Variations of CT-Based Trunk Muscle Attenuation by Age, Sex, and Specific Muscle

Anderson, Dennis E.; D'Agostino, John; Bruno, Alexander G.; Demissie, Serkalem; Kiel, Douglas P.; Bouxsein, Mary L.

doi:10.1093/gerona/gls168

Cited by 106 publications

(107 citation statements)

References 22 publications

(57 reference statements)

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“…This time window may have led to further clinical deterioration and these findings should therefore be interpreted with caution. The significantly lower BMI and higher age in patients with low skeletal muscle density are in line with previous findings, as increasing age and adiposity are known for its association with intramuscular adipose tissue content [19, 38]. …”

Section: Discussionsupporting

confidence: 90%

Low Skeletal Muscle Density Is Associated with Early Death in Patients with Perihilar Cholangiocarcinoma Regardless of Subsequent Treatment

et al. 2018

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Background: Low skeletal muscle mass is associated with increased postoperative morbidity and worse survival following resection for perihilar cholangiocarcinoma (PHC). We investigated the predictive value of skeletal muscle mass and density for overall survival (OS) of all patients with suspected PHC, regardless of treatment. Methods: Baseline characteristics and parameters regarding disease and treatment were collected from all patients with PHC from 2002 to 2014. Skeletal muscle mass and density were measured at the level of the third lumbar vertebra on CT. The association between skeletal muscle mass and density with OS was investigated using the Kaplan-Meier method and Cox survival. Results: Median OS in 233 included patients did not differ between those with and without low skeletal muscle mass (p = 0.203), whereas a significantly different median OS (months) was observed between patients with low (HR 7.0, 95% CI 4.7–9.3) and high (HR 12.1, 95% CI 8.1–16.1) skeletal muscle density (p = 0.004). Low skeletal muscle density was independently associated with decreased OS (HR 1.78, 95% CI 1.03–3.07, p = 0.040) within the first 6 months but not after 6 months (HR 0.68, 95% CI 0.44–1.07, p = 0.093), after adjusting for age, tumour size and suspected peritoneal or other distant metastases on imaging. Conclusion: A time-dependent effect of skeletal muscle density on OS was found in patients with PHC, regardless of subsequent treatment. Low skeletal muscle density may identify patients at risk for early death.

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Section: Discussionsupporting

confidence: 90%

Low Skeletal Muscle Density Is Associated with Early Death in Patients with Perihilar Cholangiocarcinoma Regardless of Subsequent Treatment

et al. 2018

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“…Muscle CSA and attenuation were calculated from voxels within the contours of the right and left side muscles combined, with voxels outside the range of -50 to 150 HU excluded prior to calculations to exclude tissue that is clearly outside the range of normal muscle that may have fallen within the contour. We have previously found good overall inter- and intra-reader reliability for muscle CSA and attenuation measurements using this approach 18 .…”

Section: Methodsmentioning

confidence: 76%

Computed Tomography-Based Muscle Attenuation and Electrical Impedance Myography as Indicators of Trunk Muscle Strength Independent of Muscle Size in Older Adults

Anderson

Bean

Holt

et al. 2014

American Journal of Physical Medicine &Amp; Rehabilitation

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Objective To examine the associations of computed tomography (CT) -based x-ray attenuation and paraspinal electrical impedance myography (EIM) measures of trunk muscles with absolute and relative (normalized by body weight) trunk extension strength, independent of muscle cross-sectional area (CSA). Design A cross-sectional study of mobility-limited community dwelling older adults (34 women, 15 men, mean age 78.2±7.2 years) recruited from within an existing prospective research cohort. Trunk extension strength, CT-based trunk muscle CSA and attenuation at L4 level, and paraspinal EIM measures were collected. Results Attenuation was positively correlated with absolute and relative strength for multiple muscle groups (r = 0.32 to 0.61, p < 0.05). Paraspinal EIM phase was positively correlated with paraspinal attenuation (r = 0.30, p = 0.039) and with relative strength (r = 0.30, p = 0.042). In multivariable linear regressions adjusting for sex and CSA, attenuations of the anterior abdominal muscles (semipartial r2 = 0.11, p = 0.013) and combined muscles (semipartial r2 = 0.07, p = 0.046) were associated with relative strength. Conclusions While attenuation was associated with relative strength, small effect sizes indicate limited usefulness as clinical measures of muscle strength independent of muscle size. However, there remains a need for additional studies in larger and more diverse groups of subjects.

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“…Because follow‐up CT after adrenalectomy is not a standard of practice at current stage, applicability of our findings to clinical settings need to be validated in further studies. Muscle attenuation is known to vary widely between trunk muscle groups . Because definitions of sarcopenia and low SMD for CT‐derived L3 single slice images have not been established, we used thresholds determined from a kidney donor cohort consisted of healthy US adults, which need to be validated in association with clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Changes of computed tomography‐based body composition after adrenalectomy in patients with endogenous hypercortisolism

Hong

Lee

et al. 2018

Clinical Endocrinology

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Summary Context Data on longitudinal changes of computed tomography (CT)‐determined visceral fat area (VFA), skeletal muscle area (SMA) and skeletal muscle radiodensity (SMD) after adrenalectomy are limited in patients with hypercortisolism. Objective To examine the association of severity of cortisol excess and improvement of CT‐based muscle and fat parameters after adrenalectomy. Design Retrospective observational cohort study. Patients One hundred thirty‐four patients with overt Cushing's syndrome (CS; n = 39), mild autonomous cortisol excess (MACE; n = 57), or nonfunctioning adrenal tumour (NFAT; n = 38) at a tertiary endocrinology institution between 2006 and 2017 were included. Measurements Changes in CT‐determined VFA, visceral‐to‐subcutaneous fat ratio (VSR), SMA, skeletal muscle index (SMI), and SMD measured at the third lumbar vertebra (L3). Results At baseline, CS patients had higher VFA, lower SMA, SMI and SMD values, compared to NFAT or MACE patients. Compared to NFAT, significant decreases in VFA and increases in SMA, SMI and SMD was observed in CS 1 year after adrenalectomy. In MACE, adjusted mean changes of SMD but not VFA, SMA or SMI differ significantly compared to NFAT (+8.9% vs −3.4%, P = 0.032). In a multivariate linear regression model, the increase by 1 μg/dL of post‐dexamethasone serum cortisol at baseline was independently associated with greater reduction of VFA (−3.95%), VSR (−3.07%), and increase in SMD (+0.92%, P < 0.05 for all) after adrenalectomy. Conclusions The severity of cortisol excess was associated with greater improvement of L3 VFA, VSR and SMD 1 year after adrenalectomy. These CT‐based markers may allow more objective assessment of treatment benefit at earlier stage.

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Variations of CT-Based Trunk Muscle Attenuation by Age, Sex, and Specific Muscle

Cited by 106 publications

References 22 publications

Low Skeletal Muscle Density Is Associated with Early Death in Patients with Perihilar Cholangiocarcinoma Regardless of Subsequent Treatment

Low Skeletal Muscle Density Is Associated with Early Death in Patients with Perihilar Cholangiocarcinoma Regardless of Subsequent Treatment

Computed Tomography-Based Muscle Attenuation and Electrical Impedance Myography as Indicators of Trunk Muscle Strength Independent of Muscle Size in Older Adults

Changes of computed tomography‐based body composition after adrenalectomy in patients with endogenous hypercortisolism

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