Table 1.

Advantages and disadvantages of imaging modalities in assessing myosteatosis.

	Advantages	Disadvantages
Computed tomography (CT)	Differentiates SAT and IMAT Axial and appendicular anatomic sites can be scanned Excellent reproducibility and reliability of muscle and adipose tissue attenuation Allows 3D reconstruction	Cannot directly measure the location of fat storage or lipid droplets within muscle High cost Limited access Ionizing radiation Not portable
Peripheral quantitative computed tomography (pQCT)	Differentiates SAT from intramuscular adipose and IMAT Quantifies muscle density Lower cost Limited ionizing radiation Portable device	Axial and proximal appendicular anatomic sites cannot be scanned Individual muscle groups cannot be segmented Cannot distinguish between intramuscular fat and IMAT
Magnetic resonance imaging (MRI)	Muscle compartments can be segmented Differentiates SAT, intramuscular adipose, and IMAT High quality visualization of IMAT distribution Spectroscopy permits IMCL quantification	Cannot measure muscle density High cost Limited access Not portable Cannot be used in individuals with metal implants Lack of standardized protocols for scan acquisition and adipose tissue quantification
Quantitative ultrasound (QUS)	Reliable measures of muscle thickness and echogenicity Axial and appendicular anatomic sites can be scanned Lower cost No ionizing radiation Portable device	Inter-machine validity unknown Consistency relies on probe placement, pressure, and angle of incidence Cannot distinguish between intramuscular fat and IMAT