Body composition measurement using computed tomography: Does the phase of the scan matter?

Rollins, Katie E.; Javanmard‐Emamghissi, Hannah; Awwad, Amir; Macdonald, I. A.; Fearon, Kenneth C. H.; Lobo, Dileep N.

doi:10.1016/j.nut.2017.02.011

Cited by 64 publications

(64 citation statements)

References 24 publications

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“…also recommended using the portal‐venous phase of contrast‐enhanced CT for studies that describe the association between SMD and outcome measures to improve comparability between studies . Evaluating the association between SMD and outcomes, using CT images acquired with standardized protocol, would provide more comparable results in body composition studies . In this study, all CT images of patients were contrast enhanced and acquired with standardized protocol.…”

Section: Discussionmentioning

confidence: 96%

“…The clinically optimal and practical cut‐off values need to be determined in a larger cohort . In addition, it should also be noted that SMD change during treatment may not be comparable between unenhanced and contrast‐enhanced CT images . For example, contrast‐enhanced pretreatment CT images are not comparable with unenhanced post‐treatment CT images, as significant SMD decrease might be reported, which might be mainly due to the non‐enhanced image and not muscle loss.…”

Section: Discussionmentioning

confidence: 99%

“…65 Evaluating the association between SMD and outcomes, using CT images acquired with standardized protocol, would provide more comparable results in body composition studies. 66 In this study, all CT images of patients were contrast enhanced and acquired with standardized protocol. We observed that SMD change was independently associated with poor survival, based on our choice of 5% change, which might not be a clinically useful cut-off value.…”

Section: Discussionmentioning

confidence: 99%

“…67 In addition, it should also be noted that SMD change during treatment may not be comparable between unenhanced and contrast-enhanced CT images. 65,66 For example, contrast-enhanced pretreatment CT images are not comparable with unenhanced post-treatment CT images, as significant SMD decrease might be reported, which might be mainly due to the non-enhanced image and not muscle loss. Therefore, documentation of the phase of CT analysed and incorporation of standardized CT protocol may provide more comparable results in future studies.…”

Section: Discussionmentioning

confidence: 99%

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Muscle radiodensity loss during cancer therapy is predictive for poor survival in advanced endometrial cancer

Lee

Lin

et al. 2019

J cachexia sarcopenia muscle

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Background Treatment‐related toxicities and decreased levels of patient performance during cancer therapy might contribute to body composition changes and thereby impact outcomes. However, the effect of longitudinal body composition changes on outcomes in patients with advanced endometrial cancer is unknown. This study investigated the association between body composition changes during staging surgery and adjuvant chemoradiotherapy and outcomes in patients with stage III endometrial cancer. Methods Pretreatment and post‐treatment computed tomography (CT) images of 131 patients with stage III endometrial cancer who were treated between 2008 and 2016 were analysed. All CT images were contrast enhanced and acquired according to the standardized protocol. The skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), and total adipose tissue index were measured from two sets of CT images obtained at the level of the third lumbar vertebra. The skeletal muscle gauge was calculated by multiplying SMI by SMD (SMI × SMD). Predictors of overall survival and progression‐free survival were identified using Cox regression models. Results The median follow‐up was 50.6 (range 12.1–117.0) months. Overall, body mass index (BMI) changes during treatment were 0.4% per 210 days (95% confidence interval: −0.6 to 1.4; P = 0.41), and patients experienced an average SMD loss of 2.1% per 210 days (95% confidence interval: −4.0 to −0.2; P = 0.03). Weight loss and SMD loss ≥5% were observed in 23 (17.6%) and 54 (41.2%) patients, respectively. The changes in SMD did not correlate with those in BMI (Spearman's ρ for SMD, −0.13; P = 0.13). SMD change (per 1 Hounsfield unit/210 days decrease) was independently associated with poorer overall survival (hazard ratio: 1.32, 95% confidence interval: 1.14–1.52; P < 0.001) and progression‐free survival (hazard ratio: 1.28, 95% confidence interval: 1.12–1.43; P < 0.001). Our results did not show association between survival and pretreatment myosteatosis and sarcopenia or changes in SMI and total adipose tissue index during treatment. The pretreatment skeletal muscle gauge was associated with treatment modifications such as delays, dose reductions, and discontinuation of chemotherapy. Conclusions Skeletal muscle radiodensity decreased significantly during treatment and was independently associated with poorer survival in patients with stage III endometrial cancer who underwent staging surgery and adjuvant chemoradiotherapy. SMD loss was occult and occurred independently of BMI change.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Muscle radiodensity loss during cancer therapy is predictive for poor survival in advanced endometrial cancer

Lee

Lin

et al. 2019

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

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“…), identification of the impact of increased myosteatosis and sarcopenia on outcomes for patients with inoperable pancreatic cancer, development of validated protocols for the use of computed tomography to document sarcopenia in surgical patients (Rollins et al . , ) and the demonstration of a 50% reduction in insulin sensitivity alongside an increase in inflammatory cytokine (predominantly CRP) 24 hours after major, open gastrointestinal surgery (Tewari et al . ).…”

Section: My Own Research Experiencesmentioning

confidence: 99%