Skip to main content
Erschienen in:

10.11.2021 | Technical Report

Utility of multidetector computed tomography quantitative measurements in identifying sarcopenia: a propensity score matched study

verfasst von: Yu-Qiang Zuo, Zhi-Hong Gao, Zheng Wang, Qing Liu, Xu Yang, Yu-Ling Yin, Ping-Yong Feng

Erschienen in: Skeletal Radiology | Ausgabe 6/2022

Einloggen, um Zugang zu erhalten

Abstract

Objective

To evaluate the utility of multidetector computed tomography MDCT quantitative measurements in identifying sarcopenia.

Materials and methods

The clinical data and MDCT images of 64 patients of sarcopenia and 184 non-sarcopenic participants between October 2020 and January 2021were retrospectively analyzed. Propensity score matching was used to match the sarcopenic patients with the non-sarcopenic participants. Two radiologists independently measured the cross-sectional area (CSA) of skeletal muscle and intramuscular fat tissue and CT density of skeletal muscle at the middle L3 vertebral level on CT images of all participants. Intra-observer agreement was evaluated via intraclass correlation coefficients (ICC). A receiver operating characteristic (ROC) curve was built for each variable. Correlations between CT parameters and clinical data were assessed via Pearson or Spearman correlation coefficient.

Results

A total of 74 participants (mean age 72 ± 4 years, range 66–85 years; 38 men and 36 women) were included, comprising 37 sarcopenic patients and 37 non-sarcopenic participants. There were no significant intergroup differences regarding age, sex ratio, and body mass index (BMI) (P < 0.05). The CSA and density of skeletal muscle measured by two radiologists were reliable (ICC ≥ 0.75, P < 0.001). Compared with the sarcopenic group, the non-sarcopenic group had a significantly greater CSA and CT density of the total skeletal muscle (TSM) and paraspinal skeletal muscle (PSM) and skeletal muscle index at L3 level (L3 SMI) (P < 0.05). The fat infiltration ratio (FIR) of TSM, PSM, and psoas muscle was significantly higher in the sarcopenic group than that in non-sarcopenic participants (P < 0.05). ROC curve analysis showed the PSM FIR + PSM CT density (PSM D) had the best predictive value for sarcopenia (AUC = 0.836). The PSM FIR and age were moderately positively correlated (r = 0.410, P < 0.001).

Conclusion

Fat infiltration of skeletal muscle had better predictive value than L3 SMI in the diagnosis of sarcopenic. The PSM FIR + PSMD had the best predictive value for sarcopenia, which was moderately positively correlated with age.
Literatur
1.
Zurück zum Zitat Lee K, Shin Y, Huh J, et al. Recent issues on body composition imaging for sarcopenia evaluation [J]. Korean J Radiol. 2019;220(2):205–17.CrossRef Lee K, Shin Y, Huh J, et al. Recent issues on body composition imaging for sarcopenia evaluation [J]. Korean J Radiol. 2019;220(2):205–17.CrossRef
2.
Zurück zum Zitat Pinto Dos Santos D, Kloeckner R, Koch S, et al. Sarcopenia as prognostic factor for survival after orthotopic liver transplantation[J]. Eur J Gastroenterol Hepatol. 2020;32(5):626–35.PubMedCrossRef Pinto Dos Santos D, Kloeckner R, Koch S, et al. Sarcopenia as prognostic factor for survival after orthotopic liver transplantation[J]. Eur J Gastroenterol Hepatol. 2020;32(5):626–35.PubMedCrossRef
3.
Zurück zum Zitat Onishi S, Tajika M, Tanaka T, et al. Prognostic significance of sarcopenia in patients with unresectable advanced esophageal cancer. J Clin Med. 2019;8(10):1647.PubMedCentralCrossRef Onishi S, Tajika M, Tanaka T, et al. Prognostic significance of sarcopenia in patients with unresectable advanced esophageal cancer. J Clin Med. 2019;8(10):1647.PubMedCentralCrossRef
4.
Zurück zum Zitat Dong Q. Fully-automated segmentation of muscle measurement on CT in detecting central sarcopenia: a trend of standardization. Acad Radiol. 2020;27(3):321–2.PubMedCrossRef Dong Q. Fully-automated segmentation of muscle measurement on CT in detecting central sarcopenia: a trend of standardization. Acad Radiol. 2020;27(3):321–2.PubMedCrossRef
5.
Zurück zum Zitat Taguchi S, Akamatsu N, Nakagawa T, et al. Sarcopenia evaluated using the skeletal muscle index is a significant prognostic factor for metastatic urothelial carcinoma. Clin Genitourin Cancer. 2016;14(3):237–43.PubMedCrossRef Taguchi S, Akamatsu N, Nakagawa T, et al. Sarcopenia evaluated using the skeletal muscle index is a significant prognostic factor for metastatic urothelial carcinoma. Clin Genitourin Cancer. 2016;14(3):237–43.PubMedCrossRef
6.
Zurück zum Zitat Schweitzer L, Geisler C, Pourhassan M, et al. What is the best reference site for a single MRI slice to assess whole-body skeletal muscle and adipose tissue volumes in healthy adults? Am J Clin Nutr. 2015;102(1):58–65.PubMedCrossRef Schweitzer L, Geisler C, Pourhassan M, et al. What is the best reference site for a single MRI slice to assess whole-body skeletal muscle and adipose tissue volumes in healthy adults? Am J Clin Nutr. 2015;102(1):58–65.PubMedCrossRef
7.
Zurück zum Zitat Prado CM, Lieffers JR, McCargar LJ, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumors of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol. 2008;9(7):629–35.PubMedCrossRef Prado CM, Lieffers JR, McCargar LJ, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumors of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol. 2008;9(7):629–35.PubMedCrossRef
8.
Zurück zum Zitat Van Rijssen LB, Van Huijgevoort NC, Coelen RJ, et al. Skeletal muscle quality is associated with worse survival after pancreatoduodenectomy for periampullary, nonpancreatic cancer. Ann Surg Oncol. 2017;24(1):272–80.PubMedCrossRef Van Rijssen LB, Van Huijgevoort NC, Coelen RJ, et al. Skeletal muscle quality is associated with worse survival after pancreatoduodenectomy for periampullary, nonpancreatic cancer. Ann Surg Oncol. 2017;24(1):272–80.PubMedCrossRef
9.
Zurück zum Zitat Iritani S, Imai K, Takai K, et al. Skeletal muscle depletion is an independent prognostic factor for hepatocellular carcinoma. J Gastroenterol. 2015;50(3):323–32.PubMedCrossRef Iritani S, Imai K, Takai K, et al. Skeletal muscle depletion is an independent prognostic factor for hepatocellular carcinoma. J Gastroenterol. 2015;50(3):323–32.PubMedCrossRef
10.
Zurück zum Zitat Nakamura N, Hara T, Shibata Y, et al. Sarcopenia is an independent prognostic factor in male patients with diffuse large B-cell lymphoma. Ann Hematol. 2015;94(12):2043–53.PubMedCrossRef Nakamura N, Hara T, Shibata Y, et al. Sarcopenia is an independent prognostic factor in male patients with diffuse large B-cell lymphoma. Ann Hematol. 2015;94(12):2043–53.PubMedCrossRef
11.
Zurück zum Zitat Cho KM, Park HY, Oh DY, et al. Skeletal muscle depletion predicts survival of patients with advanced biliary tract cancer undergoing palliative chemotherapy. Oncotarget. 2017;8(45):79441–52.PubMedPubMedCentralCrossRef Cho KM, Park HY, Oh DY, et al. Skeletal muscle depletion predicts survival of patients with advanced biliary tract cancer undergoing palliative chemotherapy. Oncotarget. 2017;8(45):79441–52.PubMedPubMedCentralCrossRef
12.
Zurück zum Zitat Choi Y, Oh DY, Kim TY, et al. Skeletal muscle depletion predicts the prognosis of patients with advanced pancreatic cancer undergoing palliative chemotherapy, independent of body mass index. PLoS One. 2015;10(10):e0139749.PubMedPubMedCentralCrossRef Choi Y, Oh DY, Kim TY, et al. Skeletal muscle depletion predicts the prognosis of patients with advanced pancreatic cancer undergoing palliative chemotherapy, independent of body mass index. PLoS One. 2015;10(10):e0139749.PubMedPubMedCentralCrossRef
13.
Zurück zum Zitat Camastra S, Vitali A, Anselmino M, et al. Muscle and adipose tissue morphology, insulin sensitivity and beta-cell function in diabetic and nondiabetic obese patients: effects of bariatric surgery[J]. Sci Rep. 2017;7(1):9007.PubMedPubMedCentralCrossRef Camastra S, Vitali A, Anselmino M, et al. Muscle and adipose tissue morphology, insulin sensitivity and beta-cell function in diabetic and nondiabetic obese patients: effects of bariatric surgery[J]. Sci Rep. 2017;7(1):9007.PubMedPubMedCentralCrossRef
14.
Zurück zum Zitat Jankowski CM, Gozansky WS, Van Pelt RE, et al. Relative contributions of adiposity and muscularity to physical function in community-dwelling older adults[J]. Obesity (Silver Spring). 2008;16(5):1039–44.CrossRef Jankowski CM, Gozansky WS, Van Pelt RE, et al. Relative contributions of adiposity and muscularity to physical function in community-dwelling older adults[J]. Obesity (Silver Spring). 2008;16(5):1039–44.CrossRef
15.
Zurück zum Zitat Hamrick MW, McGee-Lawrence ME, Frechette DM. Fatty infiltration of skeletal muscle: mechanisms and comparisons with bone marrow adiposity[J]. Front Endocrinol (Lausanne). 2016;7:69.CrossRef Hamrick MW, McGee-Lawrence ME, Frechette DM. Fatty infiltration of skeletal muscle: mechanisms and comparisons with bone marrow adiposity[J]. Front Endocrinol (Lausanne). 2016;7:69.CrossRef
16.
Zurück zum Zitat Goodpaster BH, Kelly DE, Thaete FL, et al. Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content[J]. J Appl Physiol (1985). 2000;89(1):104–10.CrossRef Goodpaster BH, Kelly DE, Thaete FL, et al. Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content[J]. J Appl Physiol (1985). 2000;89(1):104–10.CrossRef
17.
Zurück zum Zitat Chen LK, Woo J, Assantachai P, et al. Asian working group for sarcopenia:2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21(3):300–7.PubMedCrossRef Chen LK, Woo J, Assantachai P, et al. Asian working group for sarcopenia:2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21(3):300–7.PubMedCrossRef
18.
Zurück zum Zitat Sinelnikov A, Qu CX, Fetzer D, et al. Measurement of skeletal muscle area: comparison of CT and MR imaging. Eur J Radiol. 2016;85(10):1716–21.PubMedCrossRef Sinelnikov A, Qu CX, Fetzer D, et al. Measurement of skeletal muscle area: comparison of CT and MR imaging. Eur J Radiol. 2016;85(10):1716–21.PubMedCrossRef
19.
Zurück zum Zitat Beattie K, Davison MJ, Noseworthy M, et al. Quantifying fat and lean muscle in the lower legs of women with knee osteoarthritis using two different MRI systems. Rheumatol Int. 2016;36(6):855–62.PubMedCrossRef Beattie K, Davison MJ, Noseworthy M, et al. Quantifying fat and lean muscle in the lower legs of women with knee osteoarthritis using two different MRI systems. Rheumatol Int. 2016;36(6):855–62.PubMedCrossRef
20.
Zurück zum Zitat Antoun S, Lanoy E, Albiges-Sauvin L, et al. Clinical implications of body composition assessment by computed tomography in metastatic renal cell carcinoma. Expert Rev Anticancer Ther. 2014;14(3):279–88. Antoun S, Lanoy E, Albiges-Sauvin L, et al. Clinical implications of body composition assessment by computed tomography in metastatic renal cell carcinoma. Expert Rev Anticancer Ther. 2014;14(3):279–88.
21.
Zurück zum Zitat Khan AI, Reiter DA, Sekhar A, et al. MRI quantitation of abdominal skeletal muscle correlates with CT-based analysis: implications for sarcopenia measurement. Appl Physiol Nutr Metab. 2019;44(8):814–9.PubMedCrossRef Khan AI, Reiter DA, Sekhar A, et al. MRI quantitation of abdominal skeletal muscle correlates with CT-based analysis: implications for sarcopenia measurement. Appl Physiol Nutr Metab. 2019;44(8):814–9.PubMedCrossRef
22.
Zurück zum Zitat Prasetyo M, Nindita N, Murdana IN, et al. Computed tomography evaluation of fat infiltration ratio of the multifidus muscle in chronic low back pain patients. Eur J Radiol Open. 2020;7:100293.PubMedPubMedCentralCrossRef Prasetyo M, Nindita N, Murdana IN, et al. Computed tomography evaluation of fat infiltration ratio of the multifidus muscle in chronic low back pain patients. Eur J Radiol Open. 2020;7:100293.PubMedPubMedCentralCrossRef
23.
Zurück zum Zitat Albano D, Messina C, Vitale J, et al. Imaging of sarcopenia: old evidence and new insights. Eur Radiol. 2020;30(4):2199–208.PubMedCrossRef Albano D, Messina C, Vitale J, et al. Imaging of sarcopenia: old evidence and new insights. Eur Radiol. 2020;30(4):2199–208.PubMedCrossRef
24.
Zurück zum Zitat Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on sarcopenia in older people. Age Ageing. 2010;39(4):412–23.PubMedPubMedCentralCrossRef Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on sarcopenia in older people. Age Ageing. 2010;39(4):412–23.PubMedPubMedCentralCrossRef
25.
Zurück zum Zitat Brioche T, Pagano AF, Py G, et al. Muscle wasting and aging: experimental models, fatty infiltrations, and prevention. Mol Aspects Med. 2016;50:56–87.PubMedCrossRef Brioche T, Pagano AF, Py G, et al. Muscle wasting and aging: experimental models, fatty infiltrations, and prevention. Mol Aspects Med. 2016;50:56–87.PubMedCrossRef
26.
Zurück zum Zitat Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.PubMedCrossRef Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.PubMedCrossRef
27.
Zurück zum Zitat Kalichman L, Carmeli E, Been E. The association between imaging parameters of the paraspinal muscles, spinal degeneration, and low back pain. Biomed Res Int. 2017;2017:2562957.PubMedPubMedCentralCrossRef Kalichman L, Carmeli E, Been E. The association between imaging parameters of the paraspinal muscles, spinal degeneration, and low back pain. Biomed Res Int. 2017;2017:2562957.PubMedPubMedCentralCrossRef
28.
Zurück zum Zitat Ranson CA, Burnett AF, Kerslake R, et al. An investigation into the use of MR imaging to determine the functional cross-sectional area of lumbar paraspinal muscles. Eur Spine J. 2006;15:764–73.PubMedCrossRef Ranson CA, Burnett AF, Kerslake R, et al. An investigation into the use of MR imaging to determine the functional cross-sectional area of lumbar paraspinal muscles. Eur Spine J. 2006;15:764–73.PubMedCrossRef
29.
Zurück zum Zitat Hicks GE, Simonsick EM, Harris TB, et al. Cross-sectional associations between trunk muscle composition, back pain, and physical function in the health, aging and body composition study. J Gerontol A Biol Sci Med Sci. 2005;60(7):882–7.PubMedCrossRef Hicks GE, Simonsick EM, Harris TB, et al. Cross-sectional associations between trunk muscle composition, back pain, and physical function in the health, aging and body composition study. J Gerontol A Biol Sci Med Sci. 2005;60(7):882–7.PubMedCrossRef
30.
Zurück zum Zitat Kim WJ, Kim KJ, Song DG, et al. Sarcopenia and back muscle degeneration as risk factors for back pain: a comparative study. Asian Spine J. 2020;14(3):364–72.PubMedPubMedCentralCrossRef Kim WJ, Kim KJ, Song DG, et al. Sarcopenia and back muscle degeneration as risk factors for back pain: a comparative study. Asian Spine J. 2020;14(3):364–72.PubMedPubMedCentralCrossRef
31.
Zurück zum Zitat Kalichman L, Hodges P, Li L, et al. Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study. Eur Spine J. 2010;19(7):1136–44.PubMedCrossRef Kalichman L, Hodges P, Li L, et al. Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study. Eur Spine J. 2010;19(7):1136–44.PubMedCrossRef
32.
Zurück zum Zitat Kalichman L, Klindukhov A, Li L, et al. Indices of paraspinal muscles degeneration: reliability and association with facet joint osteoarthritis: feasibility study. Clin Spine Surg. 2016;29(9):465–70.PubMedCrossRef Kalichman L, Klindukhov A, Li L, et al. Indices of paraspinal muscles degeneration: reliability and association with facet joint osteoarthritis: feasibility study. Clin Spine Surg. 2016;29(9):465–70.PubMedCrossRef
33.
Zurück zum Zitat Termote JL, Baert A, Crolla D, et al. Computed tomography of the normal and pathologic muscular system. Radiology. 1980;137(2):439–44.PubMedCrossRef Termote JL, Baert A, Crolla D, et al. Computed tomography of the normal and pathologic muscular system. Radiology. 1980;137(2):439–44.PubMedCrossRef
34.
Zurück zum Zitat Roubenoff R. Sarcopenia and its implications for the elderly. Eur J Clin Nutr. 2000;54(Supp. 3):S40-47.PubMedCrossRef Roubenoff R. Sarcopenia and its implications for the elderly. Eur J Clin Nutr. 2000;54(Supp. 3):S40-47.PubMedCrossRef
35.
Zurück zum Zitat Jones DA, Rutherford OM, Parker DF. Physiological changes in skeletal muscle as a results of strength training. Q J Exp Physiol. 1989;74:233–56.PubMedCrossRef Jones DA, Rutherford OM, Parker DF. Physiological changes in skeletal muscle as a results of strength training. Q J Exp Physiol. 1989;74:233–56.PubMedCrossRef
36.
Zurück zum Zitat Goodpaster BH, Kelly DE, Thaete FL, et al. Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content[J]. J Appl Physiol (1985). 2000;89(1):104–10.CrossRef Goodpaster BH, Kelly DE, Thaete FL, et al. Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content[J]. J Appl Physiol (1985). 2000;89(1):104–10.CrossRef
37.
Zurück zum Zitat Sebro R, O’Brien L, Torriani M, et al. Assessment of trunk muscle density using CT and its association with degenerative disc and facet joint disease of the lumbar spine. Skeletal Radiol. 2016;45(9):1221–6.PubMedCrossRef Sebro R, O’Brien L, Torriani M, et al. Assessment of trunk muscle density using CT and its association with degenerative disc and facet joint disease of the lumbar spine. Skeletal Radiol. 2016;45(9):1221–6.PubMedCrossRef
38.
Zurück zum Zitat Takayama K, Kita T, Nakamura H, et al. New predictive index for lumbar paraspinal muscle degeneration associated with aging. Spine (Phila Pa 1976). 2016;41(2):E84-90.CrossRef Takayama K, Kita T, Nakamura H, et al. New predictive index for lumbar paraspinal muscle degeneration associated with aging. Spine (Phila Pa 1976). 2016;41(2):E84-90.CrossRef
39.
Zurück zum Zitat Roberto V, Gabriella M, Franzin C, et al. The origin of intermuscular adipose tissue and its pathophysiological implications. Am J Physiol Endocrinol Metab. 2009;297(5):E987-998.CrossRef Roberto V, Gabriella M, Franzin C, et al. The origin of intermuscular adipose tissue and its pathophysiological implications. Am J Physiol Endocrinol Metab. 2009;297(5):E987-998.CrossRef
40.
41.
Zurück zum Zitat Parkkola R, Kormano M. Lumbar disc and back muscle degeneration on MRI: correlation to age and body mass. J Spinal Disord. 1992;5(1):86–92.PubMedCrossRef Parkkola R, Kormano M. Lumbar disc and back muscle degeneration on MRI: correlation to age and body mass. J Spinal Disord. 1992;5(1):86–92.PubMedCrossRef
42.
Zurück zum Zitat Kjaer P, Bendix T, Sorensen JS, et al. Are MRI-defined fat infiltration in the multifidus muscles associated with low back pain? BMC Med. 2007;5:2.PubMedPubMedCentralCrossRef Kjaer P, Bendix T, Sorensen JS, et al. Are MRI-defined fat infiltration in the multifidus muscles associated with low back pain? BMC Med. 2007;5:2.PubMedPubMedCentralCrossRef
Metadaten
Titel
Utility of multidetector computed tomography quantitative measurements in identifying sarcopenia: a propensity score matched study
verfasst von
Yu-Qiang Zuo
Zhi-Hong Gao
Zheng Wang
Qing Liu
Xu Yang
Yu-Ling Yin
Ping-Yong Feng
Publikationsdatum
10.11.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 6/2022
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-021-03953-y

Neu im Fachgebiet Radiologie

Ringen um den richtigen Umgang mit Zufallsbefunden

Wenn 2026 in Deutschland das Lungenkrebsscreening mittels Low-Dose-Computertomografie (LDCT) eingeführt wird, wird es auch viele Zufallsbefunde ans Licht bringen. Das birgt Chancen und Risiken.

Bald 5% der Krebserkrankungen durch CT verursacht

Die jährlich rund 93 Millionen CTs in den USA könnten künftig zu über 100.000 zusätzlichen Krebserkrankungen führen, geht aus einer Modellrechnung hervor. Damit würde eine von 20 Krebserkrankungen auf die ionisierende Strahlung bei CT-Untersuchungen zurückgehen.

Röntgen-Thorax oder LDCT fürs Lungenscreening nach HNSCC?

Personen, die an einem Plattenepithelkarzinom im Kopf-Hals-Bereich erkrankt sind, haben ein erhöhtes Risiko für Metastasen oder zweite Primärmalignome der Lunge. Eine Studie hat untersucht, wie die radiologische Überwachung aussehen sollte.

Statine: Was der G-BA-Beschluss für Praxen bedeutet

Nach dem G-BA-Beschluss zur erweiterten Verordnungsfähigkeit von Lipidsenkern rechnet die DEGAM mit 200 bis 300 neuen Dauerpatienten pro Praxis. Im Interview erläutert Präsidiumsmitglied Erika Baum, wie Hausärztinnen und Hausärzte am besten vorgehen.

Update Radiologie

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