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Mirza Faisal Beg: Staging the Host in Precision Medicine – The Under-explored Landscape

Mirza Faisal Beg/LinkedIn

Jun 13, 2025, 08:33

Mirza Faisal Beg: Staging the Host in Precision Medicine – The Under-explored Landscape

Mirza Faisal Beg, Professor at the School of Engineering Science, Simon Fraser University, shared on LinkedIn:

“Staging the Host in Precision Medicine: The Under-explored Landscape

Decades of research and clinical workflows have focused on ‘staging the disease’ to choose and personalize cancer treatments. However, despite many advances, treatments often undertreat or overtreat, both of which carry stark consequences such as recurrence and toxicity. The ‘same’ tumor, the ‘same’ treatment, but outcomes differ widely across individuals. What is the missing piece that explains these variations in outcomes?

Enter the elephant in the room: the body habitus makeup of the individual. Mounting evidence is revealing that body composition, particularly muscle and fat distribution, is a significant factor influencing cancer treatment outcomes. CT scans, which are routinely performed for cancer staging and monitoring, contain a rich trove of underutilized data that can be harnessed for “staging the host”, quantifying key elements of the patient’s physiology that influence disease progression and treatment outcomes. However, extracting this data has been laborious, as it traditionally requires manual segmentation across hundreds of axial slices.

To simplify the problem, researchers initially focused on a single axial slice at the L3 vertebral level, where strong correlations with whole-body composition had been established. However, manual analysis of even a single slice is time-consuming and operator-dependent.

To address this problem, we developed DAFS Express, a platform that automates quantitative body composition analysis from routinely acquired CT/MRI scans, making the process ‘as easy as using a calculator, and as reliable as a plane flight.’ Now validated by independent research groups globally, DAFS Express has become the de facto standard for CT and Dixon MRI-based body composition analysis.

Still, single-slice muscle and fat measurements, while a great start, are not enough. No organ functions autonomously. Organs are nodes in a network and are constantly in communication. Diseases, especially chronic and complex ones like cancer, are rarely isolated to a single location; they are systemic. Treatments and interventions impact multiple systems, and the compensatory mechanisms engaged by the body often have ripple effects far beyond the site of disease or treatment. For instance, the liver also modulates drug metabolism, the kidneys regulate electrolyte balance under chemotherapy, and the heart must cope with fluid shifts from various treatments. Body composition, if limited to muscle and fat, is therefore only one dimension of characterizing a complex, interconnected biological system.

To fully realize the promise of precision medicine, we must embrace SYSTEM-LEVEL biomedical thinking, research, and engineering.”