Assessing skeletal muscle mass based on the cross-sectional area of muscles at the 12th thoracic vertebra level on computed tomography in patients with oral squamous cell carcinoma

Matsuyama, Remi; Maeda, Keisuke; Yamanaka, Yasunari; Ishida, Yuria; Kato, Ryoko; Nonogaki, Tomoyuki; Shimizu, Akio; Ueshima, Junko; Kazaoka, Yoshiaki; Hayashi, Tomio; Ito, Kunihiro; Furuhashi, Akifumi; Ono, Takayuki

doi:10.1016/j.oraloncology.2020.105126

Cited by 13 publications

(12 citation statements)

References 29 publications

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“…Ishida et al found a comparable correlation between L3 and Th12 in 161 hospitalized patients aged 65 years and older (r = 0.858) [32]. Matsuyama et al describe a slightly superior correlation between L3 and Th12 in 164 Japanese oral squamous cell carcinoma patients aged 40 and over (r = 0.915) [33]. These studies were both performed at Japanese hospitals and therefore most patients were likely of Asian ethnicity.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of assessment of skeletal muscle mass on a single cross-sectional image at the level of the fourth thoracic vertebra

Heusden¹,

Swartz²,

Chargi³

et al. 2021

European Journal of Radiology

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Background: Skeletal muscle mass (SMM) determined on computed tomography (CT) is emerging as a novel imaging biomarker. Cross-sectional area (CSA) of SMM at the level of the third lumbar vertebra (L3) on abdominal imaging is considered the clinical reference standard for measuring SMM. In certain patient groups, such as those with oncological or non-oncological lung disease like COVID-19, a chest CT may be available while an abdominal CT is not. The purpose of this study was to investigate whether determining SMM on a chest CT is a feasible alternative to abdominal CT. Research question: What is the correlation between SMM measurements at the level of L3 and the level of the fourth thoracic vertebra (Th4)? Study design and methods: In this study we retrospectively analyzed abdominal and thoracic series of whole-body CT-scans of trauma patients (N = 47) and head and neck cancer patients (N = 194). All abdominal muscles were delineated on a single axial slice at the level of L3. The erector spinae, levator scapulae, rhomboideus minor and major and pectoralis minor and major muscles were delineated on a single axial slice at the level of Th4. CSA of the muscles at Th4 and the L3 level were compared using linear regression, and a multivariate linear regression model was established. Results: Muscle CSA at level Th4 strongly correlates with L3 muscle CSA (r = 0.791, p < 0.05). A multivariate model incorporating the patient characteristics arm positioning, age, sex, and weight achieved a stronger correlation (r = 0.856, p < 0.05). Interpretation: Skeletal muscle CSA measured at the level of Th4 is a feasible alternative to measurements at L3. This allows diagnosing low SMM using clinically available thoracic CT-scans. SMM measurements at the level of Th4 may become a prognostic or triage tool when faced with mechanical ventilator shortage.

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Section: Discussionmentioning

confidence: 99%

Feasibility of assessment of skeletal muscle mass on a single cross-sectional image at the level of the fourth thoracic vertebra

Heusden¹,

Swartz²,

Chargi³

et al. 2021

European Journal of Radiology

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“…When approximating the total volumes of these tissues, the most widely accepted level at which to perform 2D measurements is the 3rd lumbar vertebra (L3) (Tables 1 and 2) [44]. Other levels at which the single-slice BCA measurements have been measured include cervical spine (especially the 3 rd cervical vertebra) [45], the 12 th thoracic vertebra [46], other lumbar vertebrae [44] and various levels of thigh [44]. Anatomical landmarks, such as the vertebrae and other bony structures, are used as boundaries when performing volumetric measurements of adipose and muscle tissue compartments.…”

Section: D and 3d Measurements And The Applied Cut-off-values For The Ct-based Body Composition Metricsmentioning

confidence: 99%

Methodology, clinical applications, and future directions of body composition analysis using computed tomography (CT) images: A review

Tolonen

Pakarinen

Sassi

et al. 2021

European Journal of Radiology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…However, T12 is not a practical alternative landmark as it is even further away from the reach of a head and neck CT scan. 49 Pai et al as mentioned earlier, used CSA at T2 and compared this to L3-CSA, finding a strong correlation (r = 0.63 vs. 0.802); however, once again, agreement was not investigated. 18 The Taiwanese population in that study also had a much lower median BMI of 23.43 kg/m 2 .…”

Section: Discussionmentioning

confidence: 96%

“…Matsuyama et al examined CSA at T12 in 164 Japanese patients with oral squamous cell carcinoma, with their prediction model demonstrating very strong correlation ( r = 0.913). However, T12 is not a practical alternative landmark as it is even further away from the reach of a head and neck CT scan 49 . Pai et al as mentioned earlier, used CSA at T2 and compared this to L3‐CSA, finding a strong correlation ( r = 0.63 vs. 0.802); however, once again, agreement was not investigated 18 .…”

Section: Discussionmentioning

confidence: 99%

The use of the second thoracic vertebral landmark for skeletal muscle assessment and computed tomography‐defined sarcopenia evaluation in patients with head and neck cancer

et al. 2023

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Background:The cross-sectional area (CSA) of skeletal muscle (SM) at the third lumbar vertebra (L3) is used to determine computed tomography (CT)defined sarcopenia. We investigated the feasibility of SM assessment at the second thoracic vertebra (T2) in patients with head and neck cancer (HNC). Methods: Diagnostic PET-CT scans were used to develop a prediction model for L3-CSA using T2-CSA. Effectiveness of the model and cancer-specific survival (CSS) were investigated.Results: Scans of 111 patients (85% male) were evaluated. The predictive formula: L3-CSA (cm 2 ) = 174.15 + [0.212 Â T2-CSA (cm 2 )] -[40.032 Â sex] -[0.928 Â age (years)] + [0.285 Â weight (kg)] had good correlation r = 0.796, ICC = 0.882 (p < 0.001). SM index (SMI) mean difference (bias) was À3.6% (SD 10.2, 95% CI À8.7% to 1.3%). Sensitivity (82.8%), specificity (78.2%), with moderate agreement (ƙ = 0.540, p < 0.001). Worse 5-year CSS with lower quartile T2-SMI (51%, p = 0.003).

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Assessing skeletal muscle mass based on the cross-sectional area of muscles at the 12th thoracic vertebra level on computed tomography in patients with oral squamous cell carcinoma

Cited by 13 publications

References 29 publications

Feasibility of assessment of skeletal muscle mass on a single cross-sectional image at the level of the fourth thoracic vertebra

Feasibility of assessment of skeletal muscle mass on a single cross-sectional image at the level of the fourth thoracic vertebra

Methodology, clinical applications, and future directions of body composition analysis using computed tomography (CT) images: A review

The use of the second thoracic vertebral landmark for skeletal muscle assessment and computed tomography‐defined sarcopenia evaluation in patients with head and neck cancer

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