Computed Tomography–Measured Psoas Muscle Density as a Predictive Factor for Hypophosphatemia Associated With Refeeding

Background: Appendicular skeletal muscle mass index and muscle attenuation (density) are negatively associated with mortality in European-derived populations. Objectives: The present analyses assessed association between axial skeletal muscle density and muscle index with mortality in European Americans with type 2 diabetes mellitus (T2D). Design: Single-center observational study. Setting: Diabetes Heart Study. Participants: 839 European Americans with T2D. Methods: Computed tomography-measured psoas and paraspinous muscle mass index (cross sectional area/height2) and radiographic density (Hounsfield Units) were assessed in all participants. A Cox proportional hazards model was computed. The fully-adjusted model included covariates age, sex, body mass index, smoking, alcohol use, diabetes duration, insulin use, hormone replacement therapy (women), prevalent cardiovascular disease (CVD), hypertension, and coronary artery calcified atherosclerotic plaque mass score. Deaths were recorded in the National Death Index data through December 31, 2015. Results: Participants included 428 women and 411 men with median (25th, 75th quartile) age 62.8 (56.1, 69.1) years and diabetes duration 8.0 (5.0, 14.0) years. After 11.9 (9.4, 13.3) years of follow-up, 314 (37.4%) of participants were deceased. In the fully-adjusted model, psoas muscle density (hazard ratio [HR] 0.81, p<0.001), psoas muscle index (HR 0.82, p=0.008), and paraspinous muscle density (HR 0.85, p=0.003) were inversely associated with mortality. Paraspinous muscle index was not significantly associated with mortality (HR 0.90, p=0.08). Results did not differ significantly between men and women. Conclusions: In addition to established risk factors for mortality and CVD, higher psoas muscle index, psoas muscle density, and paraspinous muscle density were significantly associated with lower all-cause mortality in European Americans with T2D.

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CT Evaluation of Sarcopenia in Patients with and without Malignant Tumor: Psoas Muscle Density as a Biomarker

10.1055/s-0039-1692588 ◽

2019 ◽

Author(s):

S. P. Ivanoski ◽

V. Vasilevska Nikodinovska

Keyword(s):

Malignant Tumor ◽

Psoas Muscle ◽

Muscle Density ◽

Ct Evaluation

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Clinical implication of psoas muscle mass measurement for predicting death within 3 months in patients with incurable uterine cervical or corpus malignancy

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa248 ◽

2021 ◽

Author(s):

Hiroyuki Kurosu ◽

Yukiharu Todo ◽

Ryutaro Yamada ◽

Kaoru Minowa ◽

Tomohiko Tsuruta ◽

...

Keyword(s):

Computed Tomography ◽

Muscle Mass ◽

Cancer Cachexia ◽

Mass Measurement ◽

Characteristic Curve ◽

Lumbar Vertebra ◽

Psoas Muscle ◽

Data Set ◽

Cutoff Value ◽

Computed Tomography Images

Abstract Objective The aim of this study was to find a clinical marker for identifying refractory cancer cachexia. Methods We analyzed computed tomography imaging data, which included the third lumbar vertebra, from 94 patients who died of uterine cervix or corpus malignancy. The time between the date of examination and date of death was the most important attribute for this study, and the computed tomography images were classified into >3 months before death and ≤ 3 months before death. Psoas muscle mass index was defined as the left–right sum of the psoas muscle areas (cm2) at the level of third lumbar vertebra, divided by height squared (m2). Results A data set of 94 computed tomography images was obtained at baseline hospital visit, and a data set of 603 images was obtained at other times. One hundred (16.6%) of the 603 non-baseline images were scanned ≤3 months before death. Mean psoas muscle mass index change rates at >3 months before death and ≤3 months before death were −1.3 and −20.1%, respectively (P < 0.001). Receiver operating characteristic curve analysis yielded a cutoff value of −13.0%. The area under the curve reached a moderate accuracy level (0.777, 95% confidence interval 0.715–0.838). When we used the cutoff value to predict death within 3 months, sensitivity and specificity were 74.0 and 82.1%, respectively. Conclusions Measuring change in psoas muscle mass index might be useful for predicting cancer mortality within 3 months. It could become a potential tool for identifying refractory cancer cachexia.

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Psoas Muscle Density Evaluated by Chest CT and Long-Term Mortality in COPD Patients

Archivos de Bronconeumología ◽

10.1016/j.arbres.2021.04.012 ◽

2021 ◽

Author(s):

Ana Ezponda ◽

Ciro Casanova ◽

Carlos Cabrera ◽

Ángela Martin-Palmero ◽

Marta Marín ◽

...

Keyword(s):

Psoas Muscle ◽

Chest Ct ◽

Muscle Density ◽

Copd Patients ◽

Long Term Mortality

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SUN-P028: A New Prognostic Marker in the Intensive Care Unit (ICU): The Psoas Muscle Area Index Measured by Abdominal Computed Tomography (CT) Targeted on the Third Lumbar Vertebra (L3)

Clinical Nutrition ◽

10.1016/s0261-5614(17)30598-8 ◽

2017 ◽

Vol 36 ◽

pp. S62-S63

Author(s):

E. Lascouts ◽

A. Mulliez ◽

G. d’Assignies ◽

N. Rotovnik Kozjek ◽

A.-M. Makhlouf ◽

...

Keyword(s):

Computed Tomography ◽

Intensive Care Unit ◽

Intensive Care ◽

Prognostic Marker ◽

Lumbar Vertebra ◽

Psoas Muscle ◽

Muscle Area ◽

Area Index ◽

The Third ◽

Abdominal Computed Tomography

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Computed Tomography Evidence of Psoas Muscle Atrophy Without Concomitant Tendon Wasting in Early Sepsis

Journal of Surgical Research ◽

10.1016/j.jss.2018.09.010 ◽

2019 ◽

Vol 234 ◽

pp. 210-216

Author(s):

Carrie A. Kubiak ◽

Kavitha Ranganathan ◽

Niki Matusko ◽

Jon A. Jacobson ◽

Stewart C. Wang ◽

...

Keyword(s):

Computed Tomography ◽

Muscle Atrophy ◽

Psoas Muscle ◽

Early Sepsis

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Computed tomography (CT) features of pelvic rhabdomyosarcoma (RMS) in children

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666210826160710 ◽

2021 ◽

Vol 17 ◽

Author(s):

Lu Tian ◽

Yue Cai ◽

Xiaomeng Li ◽

Jinhua Cai

Keyword(s):

Computed Tomography ◽

Blood Vessels ◽

Lymphatic Metastasis ◽

Case Reports ◽

High Specificity ◽

Muscle Density ◽

Paediatric Patients ◽

Sensitivity Range ◽

Neoplastic Lesions ◽

Ct Features

Background: Currently, there are few literature reports on the CT features of pelvic rhabdomyosarcoma, most of which exist in the form of case reports, and some literature reports have suggested that CT features of pelvic rhabdomyosarcoma lack specificity. This study was designed to investigate the CT features of pelvic RMS in children to provide imaging evidence for clinical diagnosis. Methods: We retrospectively reviewed radiographic and clinical data of all paediatric patients with pelvic neoplastic lesions pathologically proven to be malignant in our hospitals from January 2012 through March 2021. The data of the included paediatric patients were divided into two groups according to whether the pathology results indicated RMS. CT features of RMS (n= 37) and non-RMS (n= 91) were compared by two abdominal radiologists. Results: A total of 9 CT features were statistically significant for the diagnosis of pelvic RMS in children (p＜0.05). The sensitivity (range, 0.64–0.74) and specificity (range, 0.86–0.93) of the CT features showing multinodular fusion, surrounding blood vessels, and heterogeneous progressive centripetal enhancement were both relatively high. The CT features indicating lower than muscle density, necrosis, non-calcification and non-haemorrhage exhibited high specificity (range, 0.86–0.97), but the sensitivity (range, 0.32–0.40) was relatively low, while the sensitivity (range, 0.37–0.46) and specificity (range, 0.75–0.83) of other CT features used for diagnosing pelvic RMS, namely, lobulated and lymphatic metastasis, were both relatively low. Conclusion: Pelvic rhabdomyosarcoma in children has its own specific CT features.

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Preoperative Point-of-Care Ultrasound to Identify Frailty and Predict Postoperative Outcomes: A Diagnostic Accuracy Study

Anesthesiology ◽

10.1097/aln.0000000000004064 ◽

2021 ◽

Author(s):

Cecilia Canales ◽

Einat Mazor ◽

Heidi Coy ◽

Tristan R. Grogan ◽

Victor Duval ◽

...

Keyword(s):

Computed Tomography ◽

Operating Characteristic ◽

Skilled Nursing Facility ◽

Area Under The Curve ◽

Psoas Muscle ◽

Rectus Femoris ◽

Muscle Area ◽

Nursing Facility ◽

Skilled Nursing ◽

Ultrasound Measurements

Background Frailty is increasingly being recognized as a public health issue, straining healthcare resources and increasing costs to care for these patients. Frailty is the decline in physical and cognitive reserves leading to increased vulnerability to stressors such as surgery or disease states. The goal of this pilot diagnostic accuracy study was to identify whether point-of-care ultrasound measurements of the quadriceps and rectus femoris muscles can be used to discriminate between frail and not-frail patients and predict postoperative outcomes. This study hypothesized that ultrasound could discriminate between frail and not-frail patients before surgery. Methods Preoperative ultrasound measurements of the quadriceps and rectus femoris were obtained in patients with previous computed tomography scans. Using the computed tomography scans, psoas muscle area was measured in all patients for comparative purposes. Frailty was identified using the Fried phenotype assessment. Postoperative outcomes included unplanned intensive care unit admission, delirium, intensive care unit length of stay, hospital length of stay, unplanned skilled nursing facility admission, rehospitalization, falls within 30 days, and all-cause 30-day and 1-yr mortality. Results A total of 32 patients and 20 healthy volunteers were included. Frailty was identified in 18 of the 32 patients. Receiver operating characteristic curve analysis showed that quadriceps depth and psoas muscle area are able to identify frailty (area under the curve–receiver operating characteristic, 0.80 [95% CI, 0.64 to 0.97] and 0.88 [95% CI, 0.76 to 1.00], respectively), whereas the cross-sectional area of the rectus femoris is less promising (area under the curve–receiver operating characteristic, 0.70 [95% CI, 0.49 to 0.91]). Quadriceps depth was also associated with unplanned postoperative skilled nursing facility discharge disposition (area under the curve 0.81 [95% CI, 0.61 to 1.00]) and delirium (area under the curve 0.89 [95% CI, 0.77 to 1.00]). Conclusions Similar to computed tomography measurements of psoas muscle area, preoperative ultrasound measurements of quadriceps depth shows promise in discriminating between frail and not-frail patients before surgery. It was also associated with skilled nursing facility admission and postoperative delirium. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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Skeletal muscle density as a positive predictive factor for nivolumab therapy in patients with metastatic renal cell carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e17107 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e17107-e17107

Author(s):

Meltem Ekenel ◽

Murat Sari ◽

Samil Aliyev ◽

Mert Basaran

Keyword(s):

Skeletal Muscle ◽

Renal Cell Carcinoma ◽

Adipose Tissue ◽

Cell Carcinoma ◽

Metastatic Renal Cell Carcinoma ◽

Predictive Factor ◽

Renal Cell ◽

Intermediate Risk ◽

Second Line ◽

Muscle Density

e17107 Background: Immunotherapy has shown promising clinical responses in patients with metastatic Renal Cell Carcinoma (mRCC) at second-line therapy. Since objective response rates are highly variable, it is utmost important to identify patients who may benefit from immunotherapy to avoid unnecessary adverse effects and costs. Therefore, predictive as well as prognostic markers need to be studied extensively. To our knowledge, none of the body composition measurements such as fat content or skeletal muscle density have been assessed for this purpose. The objective of the current study is to analyze whether skeletal muscle (either muscle mass or muscle density) and adipose tissue play a prognostic role in patients with mRCC who were treated with immunotherapy at second line. Methods: We retrospectively analyzed 14 patients with mRCC who were progressed after tyrosine kinase inhibitor therapy and treated with Nivolumab between March 2016 and September 2019. Skeletal muscle density (SMD), skeletal muscle and adipose tissue were assessed with computed tomography imaging. Overall Survival (OS) and Progression Free Survival (PFS) were estimated by using the Kaplan-Meier method. Results: The median OS was 13,1 months and it was strongly associated with SMD; the median OS was significantly longer in patients with high SMD compared to patients with low SMD (6,9 months vs 18,5 months; P < 0,05). Also in our analysis, SMD separated the intermediate-risk group into 2 groups with different median OS periods, ranging from 8,1 months (95% confidence interval [95% CI], 5,1 months-11,1 months) in patients with intermediate-risk Heng score and low SMD to 21,5 months (95% CI, 14 months-27 months) in patients with an intermediate-risk Heng score and high SMD. Other parameters calculated for adipose tissue or skeletal muscle did not cause any significant change in survival analysis. Conclusions: High SMD appears to be associated with improved outcome in our small patient population. It could be a predictive factor when immunotherapy, Nivolumab, is considered for therapy of mRCC patients at second line.

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