Original Article Quantification of visceral adipose tissue in polycystic ovary syndrome: dual-energy X-ray absorptiometry versus magnetic resonance imaging Signe Frøssing 1 , Malin Chatarina Nylander 2 , Elizaveta Chabanova 3 , Caroline Kistorp 1 , Sven O Skouby 2 and Jens Faber 1 Abstract Background: Polycystic ovary syndrome (PCOS) is associated with frequent overweight and abdominal obesity. Quantifying visceral adipose tissue (VAT) in PCOS patients can be a tool to assess metabolic risk and monitor effects of treatment. The latest dual-energy X-ray absorptiometry (DXA) technology can measure VAT and subcutaneous adipose tissue (SAT) in a clinical setting. Purpose: To compare DXA-measurements of VATand SATwith the gold standard MRI in women with PCOS. Material and Methods: A cross-sectional study of 67 overweight women with PCOS was performed. Measurements of VATand SATwere performed by DXA in a 5-cm thick transverse slice at the L4/L5 level and by MRI in a 1-cm thick transverse slice at the L3 level. Results: Mean (SD) DXA-VATwas 81 (34) cm 3 , DXA-SATwas 498 (118) cm 3 , MRI-VATwas 117 (48) cm 3 , and MRI-SAT was 408 (122) cm 3 . MRI and DXA measures of VAT (r ¼ 0.82, P < 0.001) and SAT (r ¼ 0.92, P < 0.001) correlated closely, and DXA-VATwas stronger correlated with MRI-VAT than BMI (r ¼ 0.62, P < 0.001) and waist circumference (r ¼ 0.60, P < 0.001). DXA-VAT coefficient of variance was 6.7% and inter correlation coefficient was 0.98. Bland–Altman analyses showed DXA to slightly underestimate VATand SAT measurements compared with MRI. Conclusion: DXA and MRI measurements of VATand SAT correlated closely despite different size of region of interest, and DXA-VATwas superior to waist circumference and BMI in estimating MRI-VAT. DXA showed high reproducibility making it is suitable for repeated measurements in the same individual over time. Keywords Visceral adipose tissue, PCOS, DXA, MRI Date received: 31 January 2017; accepted: 20 April 2017 Introduction Waist circumference is part of the definition of the metabolic syndrome as it is a surrogate measurement for the amount of visceral adipose tissue (VAT). Studies in an unselected population have shown directly measured VAT to have an even stronger association with risk of type 2 diabetes (T2D), cardiovascular dis- ease, and cancer than waist circumference and body mass index (BMI) (1). At present, VAT is measured by magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound (US). These methods are expensive, time- consuming, or must be performed by specialists, 1 Center of Endocrinology and Metabolism, Dept. of Internal medicine, Herlev Gentofte Hospital, Denmark 2 Dept. of Obstetrics and Gynecology, Herlev Gentofte Hospital, Denmark 3 University of Copenhagen, Faculty of Health and Medical sciences, Denmark Corresponding author: Signe Frøssing, Center of Endocrinology and Metabolism, Dept. of Internal Medicine, Herlev Gentofte Hospital, Herlev Ringvej 75, DK-2730 Denmark. Email: signe.froessing@regionh.dk Acta Radiologica 2018, Vol. 59(1) 13–17 ! The Foundation Acta Radiologica 2017 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0284185117711475 journals.sagepub.com/home/acr