The use of alternate vertebral levels to L3 in computed tomography scans for skeletal muscle mass evaluation and sarcopenia assessment in patients with cancer: a systematic review

2021 ◽  
pp. 1-49
Author(s):  
Belinda Vangelov ◽  
Judy Bauer ◽  
Damian Kotevski ◽  
Robert I. Smee
Keyword(s):  
Computed Tomography ◽  
Skeletal Muscle ◽  
Ct Scan ◽  
Cancer Patients ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Whole Body ◽  
Ct Scans ◽  
Cross Sectional ◽  
Patients With Cancer

ABSTRACT Body composition measurement using diagnostic computed tomography (CT) scans has emerged as a method to assess sarcopenia (low muscle mass) in oncology patients. Assessment of skeletal muscle mass (SMM) using the cross-sectional area (CSA) of a single vertebral slice (at lumbar L3) in a CT scan is correlated to whole body skeletal muscle volume. This method is used to assess CT-defined sarcopenia in patients with cancer, with low SMM effecting outcomes. However, as diagnostic scans are based on tumour location, not all include L3. We evaluated the evidence for the use of alternate vertebral CT slices for SMM evaluation when L3 is not available. Five electronic databases were searched from Jan 1996-April 2020 for studies using CT scan vertebral slices above L3 for SM measurement in adults with cancer (solid tumours). Validation with whole body SMM, rationale for the chosen slice, and sarcopenia cut-off values were investigated. Thirty-two studies were included, all retrospective and cross-sectional in design. Cervical, thoracic, and lumbar slices were used (from C3-L1), with no validation of whole body SMM using CT scans. Alternate slices were used in lung, and head and neck cancer patients. Sarcopenia cut-off values were reported in 75% of studies, with differing methods, with or without sex-specific values, and a lack of consensus. Current evidence is inadequate to provide definitive recommendations for alternate vertebral slice use for SMM evaluation in cancer patients. Variation in sarcopenia cut-offs warrants more robust investigation, in order for risk stratification to be applied to all patients with cancer.

scholarly journals Alternate Mediterranean diet score is positively associated with skeletal muscle mass index in middle-aged adults

2017 ◽  
Vol 117 (8) ◽  
pp. 1181-1188 ◽  
Author(s):  
Hui-yuan Tian ◽  
Rui Qiu ◽  
Li-peng Jing ◽  
Zhan-yong Chen ◽  
Geng-dong Chen ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Mediterranean Diet ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
General Information ◽  
Whole Body ◽  
Cross Sectional ◽  
Mediterranean Diet Score ◽  
Skeletal Muscle Mass Index ◽  
Diet Score

AbstractResearches have suggested Mediterranean diet might lower the risk of chronic diseases, but data on skeletal muscle mass (SMM) are limited. This community-based cross-sectional study examined the association between the alternate Mediterranean diet score (aMDS) and SMM in 2230 females and 1059 males aged 40–75 years in Guangzhou, China. General information and habitual dietary information were assessed in face-to-face interviews conducted during 2008–2010 and 3 years later. The aMDS was calculated by summing the dichotomous points for the items of higher intakes of whole grain, vegetables, fruits, legumes, nuts, fish and ratio of MUFA:SFA, lower red meat and moderate ethanol consumption. The SMM of the whole body, limbs, arms and legs were measured using dual-energy X-ray absorptiometry during 2011–2013. After adjusting for potential covariates, higher aMDS was positively associated with skeletal muscle mass index (SMI, SMM/height2, kg/m2) at all of the studied sites in males (all Ptrend<0·05). The multiple covariate-adjusted SMI means were 2·70 % (whole body), 2·65 % (limbs), 2·50 % (arms) and 2·70 % (legs) higher in the high (v. low) category aMDS in males (all P<0·05). In females, the corresponding values were 1·35 % (Ptrend=0·03), 1·05, 0·52 and 1·20 %, (Ptrend>0·05). Age-stratified analyses showed that the favourable associations tended to be more pronounced in the younger subjects aged less than the medians of 59·2 and 62·2 years in females and males (Pinteraction>0·10). In conclusion, the aMDS shows protective associations with SMM in Chinese adults, particularly in male and younger subjects.

scholarly journals Reference Values for Skeletal Muscle Mass – Current Concepts and Methodological Considerations

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 755 ◽  
Author(s):  
Carina O. Walowski ◽  
Wiebke Braun ◽  
Michael J. Maisch ◽  
Björn Jensen ◽  
Sven Peine ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Reference Values ◽  
Skeletal Muscle Mass ◽  
Bioelectrical Impedance ◽  
Reference Population ◽  
Muscle Quality ◽  
Whole Body ◽  
Whole Body Imaging ◽  
Cross Sectional

Assessment of a low skeletal muscle mass (SM) is important for diagnosis of ageing and disease-associated sarcopenia and is hindered by heterogeneous methods and terminologies that lead to differences in diagnostic criteria among studies and even among consensus definitions. The aim of this review was to analyze and summarize previously published cut-offs for SM applied in clinical and research settings and to facilitate comparison of results between studies. Multiple published reference values for discrepant parameters of SM were identified from 64 studies and the underlying methodological assumptions and limitations are compared including different concepts for normalization of SM for body size and fat mass (FM). Single computed tomography or magnetic resonance imaging images and appendicular lean soft tissue by dual X-ray absorptiometry (DXA) or bioelectrical impedance analysis (BIA) are taken as a valid substitute of total SM because they show a high correlation with results from whole body imaging in cross-sectional and longitudinal analyses. However, the random error of these methods limits the applicability of these substitutes in the assessment of individual cases and together with the systematic error limits the accurate detection of changes in SM. Adverse effects of obesity on muscle quality and function may lead to an underestimation of sarcopenia in obesity and may justify normalization of SM for FM. In conclusion, results for SM can only be compared with reference values using the same method, BIA- or DXA-device and an appropriate reference population. Limitations of proxies for total SM as well as normalization of SM for FM are important content-related issues that need to be considered in longitudinal studies, populations with obesity or older subjects.

scholarly journals The prevalence of CT-defined low skeletal muscle mass in patients with metastatic cancer: a cross-sectional multicenter French study (the SCAN study)

2021 ◽  
Author(s):  
Bruno Raynard ◽  
Frederic Pigneur ◽  
Mario Di Palma ◽  
Elise Deluche ◽  
François Goldwasser
Keyword(s):  
Skeletal Muscle ◽  
Cancer Patients ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Metastatic Cancer ◽  
Lumbar Vertebrae ◽  
Diagnostic Methods ◽  
Routine Practice ◽  
Nutritional Management ◽  
Cross Sectional

Abstract Background Cachexia, characterized by involuntary muscle mass loss, negatively impacts survival outcomes, treatment tolerability, and functionality in cancer patients. However, there is a limited appreciation of the true prevalence of low muscle mass due to inconsistent diagnostic methods and limited oncologist awareness. Methods Twenty-nine French healthcare establishments participated in this cross-sectional study, recruiting patients with those metastatic cancers most frequently encountered in routine practice (colon, breast, kidney, lung, prostate). The primary outcome was low skeletal muscle mass prevalence, as diagnosed by estimating the skeletal mass index (SMI) in the middle of the third-lumbar vertebrae (L3) level via computed tomography (CT). Other objectives included an evaluation of nutritional management, physical activity, and toxicities related to ongoing treatment. Results Seven hundred sixty-six patients (49.9% males) were enrolled with a mean age of 65.0 years. Low muscle mass prevalence was 69.1%. Only one-third of patients with low skeletal muscle mass were receiving nutritional counselling and only 28.4% were under nutritional management (oral supplements, enteral or parenteral nutrition). Physicians highly underdiagnosed those patients identified with low skeletal muscle mass, as defined by the primary objective, by 74.3% and 44.9% in obese and non-obese patients, respectively. Multivariate analyses revealed a lower risk of low skeletal muscle mass for females (OR: 0.22, P < 0.01) and those without brain metastasis (OR: 0.34, P < 0.01). Low skeletal muscle mass patients were more likely to have delayed treatment administration due to toxicity (11.9% versus 6.8%, P = 0.04). Conclusions There is a critical need to raise awareness of low skeletal muscle mass diagnosis among oncologists, and for improvements in nutritional management and physical therapies of cancer patients to curb potential cachexia. This calls for cross-disciplinary collaborations among oncologists, nutritionists, physiotherapists, and radiologists.

Measuring skeletal muscle mass using C3 cross-sectional computed tomography images

2018 ◽  
Vol 37 ◽  
pp. S37
Author(s):  
B.T. Muresan ◽  
C. Sánchez Juan ◽  
A. Artero ◽  
A. Montoro ◽  
G. Sanchz Jordá ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Cross Sectional ◽  
Computed Tomography Images

scholarly journals AB0251 SARCOPENIA IN MOROCCAN POPULATION WITH RHEUMATOID ARTHRITIS: PREVALENCE AND PREDICTIVE FACTORS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1425.2-1425
Author(s):  
E. Jalila ◽  
H. Azzouzi ◽  
I. Linda
Keyword(s):  
Rheumatoid Arthritis ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Cross Sectional Study ◽  
Whole Body ◽  
Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
Lean Muscle Mass

Background:Patients with rheumatoid arthritis (RA) were at risk for altered body composition with higher prevalence of sarcopenia compared to the general population. Low lean muscle mass may constitute an additional risk factor for altered bone density in RA patients.Objectives:We aimed to study the prevalence of sarcopenia and to assess its predictive factors in Moroccan patients with RA.Methods:We conducted a cross-sectional study over two months in our department of rheumatology. All RA patients fulfilled ACR/EULAR 2010 criteria. We performed a whole-body dual-energy X-ray absorptiometry (DXA) to measure lean mass, fat mass and bone mass in the whole body and body parts. The appendicular skeletal muscle mass was assessed using the sum of skeletal muscle mass in the arms and legs. The relative skeletal muscle mass index (RSMI) was calculated from the appendicular skeletal mass divided by the square of the patient’s height (kg/m2). According to Baumgartner et al, sarcopenia was defined as a relative SMI <5.5 kg/m2on women and <7.26 kg/m2on men. Body mass index (BMI) was measured and patients were classified according to World Health Organization. Disease activity and functional disability were measured using the 28-joint Disease Activity Score (DAS28) with CRP and the Health Assessment Questionnaire (HAQ). Comorbidities and medication use including corticosteroids were also recorded. Data was entered and processed using the IBM SPSS Statistics 20. A univariate analysis as well as multivariate regressions were carried out to assess the association between sarcopenia and lumbar spine and femoral neck (FN) bone mineral density (BMD) and RA characteristics.Results:We included 70 (87.5%) women and 10 (12.5%) men with a mean age of 53.59 ±10.96 years old. They had a mean disease duration of 12.35± 8.68, a mean DAS 28 CRP of 2.64±1.34, a mean HAQ of 0.94±0.63 and a mean RSMI of 5.75±1.17. Women had a mean RSMI of 6.33±1.04 while men had a mean RSMI of 5.66±1.17. The prevalence of sarcopenia in our population was 47.4% (37), of whom 81.1% (30) women.In univariate regression analysis, sarcopenia was associated with normal BMI (OR: 8.59, 95% CI [3.054-24.182], p= 0.000), DAS 28 CRP (OR: 1.78, 95% CI [1.203-2.657], p= 0.004), HAQ (OR: 2.15, 95% CI [1.165-5.433], p= 0.019), lumbar spine BMD (OR: 0.001, 95% CI [0.00001-0.043], p= 0.0004) and FN BMD (OR: 0.000006, 95% CI [0.000-0.002], p= 0,00008 at right FN and OR: 0.00009, 95% CI [0.000001-0.010], p=0.000 at left FN, respectively).In multiple regression analysis, sarcopenia was associated with normal BMI (OR: 11.56, 95% CI [2.754–48.598]), p=0.001 and FN BMD (OR: 0.00, 95% CI [0.000–0.084], p = 0.006).Conclusion:In the present study, sarcopenia was common among RA patients and associated with normal BMI and femoral neck BMD, emphasizing the importance of this modifiable risk factor. Further studies are needed to identify effective means to improve lean muscle mass in patients with RA.References:[1]Mochizuki T et al. Sarcopenia-associated factors in Japanese patients with rheumatoid arthritis: A cross-sectional study. Geriatr. Gerontol. Int. 2019;19 (9), 907-912[2]Okano T et al. Loss of lean body mass affects low bone mineral density in patients with rheumatoid arthritis -results from the TOMORROW study-, Modern Rheumatology. 2017;27(6):1-19.[4]Peggy M. Cawthon. Assessment of Lean Mass and Physical Performance in Sarcopenia. Journal of Clinical Densitometry. 2015;18(4):467-71.Disclosure of Interests:None declared

scholarly journals Accuracy of Anthropometric Equations to Estimate DXA-Derived Skeletal Muscle Mass in Professional Male Soccer Players

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Roberto Gabriel González-Mendoza ◽  
Alejandro Gaytán-González ◽  
Juan Antonio Jiménez-Alvarado ◽  
Marisol Villegas-Balcázar ◽  
Edtna E. Jáuregui-Ulloa ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Reference Method ◽  
Mean Difference ◽  
Soccer Players ◽  
Whole Body ◽  
Limits Of Agreement ◽  
Cross Sectional ◽  
Significance Level

Background. Several anthropometric equations that estimate skeletal muscle mass (SMM) have been published, but their applicability and accuracy among athletes are still uncertain. Purpose. To assess the accuracy of different anthropometric equations that estimate SMM in professional male soccer players, as compared to dual-energy X-ray absorptiometry (DXA) as the reference method. Methods. In this cross-sectional study, we evaluated 179 professional male soccer players aged between 18 and 37 years. Anthropometric measurements (height, body weight, skinfold thicknesses, and girths) and a DXA whole body scan were performed the same day for each participant, and SMM was estimated with nine anthropometric equations (Heymsfield, Martin, Doupe, Kerr, Drinkwater, Lee, De Rose, and two equations published by Kuriyan). To determine differences between SMM estimated with anthropometric equations and SMM evaluated with DXA, a Kruskal-Wallis test was performed using Dunn’s test as post hoc. The significance level was set at p < 0.05. We calculated the mean difference and 95% limits of agreement for the analyzed equations (Equation – DXA). Results. Only Heymsfield’s and Lee’s equations showed no significant differences with DXA. Heymsfield’s equation had the smallest mean difference (-0.17 kg), but wider limits of agreement with DXA (-6.61 to 6.94 kg). Lee’s equation had a small mean difference (1.10 kg) but narrower limits of agreement with DXA (-1.83 to 4.03 kg). Conclusions. In this study, the prediction equation published by Lee et al. showed the best agreement with DXA and is able to estimate SMM accurately in professional male soccer players.

scholarly journals Use of an Open-Source Software to Examine Low Skeletal Muscle Mass in Penile Cancer Patients: A Cross-Sectional Study

2021 ◽  
pp. 1-5
Author(s):  
C. Ibilibor ◽  
H. Wang ◽  
D. Kaushik ◽  
R. Rodriguez
Keyword(s):  
Skeletal Muscle ◽  
Open Source ◽  
Cancer Patients ◽  
Muscle Mass ◽  
Open Source Software ◽  
Penile Cancer ◽  
Disease Burden ◽  
Skeletal Muscle Mass ◽  
Cross Sectional Study ◽  
Cross Sectional

Purpose: Low skeletal muscle mass determined radiographically has emerged as an important prognostic marker in penile cancer patients but may be unrecognized in obese patients with a high comorbid disease burden. Moreover, publicly available software for image segmentation are limited. Thus, we describe the prevalence of radiographically low skeletal muscle mass in an obese penile cancer cohort, using an open-source software and examine its association with comorbid disease burden. Methods: This is a cross-sectional study, utilizing retrospective data from patients diagnosed with penile squamous cell carcinoma between October 2009 and December 2019. Available digital files of perioperative computerized tomography were analyzed, using CoreSlicer, an open-source image segmentation software. The correlation between radiographically low skeletal muscle mass, defined as a skeletal muscle index (SMI) less than 55 cm2/m2 and a Charlson Comorbidity Index (CCI) greater than 4 was examined, using logistic and linear regression. Results: Forty two of 59 patients had available digital files. Median SMI and body mass index (BMI) were 54.6cm2/m2 and 30.2kg/m2 respectively for the entire cohort. Of included patients, 54% had radiographically low skeletal muscle mass and a median BMI of 28.9 kg/m2. Radiographically low skeletal muscle mass was associated with a CCI greater than 4 on univariable and multivariable logistic regression with odds ratios of 4.85 (p = 0.041) and 7.32 (p = 0.033), respectively. When CCI was treated as a continuous variable on linear regression, the association between radiographically low skeletal muscle mass and CCI was positive, but not statistically significant with an estimated effect of 1.29 (p = 0.1) and 1.27 (p = 0.152) on univariable and multivariable analysis, respectively. Conclusion: Our data demonstrate that low skeletal muscle mass can be readily assessed with CoreSlicer and is associated with a CCI greater than 4 in obese penile cancer patients.

scholarly journals Prognostic Value of Muscle Mass Measured via Brain Computed Tomography in Neurocritically Ill Patients

2020 ◽  
Author(s):  
Yun Im Lee ◽  
Ryoung-Eun Ko ◽  
Joonghyun Ahn ◽  
Keumhee Carriere ◽  
Jeong-Am Ryu
Keyword(s):  
Computed Tomography ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Cervical Vertebra ◽  
Muscle Thickness ◽  
Chi Square ◽  
Cross Sectional ◽  
Brain Computed Tomography ◽  
Poor Neurological Outcome

Abstract We investigated whether skeletal muscle mass estimated via brain computed tomography (CT) can be used to predict neurological outcomes in neurocritically ill patients. Adult patients who were admitted to the neurosurgical intensive care unit (ICU) from January 2010 to September 2019 were eligible. We included patients who were hospitalized in the neurosurgical ICU for more than 7 days. Cross-sectional areas of paravertebral muscle at the first cervical vertebra level (C1-CSA) and temporalis muscle thickness (TMT) on brain CT were measured to evaluate skeletal muscle mass. Primary outcome was Glasgow Outcome Scale score at 3 months. Change of C1-CSA (adjusted odds ratio [OR]: 1.36, 95% confidence interval [CI]: 1.054–1.761) and change of TMT (adjusted OR: 1.27, 95% CI: 1.028–1.576) were significantly associated with poor neurological outcome (Hosmer–Lemeshow test, Chi-square = 11.4, df = 8, p = 0.178) with areas under the curve of 0.803 (95% CI 0.740–0.866) using 10-fold cross validation method. Especially, risk of poor neurologic outcome was proportional to changes of C1-CSA and TMT. In this study, the follow-up skeletal muscle mass at first week from ICU admission, based on changes in C1-CSA and TMT, was associated with neurological prognosis in neurocritically ill patients.

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