Quantitative analysis of skeletal muscle by computed tomography imaging—State of the art

Engelke, Klaus; Museyko, Oleg; Wang, Ling; Laredo, Jean‐Denis

doi:10.1016/j.jot.2018.10.004

Cited by 123 publications

(128 citation statements)

References 109 publications

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“…So far, most studies in cachexia and sarcopenia focus on body composition measured by DXA or bioelectrical impedance analysis, on muscle size, and more rarely on adipose tissue, usually either measured in T1‐weighted MR images as volume of fatty infiltration or as CT density in Hounsfield units . Correlation of lean tissue values or muscle size with functional muscle measures is usually weak .…”

Section: Discussionmentioning

confidence: 99%

Repeatability of Dixon magnetic resonance imaging and magnetic resonance spectroscopy for quantitative muscle fat assessments in the thigh

Grimm

Meyer

Nickel

et al. 2018

J cachexia sarcopenia muscle

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BackgroundChanges in muscle fat composition as for example observed in sarcopenia or muscular dystrophy affect physical performance and muscular function, like strength and power. The purpose of the present study is to measure the repeatability of Dixon magnetic resonance imaging (MRI) for assessing muscle volume and fat in the thigh. Furthermore, repeatability of magnetic resonance spectroscopy (MRS) for assessing muscle fat is determined.MethodsA prototype 6‐point Dixon MRI method was used to measure muscle volume and muscle proton density fat fraction (PDFF) in the left thigh. PDFF was measured in musculus semitendinosus of the left thigh with a T2‐corrected multi‐echo MRS method. For the determination of short‐term repeatability (consecutive examinations), the root mean square coefficients of variation of Dixon MRI and MRS data of 23 young and healthy (29 ± 5 years) and 24 elderly men with sarcopenia (78 ± 5 years) were calculated. For the estimation of the long‐term repeatability (13 weeks between examinations), the root mean square coefficients of variation of MRI data of seven young and healthy (31 ± 7 years) and 23 elderly sarcopenic men (76 ± 5 years) were calculated. Long‐term repeatability of MRS was not determined.ResultsShort‐term errors of Dixon MRI volume measurement were between 1.2% and 1.5%, between 2.1% and 1.6% for Dixon MRI PDFF measurement, and between 9.0% and 15.3% for MRS. Because of the high short‐term repeatability errors of MRS, long‐term errors were not determined. Long‐term errors of MRI volume measurement were between 1.9% and 4.0% and of Dixon MRI PDFF measurement between 2.1% and 4.2%.ConclusionsThe high degree of repeatability of volume and PDFF Dixon MRI supports its use to predict future mobility impairment and measures the success of therapeutic interventions, for example, in sarcopenia in aging populations and muscular dystrophy. Because of possible inhomogeneity of fat infiltration in muscle tissue, the application of MRS for PDFF measurements in muscle is more problematic because this may result in high repeatability errors. In addition, the tissue composition within the MRS voxel may not be representative for the whole muscle.

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Section: Discussionmentioning

confidence: 99%

Repeatability of Dixon magnetic resonance imaging and magnetic resonance spectroscopy for quantitative muscle fat assessments in the thigh

Grimm

Meyer

Nickel

et al. 2018

J cachexia sarcopenia muscle

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“…Low www.nature.com/scientificreports www.nature.com/scientificreports/ The SMD can be used to provide a qualitative, rather than quantitative (as the SMI), estimation of skeletal muscle composition; it asses distribution of adipose tissue (myosteatosis), muscle atrophy/wasting caused by or associated with inactivity, denervation, and chronic diseases 24 . The role of SMD as a predictive and prognostic parameter still remains uncertain in cancer patients, compared to other chronic disorders, but surely retain its importance in identifying more frail patients, with body composition alterations 1,3 .…”

Section: Overallmentioning

confidence: 99%

Weighing the role of skeletal muscle mass and muscle density in cancer patients receiving PD-1/PD-L1 checkpoint inhibitors: a multicenter real-life study

Cortellini

Bozzetti

Palumbo

et al. 2020

Sci Rep

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Sarcopenia represents one of the hallmarks of all chronic diseases, including cancer, and was already investigated as a prognostic marker in the pre-immunotherapy era. Sarcopenia can be evaluated using cross-sectional image analysis of CT-scans, at the level of the third lumbar vertebra (L3), to estimate the skeletal muscle index (SMI), a surrogate of skeletal muscle mass, and to evaluate the skeletal muscle density (SMD). We performed a retrospective analysis of consecutive advanced cancer patient treated with PD-1/PD-L1 checkpoint inhibitors. Baseline SMI and SMD were evaluated and optimal cut-offs for survival, according to sex and BMI (+/−25) were computed. The evaluated clinical outcomes were: objective response rate (ORR), immune-related adverse events (irAEs), progression free survival (PFS) and overall survival (OS). From April 2015 to April 2019, 100 consecutive advanced cancer patients were evaluated. 50 (50%) patients had a baseline low SMI, while 51 (51%) had a baseline low SMD according to the established cut offs. We found a significant association between SMI and ECOG-PS (p = 0.0324), while no correlations were found regarding SMD and baseline clinical factors. The median follow-up was 20.3 months. Patients with low SMI had a significantly shorter PFS (HR = 1.66 [95% CI: 1.05-2.61]; p = 0.0291) at univariate analysis, but not at the multivariate analysis. They also had a significantly shorter OS (HR = 2.19 [95% CI: 1.31-3.64]; p = 0.0026). The multivariate analysis confirmed baseline SMI as an independent predictor for OS (HR = 2.19 [1.31-3.67]; p = 0.0027). We did not find significant relationships between baseline SMD and clinical outcomes, nor between ORR, irAEs and baseline SMI (data not shown). Low SMI is associated with shortened survival in advanced cancer patients treated with PD1/PDL1 checkpoint inhibitors. However, the lack of an association between SMI and clinical response suggests that sarcopenia may be generally prognostic in this setting rather than specifically predictive of response to immunotherapy.Sarcopenia is the condition of loss of muscle mass, with decreased muscle power, and it is one of the hallmarks of cancer, which negatively affects the most of clinical outcomes such as toxicities and survival 1 . The interactions must recognize also the lack of other adiposity metrics, such as the waist circumference, the waist-to-height ratio, and the body fat percentage. Moreover, the CT imaging analysis was limited by the data availability; indeed, the acquisition protocol was planned according to the presence of previous examination. conclusionOur finding of a significant shorter OS for low-SMI patients treated with PD-1/PD-L1 checkpoint inhibitors, suggests that sarcopenia might have a prognostic role, rather than predictive. However, to properly weighing our results, we must consider the significant association between poorer PS and low-SMI. Without making conclusive considerations, we can assume that after the advent of ICIs, we should give back further relevance to baseline nut...

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“…Given that the cellular and biochemical factors (the aforementioned endophenotypes) affecting muscle structure and composition in aging are still uncertain, measuring or imaging body composition offers a rough approximation. The two standard techniques available for body composition parameter quantification are dual X-ray absorptiometry (DXA), which estimates fat-free (lean) and fat mass (Engelke et al, 2018), and bioelectrical impedance (Kyle et al, 2003). Both bioelectrical impedance and DXA cannot provide a spatially resolved distribution of muscle or adipose tissue.…”

Section: Diagnosis Of Sarcopeniamentioning

confidence: 99%

Zebrafish models of sarcopenia

2020

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Sarcopeniathe accelerated age-related loss of muscle mass and functionis an under-diagnosed condition, and is central to deteriorating mobility, disability and frailty in older age. There is a lack of treatment options for older adults at risk of sarcopenia. Although sarcopenia's pathogenesis is multifactorial, its major phenotypesmuscle mass and muscle strengthare highly heritable. Several genome-wide association studies of musclerelated traits were published recently, providing dozens of candidate genes, many with unknown function. Therefore, animal models are required not only to identify causal mechanisms, but also to clarify the underlying biology and translate this knowledge into new interventions. Over the past several decades, small teleost fishes had emerged as powerful systems for modeling the genetics of human diseases. Owing to their amenability to rapid genetic intervention and the large number of conserved genetic and physiological features, small teleostssuch as zebrafish, medaka and killifishhave become indispensable for skeletal muscle genomic studies. The goal of this Review is to summarize evidence supporting the utility of small fish models for accelerating our understanding of human skeletal muscle in health and disease. We do this by providing a basic foundation of the (zebra)fish skeletal muscle morphology and physiology, and evidence of muscle-related gene homology. We also outline challenges in interpreting zebrafish mutant phenotypes and in translating them to human disease. Finally, we conclude with recommendations on future directions to leverage the large body of tools developed in small fish for the needs of genomic exploration in sarcopenia.

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Quantitative analysis of skeletal muscle by computed tomography imaging—State of the art

Cited by 123 publications

References 109 publications

Repeatability of Dixon magnetic resonance imaging and magnetic resonance spectroscopy for quantitative muscle fat assessments in the thigh

Repeatability of Dixon magnetic resonance imaging and magnetic resonance spectroscopy for quantitative muscle fat assessments in the thigh

Weighing the role of skeletal muscle mass and muscle density in cancer patients receiving PD-1/PD-L1 checkpoint inhibitors: a multicenter real-life study

Zebrafish models of sarcopenia

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