Validation for measurements of skeletal muscle areas using low-dose chest computed tomography

Abstract

Various methods were suggested to measure skeletal muscle areas (SMAs) using chest low-dose computed tomography (chest LDCT) as a substitute for SMA at 3rd lumbar vertebra level (L3-SMA). In this study, four SMAs (L1-SMA, T12-erector spinae muscle areas, chest wall muscle area at carina level, pectoralis muscle area at aortic arch level) were segmented semi-automatically in 780 individuals taking concurrent chest and abdomen LDCT for healthcare screening. Four SMAs were compared to L3-SMA and annual changes were calculated from individuals with multiple examinations (n = 101). Skeletal muscle index (SMI; SMA/height2) cut-off for sarcopenia was determined by lower 5th percentile of young individuals (age ≤ 40 years). L1-SMA showed the greatest correlation to L3-SMA (men, R2 = 0.7920; women, R2 = 0.7396), and the smallest annual changes (0.3300 ± 4.7365%) among four SMAs. L1-SMI cut-offs for determining sarcopenia were 39.2cm2/m2 in men, and 27.5cm2/m2 in women. Forty-six men (9.5%) and ten women (3.4%) were found to have sarcopenia using L1-SMI cut-offs. In conclusion, L1-SMA could be a reasonable substitute for L3-SMA in chest LDCT. Suggested L1-SMI cut-offs for sarcopenia were 39.2cm2/m2 for men and 27.5cm2/m2 for women in Asian.

CT analysis of thoracolumbar body composition for estimating whole-body composition

“…This results in significant missing data if a single-slice body composition analysis is performed at the L1 level in low-dose CT screening for lung cancer. However, multi-slice T12–L1 averaging can effectively complete body composition data acquisition, allowing for the identification of sarcopenic heavy smokers in a large-data low-dose CT scan analysis [ 39 ]. However, it should be acknowledged that the network’s results required an assistance of a radiologist for the confirmation and readjustment of the intrathoracic VF for this study.…”

Musculoskeletal Comorbidities Predict Lung Function and Mortality in Patients with Idiopathic Pulmonary Fibrosis

“…Seventy IPF patients diagnosed at the interstitial lung disease clinic were prospectively recruited. Quantitative assessment of pectoralis muscle cross-sectional area (PM-CSA) on axial CT chest imaging was done using CT Slicer 4.8 software ( gure 1) described in detail elsewhere [7][8][9][10] . FFMI was calculated using PM-CSA, height, weight, and gender by previously validated formulae 11 .…”

Skeletal muscle estimation: A review of techniques and their applications

“…Sarcopenia cutoffs have been defined for SMM values taken at L3, so if scans are conducted elsewhere (e.g., chest or pelvic area), applying cut‐offs derived from L3 may yield inaccurate diagnoses (Derstine et al, 2018). Several have evaluated the efficacy of alternative slices to L3 for surrogate measures of SMM and have reported the value of slices at C3, T1, T10, T11, T12, L1, L2, L4, L5, a full chest scan (T1 to L5), and the psoas muscle in pediatric and adult patients (Cruz‐Jentoft et al, 2019; Derstine et al, 2018; Deyell et al, 2023; Lim & Park, 2022; Nemec et al, 2017; Pu et al, 2022; Swartz et al, 2016; Vangelov et al, 2022b). While these data are promising, the current evidence is not sufficiently robust to offer definitive recommendations for the use of alternate vertebral slices to L3 in CT scans of cancer patients, for the evaluation of SMM, and the diagnosis of CT‐defined sarcopenia (Vangelov et al, 2022a).…”