the study, of whom 79% reported any body fat changes. Persons reporting increased abdominal girth had higher visceral ([mean+/-standard deviation] 142+/-75 vs. 59+/-48 cm2; P<0.0001) and total abdominal adipose tissue than those reporting no change (344+/-119 vs. 201+/-95 cm2; P<0.0001). The amount of localized fat was less for persons reporting sunken cheeks and reduced diameter of the legs compared with those who noted no changes (5.9+/-3.6 vs. 9.3+/-3.8 cm2; P<0.0001, and 35+/-28 vs. 112+/-56 cm2; P<0.0001). Participants reporting increased neck girth had a thicker fat layer in the dorsocervical region compared with those reporting no change (4.0+/-1.8 vs. 2.3+/-1.4 cm; P<0.0002). CONCLUSIONS: MRI is a precise method for rapidly surveying body regions affected by HIV-1-associated lipodystrophy. Our proposed protocol provides a rapid, comprehensive survey of these areas, without the need to combine multiple modalities or to expose subjects to radiation.