Rectus Femoris Muscle Mass Measured by Ultrasound is an Indicator of Whole-Body Muscle Mass at Intensive Care Unit Admission: A Retrospective Study

2021 ◽  
Author(s):  
Yuta Arai ◽  
Nobuto Nakanishi ◽  
Yuko Ono ◽  
Shigeaki Inoue ◽  
Joji Kotani ◽  
...  
Keyword(s):  
Muscle Mass ◽  
Rectus Femoris ◽  
Ct Imaging ◽  
Cross Sectional Area ◽  
Whole Body ◽  
Sectional Area ◽  
Cross Sectional ◽  
Icu Admission ◽  
Body Muscle ◽  
Ultrasound Measurements

Abstract Background: Muscle mass is an important biomarker of survival from a critical illness, but it is not a widely accepted method to assess whole-body muscle mass when patients are admitted to the intensive care unit (ICU). We hypothesize that ultrasound-based muscle mass assessments can reflect whole-body muscle mass. Methods: We conducted a retrospective analysis of prospectively obtained ultrasound data at ICU admission. We included patients who underwent computed tomography (CT) imaging at the third lumbar vertebral level, within 2 days before and after ICU admission. Primary outcomes included the correlation between the muscle mass (thickness and cross-sectional area) of the rectus femoris measured using ultrasound and whole-body muscle mass measurements obtained from CT. We aimed to determine whether ultrasound assessments can identify sarcopenia, defined as a skeletal muscle index of 29.0 cm2/m2 for males and 36.0 cm2/m2 for females. Secondary outcomes included the ultrasound measurements of the biceps brachii muscle mass and diaphragm thickness. Results: Among 133 patients, 89 patients underwent CT imaging, which included the third lumbar vertebra. The patients’ mean age was 72 ± 13 years, and 60 patients were male. The correlation between rectus femoris muscle ultrasound and CT was ρ = 0.57 (p < 0.01, n = 89) and ρ = 0.48 (p < 0.01, n = 89) on thickness and cross-sectional area, respectively. The thickness of the rectus femoris and cross-sectional area had the discriminative power to assess sarcopenia when the areas under the curve were 0.84 and 0.76, respectively. Ultrasound measurements of the biceps brachii muscle mass and diaphragm thickness were correlated with CT imaging [ρ = 0.57–0.60 (p < 0.01, n = 52) and ρ = 0.35 (p < 0.01, n = 79)]. Conclusions: Ultrasound measurements of muscle mass are a promising method to assess whole-body muscle mass and sarcopenia at ICU admission.Trial registration: UMIN000044032. Retrospectively registered on 25 April 2021

scholarly journals Rectus Femoris Mimicking Ultrasound Phantom for Muscle Mass Assessment: Design, Research, and Training Application

2021 ◽  
Vol 10 (12) ◽  
pp. 2721
Author(s):  
Nobuto Nakanishi ◽  
Shigeaki Inoue ◽  
Rie Tsutsumi ◽  
Yusuke Akimoto ◽  
Yuko Ono ◽  
...  
Keyword(s):  
Measurement Accuracy ◽  
Rectus Femoris ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Phantom Model ◽  
Ultrasound Measurements ◽  
Ultrasound Phantom

Ultrasound has become widely used as a means to measure the rectus femoris muscle in the acute and chronic phases of critical illness. Despite its noninvasiveness and accessibility, its accuracy highly depends on the skills of the technician. However, few ultrasound phantoms for the confirmation of its accuracy or to improve technical skills exist. In this study, the authors created a novel phantom model and used it for investigating the accuracy of measurements and for training. Study 1 investigated how various conditions affect ultrasound measurements such as thickness, cross-sectional area, and echogenicity. Study 2 investigated if the phantom can be used for the training of various health care providers in vitro and in vivo. Study 1 showed that thickness, cross-sectional area, and echogenicity were affected by probe compression strength, probe angle, phantom compression, and varying equipment. Study 2 in vitro showed that using the phantom for training improved the accuracy of the measurements taken within the phantom, and Study 2 in vivo showed the phantom training had a short-term effect on improving the measurement accuracy in a human volunteer. The new ultrasound phantom model revealed that various conditions affected ultrasound measurements, and phantom training improved the measurement accuracy.

Psoas Cross-Sectional Area As Radiographic Measure Of Sarcopenia Does Not Predict Overall Survival In Multiple Myeloma

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5326-5326
Author(s):  
Pavan Kumar Bhamidipati ◽  
Kenneth R Carson ◽  
Tanya M Wildes
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Muscle Mass ◽  
Psoas Muscle ◽  
Cross Sectional Area ◽  
Whole Body ◽  
Sectional Area ◽  
Cross Sectional ◽  
Muscle Density ◽  
Pet Ct

Abstract Introduction Although various disease-related markers have been implemented in the prognosis of multiple myeloma, nutritional or physical characteristics have not been utilized in the assessment for prognosis. Sarcopenia, defined as loss of lean skeletal muscle mass, is prognostic in non-malignant diseases such as COPD and non-hematologic malignancies such as breast cancer and pancreatic cancer. For the first time, we sought to analyze the prognostic value of sarcopenia in multiple myeloma (MM) by utilizing PET / CT scans done around the time of diagnosis. Methods In this retrospective cohort study, we identified all patients diagnosed and treated for multiple myeloma from 2000-2010 from the Barnes-Jewish Hospital Oncology Data Services registry, then identified patients who had undergone cross-sectional imaging (CT or PET/CT) for diagnostic purposes within 2 months of diagnosis. Medical records were reviewed for clinical and anthropomorphic data. The radiographic images were accessed to manually measure the psoas muscle cross sectional area (PCA) at the level of 3rdlumbar vertebra (L3) by a single trained person. This landmark was chosen as the PCA at the level of L3 correlates with the whole–body lean muscle mass in previous studies (Mourtzakis M, 2008 PMID: 18923576).The psoas muscle density was identified based on the average CT Hounsfield units for the cross-sectional area being measured. This value was then normalized for stature based on height to calculate L3 muscle index (LMI)(Total Psoas Area (TPA), in cm2/m2). Overall survival was defined as the time from diagnosis to death from any cause, censored at last follow-up. Survival between tertiles of LMI was compared using the methods of Kaplan-Meier and the Log-Rank test. Results A total of 129 MM patients with radiographic imaging were identified (median age 61 years, range 32-91; 57% males; 66% white race, 31.8% black race). The median body mass index (BMI) was 28.7, range 16.6-49.9). Of the 93 patients with staging information available, 27% had ISS stage 1, 36.6% stage II, 36.6% stage III. The median OS for the entire cohort was 34.2 months (95% Confidence Intervals 23.5-45.0 months). Survival did not differ between the tertiles of LMI: median OS 26.9 months (95% CI 9.2-44.6) in lowest tertile of TPA, 54.1 months (95% CI 30.6-77.6) in middle tertile and 38.2 months in highest tertile [Log-rank c21.439, p=0.487]. We then evaluated psoas muscle density in the 56 patients who underwent abdominal CT imaging without intravenous contrast. Survival did not differ between the tertiles of psoas density: median OS 24.3 months (95% CI 10.3-38.2) in the lowest tertile, 33.8 months (95% CI 14.8-52.8) in middle tertile, and 44.8 months (95% CI 25.8 – 53.5) in the highest tertile, p=0.122. Conclusion Total psoas area and psoas density as a measure of sarcopenia did not predict overall survival in this cohort. Limitations of this study include the fact that patients underwent imaging for diagnostic purposes at clinician. Future study will evaluate whether radiographic measures of sarcopenia in a less selected MM population have prognostic utility. Disclosures: Carson: Spectrum Pharmaceuticals: Honoraria, Research Funding, Speakers Bureau.

scholarly journals Rectus Femoris Mmimicking Ultrasound Phantom for Muscle Mass Assessment: Design, Research, and Training Application

2021 ◽  
Author(s):  
Nobuto Nakanishi ◽  
Shigeaki Inoue ◽  
Rie Tsutsumi ◽  
Yusuke Akimoto ◽  
Yuko Ono ◽  
...  
Keyword(s):  
Measurement Accuracy ◽  
Rectus Femoris ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Care Providers ◽  
Cross Sectional ◽  
Phantom Model ◽  
Ultrasound Measurements ◽  
Ultrasound Phantom

Ultrasound has become widely used as a mean to measure the rectus femoris muscle in the acute and chronic phase of critical illness. Despite its noninvasiveness and accessibility, its accuracy highly depends on the skills of the technician. However, few ultrasound phantoms for the confirmation of its accuracy or to improve technical skills exist. In this study, we created a novel phantom model and used it for investigating the accuracy of measurements and for training. Study 1 investigated how various conditions affect ultrasound measurements such as thickness, cross-sectional area, and echogenicity. Study 2 investigated if the phantom can be used for training of various health care providers in vitro and vivo. Study 1 showed that thickness, cross-sectional area, and echogenicity were affected by probe compression strength, probe angle, phantom compression, and varying equipment. Study 2 in vitro showed that using the phantom for training improved the accuracy of the measurements taken within phantom, and Study 2 in vivo showed the phantom training had a short-term effect on improving the measurement accuracy in a human volunteer. The new ultrasound phantom model revealed that various conditions affected ultrasound measurements, and phantom training improved the measurement accuracy.

scholarly journals The Nonlinear Relationship Between Psoas Cross-sectional Area and BMI: A New Observation and Its Insights into Diabetes Remission After Roux-en-Y Gastric Bypass

2021 ◽  
Author(s):  
Shaobo Li ◽  
Haoyong Yu ◽  
Pin Zhang ◽  
Yinfang Tu ◽  
Yunfeng Xiao ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Linear Relationship ◽  
Muscle Mass ◽  
Diabetes Remission ◽  
Cross Sectional Area ◽  
Fat Free Mass ◽  
Sectional Area ◽  
Cross Sectional ◽  
Non Linear ◽  
Design And Methods

OBJECTIVE <p>To<a> explore the potential relevance of muscle mass as a variable contributor to body mass index (BMI) on BMI limitations in predicting diabetes remission (DR) after Roux-en-Y gastric bypass (RYGB). </a></p> <p> </p> <p>RESEARCH DESIGN AND METHODS</p> <p>We evaluated the relationship between muscle mass and BMI in 501 patients with type 2 diabetes mellitus and overweight or obesity. Of which <a>186 patients who underwent R</a>YGB were <a>studied to determine the role of baseline muscle mass </a><a>and BMI </a>in predicting DR. Muscle mass was assessed by estimated fat-free mass index (eFFMI) and psoas cross-sectional area (CSA).</p> <p> </p> <p>RESULTS</p> <p>A non-linear relationship existed between psoas CSA and BMI, whereas psoas CSA showed a highly positive correlation with <a>eFFMI</a>. Baseline psoas CSA and eFFMI were better than BMI for predicting 1- and 5-year DR. </p> <p> </p> <p>CONCLUSIONS</p> <p><a>The </a><a>non-linear relationship between</a> muscle mass and BMI may <a>partially contribute to </a><a>BMI limitations in predicting DR</a> after RYGB. </p>

Relationship among running mileage, bone density, and serum testosterone in male runners

1992 ◽  
Vol 73 (3) ◽  
pp. 1165-1170 ◽  
Author(s):  
J. D. MacDougall ◽  
C. E. Webber ◽  
J. Martin ◽  
S. Ormerod ◽  
A. Chesley ◽  
...  
Keyword(s):  
Bone Density ◽  
Bone Mineral ◽  
Cross Sectional Area ◽  
Whole Body ◽  
Control Group ◽  
Dual Photon Absorptiometry ◽  
Sectional Area ◽  
Mineral Density ◽  
Cross Sectional ◽  
Density Measurements

Our purpose was to investigate the relationship between running volume and bone mineral mass in adult male runners. Whole body and regional bone mineral density were determined by dual-photon absorptiometry in 22 sedentary controls and 53 runners who were selected according to their running mileage to fall into a 5- to 10-, 15- to 20-, 25- to 30-, 40- to 55-, or 60- to 75-mile/wk group. All groups were of similar age (20–45 yr) and nutritional status, as determined by 7-day food records. Regional sites for bone density measurements included the trunk, spine, pelvis, thighs, and lower legs. In addition, serum total testosterone was determined in each subject and computed tomography scans were made of the lower legs in 34 subjects to assess bone cross-sectional area. No significant differences were detected for bone density measurements with the exception of the lower legs where it was significantly (P less than 0.05) greater for the 15- to 20-mile/wk group than for the control and 5- to 10-mile/wk groups. With mileage greater than 20 miles/wk, bone density of the lower legs showed no further increase and, in fact, tended to decrease, so that for the 60- to 75-mile/wk group it was similar to that of the controls. Cross-sectional area of the tibia and fibula when normalized to body weight tended to be greater as weekly mileage increased and was significantly greater in the 40- to 55-mile/wk runners than in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Inorganic Arsenic Exposure Decreases Muscle Mass and Enhances Denervation-Induced Muscle Atrophy in Mice

Molecules ◽  
2020 ◽  
Vol 25 (13) ◽  
pp. 3057
Author(s):  
Chang-Mu Chen ◽  
Min-Ni Chung ◽  
Chen-Yuan Chiu ◽  
Shing-Hwa Liu ◽  
Kuo-Cheng Lan
Keyword(s):  
Drinking Water ◽  
Protein Expression ◽  
Muscle Mass ◽  
Muscle Atrophy ◽  
Arsenic Exposure ◽  
Inorganic Arsenic ◽  
Cross Sectional Area ◽  
Muscle Endurance ◽  
Sectional Area ◽  
Cross Sectional

Arsenic is a toxic metalloid. Infants with a low birth-weight have been observed in areas with high-level arsenic in drinking water ranging from 463 to 1025 μg/L. A distal muscular atrophy side effect has been observed in acute promyelocytic leukemia patients treated with arsenic trioxide (As2O3) for therapy. The potential of As2O3 on muscle atrophy remains to be clarified. In this study, the myoatrophic effect of arsenic was evaluated in normal mice and sciatic nerve denervated mice exposed with or without As2O3 (0.05 and 0.5 ppm) in drinking water for 4 weeks. We found that both 0.05 and 0.5 ppm As2O3 increased the fasting plasma glucose level; but only 0.5 ppm arsenic exposure significantly decreased muscle mass, muscle endurance, and cross-sectional area of muscle fibers, and increased muscle Atrogin-1 protein expression in the normal mice. Both 0.05 and 0.5 ppm As2O3 also significantly enhanced the inhibitory effects on muscle endurance, muscle mass, and cross-sectional area of muscle fibers, and increased the effect on muscle Atrogin-1 protein expression in the denervated mice. These in vivo results suggest that inorganic arsenic at doses relevant to humans may possess myoatrophic potential.

Intra- and inter-rater reliability in the cross-sectional area of feline lumbar epaxial musculature evaluated via abdominal CT scan

2019 ◽  
Vol 22 (8) ◽  
pp. 721-728
Author(s):  
Laura H Rayhel ◽  
Jessica M Quimby ◽  
Eric M Green ◽  
Valerie J Parker ◽  
Shasha Bai
Keyword(s):  
Ct Scan ◽  
Muscle Mass ◽  
Ct Images ◽  
Cross Sectional Area ◽  
Area Measurement ◽  
Thoracic Vertebrae ◽  
Sectional Area ◽  
Cross Sectional ◽  
Rater Reliability ◽  
Epaxial Muscle

Objectives The aim of this study was to evaluate the intra- and inter-rater reliability of epaxial muscle cross-sectional area measurement on feline CT images and to determine the relationship between normalized epaxial muscle area (EMA) and subjective muscle condition score (MCS). Methods Feline transverse CT images including the junction of the 13th thoracic vertebrae/13th rib head were retrospectively reviewed. Right and left epaxial muscle circumference and vertebral body height were measured and an average normalized EMA (ratio of epaxial area:vertebral height) was calculated for each image. Measurements were performed by three individuals blinded to the clinical data and were repeated 1 month later. Intra- and inter-rater reliability of EMA was assessed with concordance correlation coefficient (CCC), and Bland–Altman analysis was performed to assess bias and limits of agreement (LoA) between and within observers at different time points. In cats for which MCS data were available, EMA was compared between differing MCSs via the Kruskal–Wallis test, with Bonferroni-corrected Wilcoxon rank-sum post-hoc analysis. Results In total, 101 CT scans met the inclusion criteria for reliability analysis, 29 of which had muscle condition information available for analysis. Intra-rater EMA CCC ranged from 0.84 to 0.99 with minimal bias (range –0.16 to 0.08) and narrow LoA. Inter-rater EMA CCC ranged from 0.87 to 0.94, bias was larger (range –0.46 to 0.66) and LoA were wider when assessed between observers. Median EMA was significantly lower in cats with severe muscle atrophy (2.76, range 1.28–3.96) than in all other MCS groups ( P <0.0001 for all comparisons). Conclusions and relevance Measurement of EMA on CT showed strong intra-rater reliability, and median EMA measurements were significantly lower in cats with severe muscle wasting, as assessed on physical examination. Further studies correlating EMA to lean muscle mass in cats are needed to determine whether this method may be useful to quantify muscle mass in patients undergoing a CT scan.

scholarly journals The Effects of Calcium-β-Hydroxy-β-Methylbutyrate on Aging-Associated Apoptotic Signaling and Muscle Mass and Function in Unloaded but Nonatrophied Extensor Digitorum Longus Muscles of Aged Rats

2020 ◽  
Vol 2020 ◽  
pp. 1-18
Author(s):  
Brian T. Bennett ◽  
Junaith S. Mohamed ◽  
Stephen E. Alway
Keyword(s):  
Muscle Mass ◽  
Satellite Cells ◽  
Muscle Function ◽  
Extensor Digitorum Longus ◽  
Cross Sectional Area ◽  
Extensor Digitorum ◽  
Aged Rats ◽  
Sectional Area ◽  
Cross Sectional ◽  
Apoptotic Signaling

Beta-hydroxy-beta-methylbutyrate (HMB), a naturally occurring leucine metabolite, has been shown to attenuate plantar flexor muscle loss and increase myogenic stem cell activation during reloading after a period of significant muscle wasting by disuse in old rodents. However, it was less clear if HMB would alter dorsiflexor muscle response to unloading or reloading when there was no significant atrophy that was induced by unloading. In this study, we tested if calcium HMB (Ca-HMB) would improve muscle function and alter apoptotic signaling in the extensor digitorum longus (EDL) of aged animals that were unloaded but did not undergo atrophy. The EDL muscle was unloaded for 14 days by hindlimb suspension (HS) in aged (34-36 mo.) male Fisher 344×Brown Norway rats. The rats were removed from HS and allowed normal cage ambulation for 14 days of reloading (R). Throughout the study, the rats were gavaged daily with 170 mg of Ca-HMB or water 7 days prior to HS, then throughout 14 days of HS and 14 days of recovery after removing HS. The animals’ body weights were significantly reduced by ~18% after 14 days of HS and continued to decline by ~22% during R as compared to control conditions; however, despite unloading, EDL did not atrophy by HS, nor did it increase in mass after R. No changes were observed in EDL twitch contraction time, force production, fatigue resistance, fiber cross-sectional area, or markers of nuclear apoptosis (myonuclei + satellite cells) after HS or R. While HS and R increased the proapoptotic Bax protein abundance, BCL-2 abundance was also increased as was the frequency of TUNEL-positive myonuclei and satellite cells, yet muscle mass and fiber cross-sectional area did not change and Ca-HMB treatment had no effect reducing apoptotic signaling. These data indicate that (i) increased apoptotic signaling preceded muscle atrophy or occurred without significant EDL atrophy and (ii) that Ca-HMB treatment did not improve EDL signaling, muscle mass, or muscle function in aged rats, when HS and R did not impact mass or function.

Rectus femoris cross-sectional area in COPD: are there functionally relevant cut-points?

2017 ◽  
Author(s):  
Suhani Patel ◽  
Claire M Nolan ◽  
Ruth E Barker ◽  
Sarah E Jones ◽  
Matthew M Maddocks ◽  
...  
Keyword(s):  
Rectus Femoris ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Cut Points
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