Multi-organ aging quantified from routine chest CT predicts chronic disease risk and mortality
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Biological aging occurs heterogeneously across individuals and organs. However, current measures of biological age incompletely capture organ-specific differences in health and disease risk. Because chest CT visualizes multiple thoracic organs, it offers an opportunity to quantify structural aging across organ systems. Here, we developed MOSAIC-Age, a framework characterizing eight organ-specific aging clocks on chest CT. The clocks were developed and validated using 9,971 CT scans from CT-RATE and MIDRC, and subsequently locked and applied to two independent prospective cohorts with 35,293 participants from the National Lung Screening Trial and Genetic Epidemiology of COPD study. CT-derived biological age gaps (BAGs) were examined in relation to lifestyle and socioeconomic factors, prevalent comorbidities, incident chronic diseases, and all-cause and cause-specific mortality. Higher BAGs, indicating organs that appeared older on CT than expected for their chronological age, were broadly associated with adverse health characteristics, chronic disease burden, and increased mortality risk. Multiple disease outcomes were associated with aging across several organs, whereas in multivariable analyses including all eight organ-specific BAGs, the remaining associations were more organ specific. A greater number of markedly older-appearing organs and a faster pace of aging were each associated with higher mortality. Together, these findings demonstrate that routine chest CT captures both shared and organ-specific patterns of biological aging and establish CT-derived organ aging as a quantitative imaging biomarker for assessing multi-organ health and long-term disease risk.
Source: medRxiv
Authors: Junya Sato, Morteza Salehjahromi, Anas Zafar, Amgad Muneer, Xinyan Xu, Erjia Zhu, Natalie I. Vokes, Tina Cascone, Xiuning Le, Mehmet Altan, Eric E. Gardner, Ajay Sheshadri, Edwin J. Ostrin, Ameen A. Salahudeen, Tianhong Li, Miriam Merad, Aadel A. Chaudhuri, David E. Gerber, Fernando U. Kay, Myrna C.B. Godoy, Brett W. Carter, Girish S. Shroff, Lauren A. Byers, Caroline Chung, David Jaffray, David Rice, Zhongxing Liao, Joe Y. Chang, Ara A. Vaporciyan, Don L. Gibbons, Carol C. Wu, John V. Heymach, Jianjun Zhang, Jia Wu
Institutions: The University of Texas MD Anderson Cancer Center, Mayo Clinic, VA Northern California Health Care System, University of California Davis Medical Center, UC Davis Comprehensive Cancer Center, University of California, Davis, Icahn School of Medicine at Mount Sinai, Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center
Topic: Frailty in Older Adults
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7204810723