Table S1: University of Michigan Morphomic Analysis Group: summary of literature review
Morphomics Study (year)
Englesbe et al. (2010)1
N
163
Morphomic measurements
Psoas muscle area
Holcombe et al. (2011)2
1150
Acetabular geometry on
acetabular fracture
Huhdanpaa et al. (2011)3
54
Cirrhosis
Lee et al. (2011)4
655
Subcutaneous fat thickness
Lee et al. (2011)5
262
Psoas muscle area
Miller et al. (2011)6
45
Psoas muscle density
Sabel et al. (2011)7
101
Psoas muscle area and
density
Outcome measured
Survival after surgery
Findings
Psoas muscle is a surrogate for
frailty in patients. Larger psoas
area correlates with better postsurgical outcomes in liver
transplant patients.
Acetabular model
Acetabular rim size and shape as
geometry in the context predicted by age, gender, height,
of fracture prediction
and weight for use in motor
vehicle occupant modeling
Quantitative measure
Morphological features, such as
of cirrhosis based on
contour and dimensions of the
computed tomorgraphy liver were predictive of cirrhosis.
scans in a threedimensional spatially
oriented database
Surgical site infection
Subcutaneous fat is an
rate
independent predictor of surgical
site infections after midline
laparotomy.
Mortality after
Core muscle size is a measure of
abdominal aortic
frailty, and correlated with
aneurysm repair
mortality after abdominal aortic
aneurysm repair.
24-hour urine cortisol
Psoas muscle density and intralevels in
abdominal fat were significantly
hypercortisolism
related to 24-hour urine cortisol
levels.
Disease free survival
Larger psoas muscle area
and distant disease free correlates with better prognosis in
survival
melanoma patients.
Englesbe et al. (2012)8
1453
Lean core muscle size
Englesbe (2012)9
n/a
Miller et al. (2012)10
125
Trunk muscle size, fat
distribution, muscle density,
bone mineral density,
vascular calcification
Psoas muscle density, lean
psoas muscle area, intraabdominal fat area, and
subcutaneous fat area
Wang et al (2012)11
8500
Wang et al (2012)12
383
Englesbe et al (2013)13
1370
Survival, surgical
complications and
costs
Sarcopenia
Analytic morphomics can be used
to evaluate perioperative risk.
Survival
Lower psoas muscle density,
lower lean psoas muscle area,
increased intra-abdominal fat, and
subcutaneous fat are all associated
with increased mortality.
There is very little variability in
the referenced large population of
the 50th percentile male – useful to
identify occupant-specific factors
that contribute to motor vehicle
crash injury
Anthropometry and tissue
quality of L4 bone mineral
density, total psoas area,
psoas muscle density, lean
psoas muscle size, intercostal
muscle thickness, intercostal
muscle density, vertebral
body to fascia distance,
fascia to skin distance,
spinous process to back skin
distance, femoral head
radius, pelvis height, anterior
superior iliac spine distance
(right to left) and femoral
head centers
Cervical vertebral levels
were identified by changes in
density along the spinal
canal
Detailed quantification
of cervical spine facet
joint morphology
Morphomic age was
Postoperative mortality
Detailed
characterization of
each cervical facet
angles
Introduction to morphomics and
its uses in surgical decision
making.
There were significant changes in
facet angle with aging for C2
through C7 vertebrae. These data
could contribute to motor vehicle
crash injury tolerance.
Morphometrically older age
assigned to general and
vascular abdominal surgery
patients
Abdominal aortic
calcification
Harbaugh et al (2013)14
1180
Holcombe et al (2013)15
327
Ribcage geometry of boys
and girls
Lisiecki et al (2013)16
19
Quantify differences in
temporalis muscle and
temporal fat pad in Pierre
Robin sequence and
Treacher Collins syndrome
Lisiecki et al (2013)17
16
Temporalis volume, area and
thickness, and zygomatic
thickness in patients with
mandible fracture
Parenteau et al (2013)18
24000
Morphometric age: vertebral
angle, depth measurements,
vertebra-to-front ski, spineto-back skin
patients experienced increased
mortality and length of stay.
Postoperative mortality
Parameters predicted
by age and gender to
describe variation in
size and shape of rib
centroidal geometry
Temporalis muscle and
temporal fat pad
measurements
Aortic calcification as measured
by analytic morphomic techniques
was significantly associated with
morbidity in patients with no
clinical cardiovascular risk
factors.
A demographics-based model was
presented describing average
ribcage geometry for children
(based on age, weight, and height)
Morphomics analysis techniques
were able to quantify significantly
less temporalis muscle and
temporal fat pad volumes in
children with Pierre Robin and
Treacher Collins compared with
age-matched controls
Temporalis wasting as Decreased thickness of zygomatic
measure of frailty
bone and temporalis muscle were
correlated with higher hospital,
ventilator, and intensive care unit
hospital days with patients with
mandibular fracture receiving
reconstructive surgery
Effect of torso depth
The changes in the vertebral
and vertebral angel was angles as a function of age and
assessed as a function
gender were greatest in the midof age, gender, and
thoracic area, which may affect
vertebral level
different seating postures or belt
Parenteau et al (2013)
19
260
Liver area and volume,
length, width, and girth
Liver injury patterns
Parenteau et al (2013)20
10952
Quantify abdomen and
torso shape and Hpoint location as a
function of body mass
index and gender
Parenteau et al (2013)21
423
H-point Longitudinal
distance between the
centroid of femoral head and
posterior skin measurement,
vertebra-to-front skin
distance, and spine-to-backskin distance along the
sagittal plane
H-point, vertebra-to-front
skin, and spine-to-back skin
Subcutaneous fat area,
visceral fat area, and
trabecular bone density
Fat and bone
distribution as a
function of age,
gender, and vertebral
level
Blood transfusion
requirement and
hospital stay
Parenteau et al (2013)22
Rinkinen et al (2013)23
117
Temporal muscle and
temporal fat pad morphomic
values
Injury risk between
males and females
positioning
When normalized by patient
weight, liver volume decreased
with age; however, no clear
distinction on injury pattern of the
livery by age group.
Morphomic data, such as H-point,
vertebra-to-front skin, and spine
to back skin distances are tangible
measurements that characterize
occupant shape.
Morphomic data provide data
regarding differences in spinal
properties between genders that
may explain higher vulnerability
in females compared with males.
Females had higher subcutaneous
fat and higher trabecular bone
density than males at L1, and
males had more visceral fat than
females.
Increased temporal fat pad volume
and local temporalis muscle
volume in craniosynostosis
patients was associated with
decreased blood transfusion
requirements and decreased
hospital stay even after
controlling for age, sex, weight,
and preoperative hematocrit.
Sabel et al. (2013)24
302
Psoas area and density,
subcutaneous fat distance,
visceral fat area
Sheetz et al. (2013)25
230
Core muscle size
Sheetz et al. (2013)26
1593
Lean psoas area
Zhang et al. (2013)27
226
Canvasser et al. (2014)28
1309
Body area, lower chest
Crash injury risk
eccentricity, visceral fat area,
body depth, spine angulation,
muscle density, trabecular
bone density, cortical bone
density, cortical bone
variation
Psoas muscle area, dorsal
Overall mortality
muscle group area
Holcombe and Wang
(2014)29
Huhdanpaa et al. (2014)30
17000
Lee et al. (2014)31
Levi et al (2014)32
Disease-free survival,
overall survival,
infectious
complications,
Overall survival and
disease free survival
Payer cost
Subcutaneous fat area and
density
Three dimensional
segmentation of the liver
N/A
325
Dorsal muscle group
Mortality and
postoperative
complications
58
Visceral adipose tissue area,
Breast reconstruction
167
Development of a
computer aided
diagnosis tool to
predict models of
cirrhosis
Psoas density is a good predictor
of overall survival and diseasefree survival. Subcutaneous fat is
a predictor of wound infections.
Lean psoas muscle area is
associated with improved survival
after esophagectomy.
Lean psoas muscle was associated
with increasing payer costs.
Morphomic variables are accurate
in predicting injury risk
Larger dorsal muscle group
correlates with better survival
after surgery.
Method for segmenting
subcutaneous fat.
Analytic morphomics provided
objective information during
interpretation of CT scans to make
diagnosis of cirrhosis – toward
developing a computer aided
diagnosis tool to improve
sensitivity of cirrhosis diagnosis
Larger dorsal muscle group size
was associated with improved
post-liver transplantation
outcomes.
Higher visceral fat area was
subcutaneous adipose tissue
area, and fascia area
post-operative
complications
Levi et al (2014)33
93
Subcutaneous fat area, total
body area, and total body
circumference
Ventral hernia postoperative
complications
Maratt et al. (2014)34
1961
Femoral radius of curvature
Miller et al (2014)35
184
Total psoas area
Determine relationship
between radius of
curvature and femoral
length, age, gender,
ethnicity, body mass
index, and cortical
thickness
Geriatric function
mobility, basic and
instrumental activities
of daily living, and
cognitive ability
Kozlow et al. (2014)36
34
Parenteau et al (2014)37
NA
Visceral fat area,
subcutaneous fat area, total
body area, fascia area, total
body circumference, and
fascia circumference.
Logistic regression models
were fitted using 18
covariate variables, including
vehicle (N=4), demographic
(N=4), and morphomic
Sternal reconstruction
post-operative
complications
Abdominal injury
outcome
associated with increased
likelihood of post-operative donor
site dehiscence after deep inferior
epigastric perforator flap breast
reconstruction
Morphomic variables measured
were better indicators of surgical
site infection after repair of
ventral hernias than body mass
index.
Differences in radius of curvature
based on ethnicity and gender
exist due to variation in average
height (useful in design of safer
intramedullary implants)
Older surgical candidates with
greater total psoas area were less
likely to have physical
impairment, cognitive difficulty,
or decreased ability to perform
daily self-care.
Increases in abdominal
morphomics correlated with
incidence of complications in
patients undergoing sternal
reconstruction
Morphomic variables were better
able to predict abdominal injury
outcomes than demographic
variables. Visceral fat area,
trabecular bone density, and spine
(N=10)
Parenteau et al (2014)38
750
Ranganathan et al (2014)39
64
Rinkinen et al (2014)40
117
Waits et al (2014)41
348
Zarinsefat et al. (2014)42
426
Caram et al. (2015)43
121
Kirk et. Al (2015)44
1279
angulation were the most
important morphomics variables.
Cervical characteristics were Assessing differences
This analysis provided descriptive
quantified in pediatric and
in injury patterns
anatomical changes associated
adult patients
between different
with age and gender for the
segments
development of models used to
assess injury mechanisms for
various occupant age groups.
Psoas muscle area and
Quantify dimensions of Temporal muscle thickness
temporal muscle thickness
temporalis muscle as
correlated with psoas muscle area
proxy for age
Temporal muscle and
Temporal morphomic
Patients with craniosynostosis
temporal fat pad morphomics values
have decreased temporalis muscle
(tissue thickness, area, and
and fat pad volume and thickness
volume)
compared with controls.
Psoas age, psoas density, and Mortality
Morphometric age correlated with
abdominal aortic
mortality after liver transplant and
calcification. Morphometric
was a better discriminator than
age was assigned based on
chronological age.
these covariates
Trunk muscle size
Survival
Trunk muscle size measured on
CT scans is a predictor of
outcome after general surgery.
Total psoas area, lean psoas
Sarcopenia, nonSarcopenia is associated with
area, psoas indices
relapse mortality, days higher non-relapse mortality,
(area/height2)
in hospital,
complication rate and more days
complication rate
in hospital after autologous
hematopoietic cell transplantation.
Psoas area
Sarcopenia and health
Sarcopenia was associated with
care costs
increased hospital costs
immediately post-surgical (30, 90,
and 180 days), but not at one year.
Sarcopenic patients were more
Krishnamurthy et al.
(2015)45
357
Lee et al (2015)46
526
Lisiecki et al (2015)47
21
Anterior vertebra-to-skin
distance, total body area,
total body circumference,
and fascia-to-skin distance
Stidham et al. (2015)48
269
Total ant-port distance at
T10, body eccentricity at
T10, visceral fat volume T10
– L5, subcutaneous fat
volume T10 – L5,
subcutaneous to visceral fat
ratio.
Acetabular rim profile,
center of the femoral head,
and normalized frontal plan
of the pelvis
Trabecular bone densities,
Tannenbaum et al. (2015)49 878
Zhang et al (2015)50
8833
Dorsal muscle group area,
liver area, spleen area,
subcutaneous fat area, fascia
area and circumference
Transsacral screw safe zone
size by sacral segmentation
Post-liver transplant
prognosis and liver
cirrhosis
Safe zone size
depending on gender,
number of
neuroforamen in
presence and absence
of lumbosacral
transitional vertebrae
Component separation
technique in complex
ventral hernia repair
likely to be discharged
somewhere other than home.
Morphomics can be used to
identify patients at risk for
cirrhosis after liver transplant.
Findings showed predictable
pattern of safe zone size based on
gender and sacral segmentation
variations.
Identify gender
differences in
acetabular morphology
Morphomic variables were used
to compare pre- and postoperative changes in patients
undergoing abdominal surgery:
decreases in total body area, total
body circumference, and fasciato-skin distance, but no change in
fascia area and circumference.
Fat subtype and distribution are
potential predictors of portsurgical complications in patients
with Crohn’s disease. Increased
subcutaneous relative to visceral
fat increases risk of infection after
bowel resection.
Mean global and focal acetabular
anteversion was greater in
women.
Heterogeneous cohort
Visceral adipose tissue was
Postoperative
infectious
complications after
surgery for Crohn’s
disease
Peterson et al (2015)51
41
cortical bone densities,
visceral adipose tissue area,
subcutaneous adipose tissue
area (T7 to L5), and psoas
muscle attenuation at L4
of adults with available
thoracic or abdominal
computed tomography
scans
Trabecular and cortical bone
densities, psoas major
muscle attenuation and area,
visceral adipose tissue area
and subcutaneous adipose
tissue area
Adults with cerebral
palsy
strongly and inversely associated
with vertebral trabecular and
cortical bone mineral densities
and muscle attenuation in adults
even after adjustment for effects
of body mass index and age
Adults with cerebral palsy have
significantly lower trabecular and
cortical bone mineral densities,
increased muscle attenuation, and
greater visceral and subcutaneous
adipose tissue areas compared
with matched-, neuro-typical
adults.
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