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09.03.2016 | Musculoskeletal | Ausgabe 12/2016

European Radiology 12/2016

Adipose tissue and muscle attenuation as novel biomarkers predicting mortality in patients with extremity sarcomas

Zeitschrift:
European Radiology > Ausgabe 12/2016
Autoren:
Joyce Veld, Josephina A. Vossen, Karen De Amorim Bernstein, Elkan F. Halpern, Martin Torriani, Miriam A. Bredella
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00330-016-4306-6) contains supplementary material, which is available to authorized users.

Abstract

Objectives

To assess CT-attenuation of abdominal adipose tissue and psoas muscle as predictors of mortality in patients with sarcomas of the extremities.

Methods

Our study was IRB approved and HIPAA compliant. The study group comprised 135 patients with history of extremity sarcoma (mean age: 53 ± 17 years) who underwent whole body PET/CT. Abdominal subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and psoas muscle attenuation (HU) was assessed on non-contrast, attenuation-correction CT. Clinical information including survival, tumour stage, sarcoma type, therapy and pre-existing comorbidities were recorded. Cox proportional hazard models were used to determine longitudinal associations between adipose tissue and muscle attenuation and mortality.

Results

There were 47 deaths over a mean follow-up period of 20 ± 17 months. Higher SAT and lower psoas attenuation were associated with increased mortality (p = 0.03 and p = 0.005, respectively), which remained significant after adjustment for age, BMI, sex, tumor stage, therapy, and comorbidities (p = 0.002 and p = 0.02, respectively). VAT attenuation was not associated with mortality.

Conclusion

Attenuation of SAT and psoas muscle, assessed on non-contrast CT, are predictors of mortality in patients with extremity sarcomas, independent of other established prognostic factors, suggesting that adipose tissue and muscle attenuation could serve as novel biomarkers for mortality in patients with sarcomas.

Key Points

CT-attenuation of adipose tissue and muscle predict mortality in sarcoma patients
CT-attenuation predicts mortality independent of established prognostic factors
Patients with sarcomas often undergo CT for staging or surveillance
Adipose tissue and muscle attenuation could serve as biomarkers for mortality

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