The predictive value of CT-based skeletal muscle attenuation measurements for sarcopenia according to age and sex
Öz
Aim: We aimed to compare the skeletal muscle attenuation measurement values in CT scanning, which is widely used in clinical practice, with literature and to contribute to the diagnosis of sarcopenia without additional examination and radiation dose.
Materials and Methods: Patients with spinal and lumbar CT images in the PACS archive of Ege University Department of Radiology were retrospectively reviewed. The study included 200 patients who underwent spinal or lumbar CT examinations without contrast between 2020 and 2024. The skeletal muscle densities of these patients were measured manually by a musculoskeletal radiologist using the ROI (Region of Interest) area and circle method.
Results: There is a statistically significant difference between area and circle measurements for each muscle group in all age groups. The measurements made with the ROI circle were higher compared to the area values (p<0.001).
All ROI measurements showed a significant difference when compared according to age in female and male groups (p<0.001). In female patients over 60 years of age, mean ROI area values were 28.6±9.7 right psoas, 28.9±8.2 left psoas, 5.9±16.9 right paraspinal, 6.5±18.0 left paraspinal; in male patients over 60 years of age, 14.9±17.9 right paraspinal, 14.8±18.2 left paraspinal.
Conclusion: Muscle density data obtained by computed tomography is an important component in the diagnosis of sarcopenia and should be integrated into clinical practice. CT provides important information to the clinician in terms of prevention and treatment of muscle loss, especially in elderly individuals.
Anahtar Kelimeler
Kaynakça
- Cruz-Jentoft AJ, Sayer AA. Sarcopenia. Lancet 2019;393:2636-2646.
- Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019;48:16-31.
- Chianca V, Albano D, Messina C, Gitto S, Ruffo G, Guarino S, et al. Sarcopenia: imaging assessment and clinical application. Abdom Radiol (NY) 2022 ;47(9):3205-3216.
- Morley JE, Anker SD, von Haehling S. Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology—update 2014. J Cachexia Sarcopenia Muscle 2014; 5:253–259.
- Fries N, Kotti A, Woisetschläger M, Spångeus A. Using CT imaging to identify sarcopenia as a risk factor for severe falls in older adults. BMC Geriatr. 2025 Feb 1;25(1):72.
- Boutin RD, Houston DK, Chaudhari AS, Willis MH, Fausett CL, Lenchik L. Imaging of Sarcopenia. Radiol Clin North Am. 2022 Jul;60(4):575-582.
- Vogele D, Otto S, Sollmann N, Haggenmüller B, Wolf D, Beer M, et al. Sarcopenia - Definition, Radiological Diagnosis, Clinical Significance. Rofo. 2023 May;195(5):393-405. English, German.
- Amini B, Boyle SP, Boutin RD, Lenchik L. Approaches to Assessment of Muscle Mass and Myosteatosis on Computed Tomography: A Systematic Review. J Gerontol A Biol Sci Med Sci. 2019 Sep 15;74(10):1671-1678.
- Nandakumar B, Baffour F, Abdallah NH, Kumar SK, Dispenzieri A, Buadi FK, et al. Sarcopenia identified by computed tomography imaging using a deep learning-based segmentation approach impacts survival in patients with newly diagnosed multiple myeloma. Cancer. 2023 Feb 1;129(3):385-392.
- Dalal S, Tucker S, Zielonka T, Kinney J, Magdich A, Parr D, et al. A CT-Derived Measurement of Sarcopenia Fails to Predict Falls. Am Surg. 2023 Jun;89(6):2890-2892.
- Yao L, Petrosyan A, Fuangfa P, Lenchik L, Boutin RD. Diagnosing sarcopenia at the point of imaging care: analysis of clinical, functional, and opportunistic CT metrics. Skeletal Radiol 2021; 50: 543-550.
- Derstine BA, Holcombe SA, Ross BE, Wang NC, Su GL, Wang SC. Skeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population. Sci Rep 2018 Jul 27;8(1):11369.
- Murray, T. É., Williams, D., & Lee, M. J. Osteoporosis, obesity, and sarcopenia on abdominal CT: a review of epidemiology, diagnostic criteria, and management strategies for the reporting radiologist. Abdominal Radiology 2017; 42(9), 2376-2386.
- Boutin RD, Lenchik L. Value-Added Opportunistic CT: Insights Into Osteoporosis and Sarcopenia. AJR Am J Roentgenol. 2020 Sep;215(3):582-594.
- Mourtzakis M, Prado CM, Lieffers JR, Reiman T, McCargar LJ, Baracos VE. A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Appl Physiol Nutr Metab 2008; 33:997–1006.
- Sergi G, Trevisan C, Veronese N, Lucato P, Manzato E. Imaging of sarcopenia. Eur J Radiol 2016; 85: 1519–1524.
- Bae KT. Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology 2010; 256:32–61
- Tagliafico AS, Bignotti B, Torri L, Rossi F. Sarcopenia: how to measure, when and why. Radiol Med. 2022 Mar;127(3):228-237.
- Martin L, Gioulbasanis I, Senesse P, Baracos VE. Cancer-associated malnutrition and CT-defined sarcopenia and myosteatosis are endemic in over-weight and obese patients. JPEN J Parenter Enteral Nutr 2019; 44: [Epub ahead of print]
- Morley JE, Anker SD, von Haehling S. Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology-update 2014. J Cachexia, Sarcopenia Muscle 5:253–259
- Burton, LA, Sumukadas D. Optimal management of sarcopenia. Clin Interv Aging 5:217–228.
- Kılıç ACK, Çayıröz S, Özbek SK, Kaya M, Kılıç HK, Erbaş G. Bilgisayarlı tomografide miyosteatozun değerlendirilmesinde L3’e alternatif olarak L1 seviye ölçümünün değerlendirilmesi. J Ankara Univ Fac Med. 2024 Jun;77(2):209-214.
- Bir Yucel K, Karabork Kilic AC, Sutcuoglu O, et al. Effects of Sarcopenia, Myosteatosis, and the Prognostic Nutritional Index on Survival in Stage 2 and 3 Gastric Cancer Patients. Nutr Cancer. 2023;75: 368-375.
- Lenchik L, Barnard R, Boutin RD, Kritchevsky SB, Chen H, Tan J, Cawthon PM, Automated muscle measurement on chest CT predicts all-cause mortality in older adults from the National Lung Screening Trial. Journals Gerontol - Ser A Biol Sci Med Sci. 2021; 76:277-285.
BT ile yapılan iskelet kası atenüasyon ölçümlerinin yaşa ve cinsiyete göre sarkopeni öngörü değeri
Öz
Amaç: Klinik pratiğinde yaygın olarak kullanılan BT çekiminde iskelet kas atenüasyon değerlerinin literatür ile birlikte karşılaştırılması, ek tetkik ve radyasyon dozuna maruz kalmadan sarkopeni tanısına katkısının değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Ege Üniversitesi Radyoloji Anabilim Dalı PACS arşivindeki spinal ve lomber BT görüntüleri bulunan hastalar retrospektif olarak taranmıştır. Çalışmaya, 2020-2024 yılları arasında kontrastsız olarak spinal ya da lomber BT incelemesi yapılmış 200 hasta dahil edilmiştir. Bu hastaların iskelet kas dansiteleri kas iskelet radyoloğu tarafından ROI (region of interest) alan ve ROI çember yöntemi ile manuel olarak ölçülmüştür.
Bulgular: Tüm yaş gruplarında her kas grubu için alan ile çember ölçümleri arasında istatistiksel anlamlı farklılık saptanmıştır. ROI çember ile yapılan ölçümler alan değerleri ile kıyaslandığında daha yüksek bulunmuştur (p<0,001). Tüm ROI ölçümleri kadın ve erkek gruplarında yaşa göre karşılaştırıldığında anlamlı farklılık gösterdi (p<0,001). 60 yaş üzeri kadın hasta grubumuzda ortalama ROI alan değerleri sağ psoas 28,6±9,7, sol psoas 28,9±8,2, sağ paraspinal 5,9±16,9, sol paraspinal 6,5±18,0, 60 yaş üzeri erkek grupta ise sağ paraspinal 14,9±17,9, sol paraspinal 14,8±18,2 ölçüldü.
Sonuç: Bilgisayarlı tomografi ile elde edilen kas atenüasyon verileri, sarkopeni tanısında önemli bir bileşen haline gelirken, klinik pratiğe entegre edilmesi gereken bir yaklaşımdır. Özellikle yaşlı bireylerde kas kaybının önlenmesi ve tedavi edilmesi açısından klinisyene önemli bilgiler sağlamaktadır.
Anahtar Kelimeler
Kaynakça
- Cruz-Jentoft AJ, Sayer AA. Sarcopenia. Lancet 2019;393:2636-2646.
- Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019;48:16-31.
- Chianca V, Albano D, Messina C, Gitto S, Ruffo G, Guarino S, et al. Sarcopenia: imaging assessment and clinical application. Abdom Radiol (NY) 2022 ;47(9):3205-3216.
- Morley JE, Anker SD, von Haehling S. Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology—update 2014. J Cachexia Sarcopenia Muscle 2014; 5:253–259.
- Fries N, Kotti A, Woisetschläger M, Spångeus A. Using CT imaging to identify sarcopenia as a risk factor for severe falls in older adults. BMC Geriatr. 2025 Feb 1;25(1):72.
- Boutin RD, Houston DK, Chaudhari AS, Willis MH, Fausett CL, Lenchik L. Imaging of Sarcopenia. Radiol Clin North Am. 2022 Jul;60(4):575-582.
- Vogele D, Otto S, Sollmann N, Haggenmüller B, Wolf D, Beer M, et al. Sarcopenia - Definition, Radiological Diagnosis, Clinical Significance. Rofo. 2023 May;195(5):393-405. English, German.
- Amini B, Boyle SP, Boutin RD, Lenchik L. Approaches to Assessment of Muscle Mass and Myosteatosis on Computed Tomography: A Systematic Review. J Gerontol A Biol Sci Med Sci. 2019 Sep 15;74(10):1671-1678.
- Nandakumar B, Baffour F, Abdallah NH, Kumar SK, Dispenzieri A, Buadi FK, et al. Sarcopenia identified by computed tomography imaging using a deep learning-based segmentation approach impacts survival in patients with newly diagnosed multiple myeloma. Cancer. 2023 Feb 1;129(3):385-392.
- Dalal S, Tucker S, Zielonka T, Kinney J, Magdich A, Parr D, et al. A CT-Derived Measurement of Sarcopenia Fails to Predict Falls. Am Surg. 2023 Jun;89(6):2890-2892.
- Yao L, Petrosyan A, Fuangfa P, Lenchik L, Boutin RD. Diagnosing sarcopenia at the point of imaging care: analysis of clinical, functional, and opportunistic CT metrics. Skeletal Radiol 2021; 50: 543-550.
- Derstine BA, Holcombe SA, Ross BE, Wang NC, Su GL, Wang SC. Skeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population. Sci Rep 2018 Jul 27;8(1):11369.
- Murray, T. É., Williams, D., & Lee, M. J. Osteoporosis, obesity, and sarcopenia on abdominal CT: a review of epidemiology, diagnostic criteria, and management strategies for the reporting radiologist. Abdominal Radiology 2017; 42(9), 2376-2386.
- Boutin RD, Lenchik L. Value-Added Opportunistic CT: Insights Into Osteoporosis and Sarcopenia. AJR Am J Roentgenol. 2020 Sep;215(3):582-594.
- Mourtzakis M, Prado CM, Lieffers JR, Reiman T, McCargar LJ, Baracos VE. A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Appl Physiol Nutr Metab 2008; 33:997–1006.
- Sergi G, Trevisan C, Veronese N, Lucato P, Manzato E. Imaging of sarcopenia. Eur J Radiol 2016; 85: 1519–1524.
- Bae KT. Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology 2010; 256:32–61
- Tagliafico AS, Bignotti B, Torri L, Rossi F. Sarcopenia: how to measure, when and why. Radiol Med. 2022 Mar;127(3):228-237.
- Martin L, Gioulbasanis I, Senesse P, Baracos VE. Cancer-associated malnutrition and CT-defined sarcopenia and myosteatosis are endemic in over-weight and obese patients. JPEN J Parenter Enteral Nutr 2019; 44: [Epub ahead of print]
- Morley JE, Anker SD, von Haehling S. Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology-update 2014. J Cachexia, Sarcopenia Muscle 5:253–259
- Burton, LA, Sumukadas D. Optimal management of sarcopenia. Clin Interv Aging 5:217–228.
- Kılıç ACK, Çayıröz S, Özbek SK, Kaya M, Kılıç HK, Erbaş G. Bilgisayarlı tomografide miyosteatozun değerlendirilmesinde L3’e alternatif olarak L1 seviye ölçümünün değerlendirilmesi. J Ankara Univ Fac Med. 2024 Jun;77(2):209-214.
- Bir Yucel K, Karabork Kilic AC, Sutcuoglu O, et al. Effects of Sarcopenia, Myosteatosis, and the Prognostic Nutritional Index on Survival in Stage 2 and 3 Gastric Cancer Patients. Nutr Cancer. 2023;75: 368-375.
- Lenchik L, Barnard R, Boutin RD, Kritchevsky SB, Chen H, Tan J, Cawthon PM, Automated muscle measurement on chest CT predicts all-cause mortality in older adults from the National Lung Screening Trial. Journals Gerontol - Ser A Biol Sci Med Sci. 2021; 76:277-285.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Radyoloji ve Organ Görüntüleme |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 8 Eylül 2025 |
| Gönderilme Tarihi | 4 Nisan 2025 |
| Kabul Tarihi | 12 Mayıs 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 64 Sayı: 3 |
