Skip to main content
Erschienen in: European Radiology 6/2018

09.01.2018 | Computed Tomography

Quantifying the effect of slice thickness, intravenous contrast and tube current on muscle segmentation: Implications for body composition analysis

verfasst von: Georg Fuchs, Yves R. Chretien, Julia Mario, Synho Do, Matthias Eikermann, Bob Liu, Kai Yang, Florian J. Fintelmann

Erschienen in: European Radiology | Ausgabe 6/2018

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To quantify the effect of IV contrast, tube current and slice thickness on skeletal muscle cross-sectional area (CSA) and density (SMD) on routine CT.

Methods

CSA and SMD were computed on 216 axial CT images obtained at the L3 level in 72 patients with variations in IV contrast, slice thickness and tube current. Intra-patient mean difference (MD), 95 % CI and limits of agreement were calculated using the Bland-Altman approach. Inter- and intra-analyst agreement was evaluated.

Results

IV contrast significantly increased CSA by 1.88 % (MD 2.33 cm2; 95 % CI 1.76–2.89) and SMD by 5.99 % (p<0.0001). Five mm slice thickness significantly increased mean CSA by 1.11 % compared to 2 mm images (1.32 cm2; 0.78–1.85) and significantly decreased SMD by 11.64 % (p<0.0001). Low tube current significantly decreased mean CSA by 4.79 % (6.44 cm2; 3.78–9.10) and significantly increased SMD by 46.46 % (p<0.0001). Inter- and intra-analyst agreement was excellent.

Conclusions

IV contrast, slice thickness and tube current significantly affect CSA and SMD. Investigators designing and analysing clinical trials using CT for body composition analysis should report CT acquisition parameters and consider the effect of slice thickness, IV contrast and tube current on myometric data.

Key Points

Intravenous contrast, slice thickness and tube current significantly affect myometric data.
Image acquisition parameter variations may obscure intrapatient muscle differences on serial measurements.
Investigators using CT for body composition analysis should report CT acquisition parameters.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Martin L, Birdsell L, Macdonald N et al (2013) Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol 31:1539–1547CrossRefPubMed Martin L, Birdsell L, Macdonald N et al (2013) Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol 31:1539–1547CrossRefPubMed
2.
Zurück zum Zitat Gomez-Perez SL, Haus JM, Sheean P et al (2016) Measuring Abdominal Circumference and Skeletal Muscle From a Single Cross-Sectional Computed Tomography Image: A Step-by-Step Guide for Clinicians Using National Institutes of Health ImageJ. JPEN J Parenter Enteral Nutr 40:308–318CrossRefPubMed Gomez-Perez SL, Haus JM, Sheean P et al (2016) Measuring Abdominal Circumference and Skeletal Muscle From a Single Cross-Sectional Computed Tomography Image: A Step-by-Step Guide for Clinicians Using National Institutes of Health ImageJ. JPEN J Parenter Enteral Nutr 40:308–318CrossRefPubMed
3.
Zurück zum Zitat Malietzis G, Johns N, Al-Hassi HO et al (2016) Low Muscularity and Myosteatosis Is Related to the Host Systemic Inflammatory Response in Patients Undergoing Surgery for Colorectal Cancer. Ann Surg 263:320–325CrossRefPubMed Malietzis G, Johns N, Al-Hassi HO et al (2016) Low Muscularity and Myosteatosis Is Related to the Host Systemic Inflammatory Response in Patients Undergoing Surgery for Colorectal Cancer. Ann Surg 263:320–325CrossRefPubMed
4.
Zurück zum Zitat Moisey LL, Mourtzakis M, Cotton BA et al (2013) Skeletal muscle predicts ventilator-free days, ICU-free days, and mortality in elderly ICU patients. Crit Care 17:R206CrossRefPubMedPubMedCentral Moisey LL, Mourtzakis M, Cotton BA et al (2013) Skeletal muscle predicts ventilator-free days, ICU-free days, and mortality in elderly ICU patients. Crit Care 17:R206CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Prado CM, Lieffers JR, McCargar LJ et al (2008) Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol 9:629–635CrossRefPubMed Prado CM, Lieffers JR, McCargar LJ et al (2008) Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol 9:629–635CrossRefPubMed
6.
Zurück zum Zitat Englesbe MJ, Lee JS, He K et al (2012) Analytic morphomics, core muscle size, and surgical outcomes. Ann Surg 256:255–261CrossRefPubMed Englesbe MJ, Lee JS, He K et al (2012) Analytic morphomics, core muscle size, and surgical outcomes. Ann Surg 256:255–261CrossRefPubMed
7.
Zurück zum Zitat Boutin RD, Yao L, Canter RJ, Lenchik L (2015) Sarcopenia: Current Concepts and Imaging Implications. AJR Am J Roentgenol 205:W255–W266CrossRefPubMed Boutin RD, Yao L, Canter RJ, Lenchik L (2015) Sarcopenia: Current Concepts and Imaging Implications. AJR Am J Roentgenol 205:W255–W266CrossRefPubMed
8.
Zurück zum Zitat Tamandl D, Paireder M, Asari R, Baltzer PA, Schoppmann SF, Ba-Ssalamah A (2015) Markers of sarcopenia quantified by computed tomography predict adverse long-term outcome in patients with resected oesophageal or gastro-oesophageal junction cancer. Eur Radiol. https://doi.org/10.1007/s00330-015-3963-1 Tamandl D, Paireder M, Asari R, Baltzer PA, Schoppmann SF, Ba-Ssalamah A (2015) Markers of sarcopenia quantified by computed tomography predict adverse long-term outcome in patients with resected oesophageal or gastro-oesophageal junction cancer. Eur Radiol. https://​doi.​org/​10.​1007/​s00330-015-3963-1
10.
Zurück zum Zitat Rollins KE, Tewari N, Ackner A et al (2016) The impact of sarcopenia and myosteatosis on outcomes of unresectable pancreatic cancer or distal cholangiocarcinoma. Clin Nutr 35:1103–1109CrossRefPubMed Rollins KE, Tewari N, Ackner A et al (2016) The impact of sarcopenia and myosteatosis on outcomes of unresectable pancreatic cancer or distal cholangiocarcinoma. Clin Nutr 35:1103–1109CrossRefPubMed
11.
Zurück zum Zitat Chu MP, Lieffers J, Ghosh S et al (2015) Skeletal muscle radio-density is an independent predictor of response and outcomes in follicular lymphoma treated with chemoimmunotherapy. PLoS One 10:e0127589CrossRefPubMedPubMedCentral Chu MP, Lieffers J, Ghosh S et al (2015) Skeletal muscle radio-density is an independent predictor of response and outcomes in follicular lymphoma treated with chemoimmunotherapy. PLoS One 10:e0127589CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Lee H, Troschel FM, Tajmir S et al (2017) Pixel-Level Deep Segmentation: Artificial Intelligence Quantifies Muscle on Computed Tomography for Body Morphometric Analysis. J Digit Imaging 30:487–498CrossRefPubMedPubMedCentral Lee H, Troschel FM, Tajmir S et al (2017) Pixel-Level Deep Segmentation: Artificial Intelligence Quantifies Muscle on Computed Tomography for Body Morphometric Analysis. J Digit Imaging 30:487–498CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Cohen JG, Goo JM, Yoo RE et al (2016) The effect of late-phase contrast enhancement on semi-automatic software measurements of CT attenuation and volume of part-solid nodules in lung adenocarcinomas. Eur J Radiol 85:1174–1180CrossRefPubMed Cohen JG, Goo JM, Yoo RE et al (2016) The effect of late-phase contrast enhancement on semi-automatic software measurements of CT attenuation and volume of part-solid nodules in lung adenocarcinomas. Eur J Radiol 85:1174–1180CrossRefPubMed
15.
Zurück zum Zitat Athelogou M, Kim HJ, Dima A et al (2016) Algorithm Variability in the Estimation of Lung Nodule Volume From Phantom CT Scans: Results of the QIBA 3A Public Challenge. Acad Radiol 23:940–952CrossRefPubMed Athelogou M, Kim HJ, Dima A et al (2016) Algorithm Variability in the Estimation of Lung Nodule Volume From Phantom CT Scans: Results of the QIBA 3A Public Challenge. Acad Radiol 23:940–952CrossRefPubMed
17.
Zurück zum Zitat Mitsiopoulos N, Baumgartner RN, Heymsfield SB, Lyons W, Gallagher D, Ross R (1998) Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol (1985) 85:115–122CrossRef Mitsiopoulos N, Baumgartner RN, Heymsfield SB, Lyons W, Gallagher D, Ross R (1998) Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol (1985) 85:115–122CrossRef
18.
Zurück zum Zitat Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310CrossRefPubMed Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310CrossRefPubMed
19.
Zurück zum Zitat Singh S, Kalra MK, Do S et al (2012) Comparison of hybrid and pure iterative reconstruction techniques with conventional filtered back projection: dose reduction potential in the abdomen. J Comput Assist Tomogr 36:347–353CrossRefPubMed Singh S, Kalra MK, Do S et al (2012) Comparison of hybrid and pure iterative reconstruction techniques with conventional filtered back projection: dose reduction potential in the abdomen. J Comput Assist Tomogr 36:347–353CrossRefPubMed
20.
Zurück zum Zitat Singh S, Kalra MK, Gilman MD et al (2011) Adaptive statistical iterative reconstruction technique for radiation dose reduction in chest CT: a pilot study. Radiology 259:565–573CrossRefPubMed Singh S, Kalra MK, Gilman MD et al (2011) Adaptive statistical iterative reconstruction technique for radiation dose reduction in chest CT: a pilot study. Radiology 259:565–573CrossRefPubMed
21.
Zurück zum Zitat Singh S, Kalra MK, Hsieh J et al (2010) Abdominal CT: comparison of adaptive statistical iterative and filtered back projection reconstruction techniques. Radiology 257:373–383CrossRefPubMed Singh S, Kalra MK, Hsieh J et al (2010) Abdominal CT: comparison of adaptive statistical iterative and filtered back projection reconstruction techniques. Radiology 257:373–383CrossRefPubMed
22.
Zurück zum Zitat Weijs PJ, Looijaard WG, Dekker IM et al (2014) Low skeletal muscle area is a risk factor for mortality in mechanically ventilated critically ill patients. Crit Care 18:R12CrossRefPubMedPubMedCentral Weijs PJ, Looijaard WG, Dekker IM et al (2014) Low skeletal muscle area is a risk factor for mortality in mechanically ventilated critically ill patients. Crit Care 18:R12CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Mueller N, Murthy S, Tainter CR et al (2016) Can Sarcopenia Quantified by Ultrasound of the Rectus Femoris Muscle Predict Adverse Outcome of Surgical Intensive Care Unit Patients as well as Frailty? A Prospective, Observational Cohort Study. Ann Surg 264:1116–1124CrossRefPubMedPubMedCentral Mueller N, Murthy S, Tainter CR et al (2016) Can Sarcopenia Quantified by Ultrasound of the Rectus Femoris Muscle Predict Adverse Outcome of Surgical Intensive Care Unit Patients as well as Frailty? A Prospective, Observational Cohort Study. Ann Surg 264:1116–1124CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Temel JS, Abernethy AP, Currow DC et al (2016) Anamorelin in patients with non-small-cell lung cancer and cachexia (ROMANA 1 and ROMANA 2): results from two randomised, double-blind, phase 3 trials. Lancet Oncol 17:519–531CrossRefPubMed Temel JS, Abernethy AP, Currow DC et al (2016) Anamorelin in patients with non-small-cell lung cancer and cachexia (ROMANA 1 and ROMANA 2): results from two randomised, double-blind, phase 3 trials. Lancet Oncol 17:519–531CrossRefPubMed
26.
Zurück zum Zitat Goodpaster BH, Kelley DE, Thaete FL, He J, Ross R (2000) Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content. J Appl Physiol (1985) 89:104–110CrossRef Goodpaster BH, Kelley DE, Thaete FL, He J, Ross R (2000) Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content. J Appl Physiol (1985) 89:104–110CrossRef
27.
Zurück zum Zitat Mamane S, Mullie L, Piazza N et al (2016) Psoas Muscle Area and All-Cause Mortality After Transcatheter Aortic Valve Replacement: The Montreal-Munich Study. Can J Cardiol 32:177–182CrossRefPubMed Mamane S, Mullie L, Piazza N et al (2016) Psoas Muscle Area and All-Cause Mortality After Transcatheter Aortic Valve Replacement: The Montreal-Munich Study. Can J Cardiol 32:177–182CrossRefPubMed
28.
Zurück zum Zitat Reisinger KW, van Vugt JL, Tegels JJ et al (2015) Functional compromise reflected by sarcopenia, frailty, and nutritional depletion predicts adverse postoperative outcome after colorectal cancer surgery. Ann Surg 261:345–352CrossRefPubMed Reisinger KW, van Vugt JL, Tegels JJ et al (2015) Functional compromise reflected by sarcopenia, frailty, and nutritional depletion predicts adverse postoperative outcome after colorectal cancer surgery. Ann Surg 261:345–352CrossRefPubMed
29.
Zurück zum Zitat Yip C, Dinkel C, Mahajan A, Siddique M, Cook GJ, Goh V (2015) Imaging body composition in cancer patients: visceral obesity, sarcopenia and sarcopenic obesity may impact on clinical outcome. Insights Imaging 6:489–497CrossRefPubMedPubMedCentral Yip C, Dinkel C, Mahajan A, Siddique M, Cook GJ, Goh V (2015) Imaging body composition in cancer patients: visceral obesity, sarcopenia and sarcopenic obesity may impact on clinical outcome. Insights Imaging 6:489–497CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Prado CM, Heymsfield SB (2014) Lean tissue imaging: a new era for nutritional assessment and intervention. JPEN J Parenter Enteral Nutr 38:940–953CrossRefPubMedPubMedCentral Prado CM, Heymsfield SB (2014) Lean tissue imaging: a new era for nutritional assessment and intervention. JPEN J Parenter Enteral Nutr 38:940–953CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Solomon JB, Christianson O, Samei E (2012) Quantitative comparison of noise texture across CT scanners from different manufacturers. Med Phys 39:6048–6055CrossRefPubMed Solomon JB, Christianson O, Samei E (2012) Quantitative comparison of noise texture across CT scanners from different manufacturers. Med Phys 39:6048–6055CrossRefPubMed
32.
Zurück zum Zitat Soderberg M, Gunnarsson M (2010) Automatic exposure control in computed tomography--an evaluation of systems from different manufacturers. Acta Radiol 51:625–634CrossRefPubMed Soderberg M, Gunnarsson M (2010) Automatic exposure control in computed tomography--an evaluation of systems from different manufacturers. Acta Radiol 51:625–634CrossRefPubMed
33.
Zurück zum Zitat Rosset A, Spadola L, Ratib O (2004) OsiriX: an open-source software for navigating in multidimensional DICOM images. J Digit Imaging 17:205–216CrossRefPubMedPubMedCentral Rosset A, Spadola L, Ratib O (2004) OsiriX: an open-source software for navigating in multidimensional DICOM images. J Digit Imaging 17:205–216CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Dello SA, Lodewick TM, van Dam RM et al (2013) Sarcopenia negatively affects preoperative total functional liver volume in patients undergoing liver resection. HPB (Oxford) 15:165–169CrossRef Dello SA, Lodewick TM, van Dam RM et al (2013) Sarcopenia negatively affects preoperative total functional liver volume in patients undergoing liver resection. HPB (Oxford) 15:165–169CrossRef
35.
Zurück zum Zitat Reisinger KW, Derikx JP, van Vugt JL et al (2016) Sarcopenia is associated with an increased inflammatory response to surgery in colorectal cancer. Clin Nutr 35:924–927CrossRefPubMed Reisinger KW, Derikx JP, van Vugt JL et al (2016) Sarcopenia is associated with an increased inflammatory response to surgery in colorectal cancer. Clin Nutr 35:924–927CrossRefPubMed
36.
Zurück zum Zitat Tegels JJ, van Vugt JL, Reisinger KW et al (2015) Sarcopenia is highly prevalent in patients undergoing surgery for gastric cancer but not associated with worse outcomes. J Surg Oncol 112:403–407CrossRefPubMed Tegels JJ, van Vugt JL, Reisinger KW et al (2015) Sarcopenia is highly prevalent in patients undergoing surgery for gastric cancer but not associated with worse outcomes. J Surg Oncol 112:403–407CrossRefPubMed
37.
Zurück zum Zitat Haak D, Page CE, Deserno TM (2016) A Survey of DICOM Viewer Software to Integrate Clinical Research and Medical Imaging. J Digit Imaging 29:206–215CrossRefPubMed Haak D, Page CE, Deserno TM (2016) A Survey of DICOM Viewer Software to Integrate Clinical Research and Medical Imaging. J Digit Imaging 29:206–215CrossRefPubMed
Metadaten
Titel
Quantifying the effect of slice thickness, intravenous contrast and tube current on muscle segmentation: Implications for body composition analysis
verfasst von
Georg Fuchs
Yves R. Chretien
Julia Mario
Synho Do
Matthias Eikermann
Bob Liu
Kai Yang
Florian J. Fintelmann
Publikationsdatum
09.01.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 6/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5191-3

Weitere Artikel der Ausgabe 6/2018

European Radiology 6/2018 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.