Methodologies for establishing and validating cut-points and comparative standards in medical imaging-based body composition analysis: a scoping review protocol.

Abstract

Background: Medical imaging-based body composition analysis (BCA) has shown promise in offering detailed, noninvasive assessments of fat, muscle, and bone, but challenges persist in establishing consistent comparative standards. Current studies reveal significant variability in methodologies, which limits comparability and clinical application. This highlights the need for a comprehensive review to explore these methodologies and address the gap in standardisation. The aim of the study is to identify and map the methodologies used in body composition imaging to establish and validate comparative standards (such as cut-points, thresholds, or normative values) and to catalogue the proposed comparative standards.

Methods: This scoping review will be conducted following JBI methodology. The following eligibility criteria will be applied: Population: healthy subjects with no major comorbidities or individuals with cancer assessed using body composition imaging (BCI) and concept: methodologies for establishing BCI comparative standards and/or formally validating them against any outcome or other BCA reference standard. This scoping review will consider studies across all clinical settings. There will be no restrictions on the setting or purpose of the original study. Validation studies using BCI as the reference standard will not be included unless the comparative standard being validated is another BCI feature. The electronic databases to be searched are Ovid MEDLINE, Ovid Embase, Scopus, EBSCOhost CINAHL, Web of Science, Cochrane Library, and IEEE Xplore. Grey literature sources will not be included. Studies published in English will be considered, with no date restrictions applied. Two independent reviewers will screen all titles and abstracts, followed by full-text articles, and will undertake data extraction. Data extracted will be presented in tabular and/or diagrammatic form for comprehensive narrative synthesis.

Discussion: The scoping review will summarise existing evidence on BCI. It will identify potential methodological gaps, describe current proposed thresholds or normative values, and highlight areas for further research to establish validated cut-points.

Systematic review registration: OSF https://doi.org/10.17605/OSF.IO/QZMN2.