Semin Musculoskelet Radiol 2019; 23(S 02): S1-S18
DOI: 10.1055/s-0039-1692588
Abstracts
Georg Thieme Verlag KG Stuttgart · New York

CT Evaluation of Sarcopenia in Patients with and without Malignant Tumor: Psoas Muscle Density as a Biomarker

S. P. Ivanoski
1   Ohrid, Republic of Macedonia
,
V. Vasilevska Nikodinovska
2   Skopje, Republic of Macedonia
› Author Affiliations
Further Information

Publication History

Publication Date:
04 June 2019 (online)

 

Purpose: Sarcopenia is related to decreased quality of life, disability, and adverse outcomes, and its diagnosis in patients with malignant disease is important. This study evaluates the prevalence of sarcopenia in patients with a malignant tumor diagnosis compared with patients without known cancer. We also assess the relationship between low muscle density measured by computed tomography (CT) as a biomarker for sarcopenia, and malignancy, age, sex, psoas muscle area, and bone mineral density in both groups.

Methods and Materials: A total of 110 consecutive patients who underwent abdominal CT were included in this retrospective study. All patients were 65 years or older (53 men and 57 women). The study group consisted of patients with a diagnosis of an active or previous malignant tumor (N = 54; mean age: 72.3 years). Fifty-six patients without a previous history or CT-proven malignancy (mean age: 72 years; age and sex matched with study group), made up the control group. Psoas muscle density was measured at the L3 vertebral body midlevel for the diagnosis of sarcopenia. Threshold values for sarcopenic low muscle density established by previous researchers were used. Psoas muscle area at the same vertebral body level, as well as bone mineral density of the trabecular bone at the upper half of the L1 vertebral body, were also measured. We used 3-mm-thick axial slices on noncontrast-enhanced series for all measurements plus regression analysis, chi-square, t test, and the Pearson correlation coefficient.

Results: Most of the study group had colorectal cancer (33.3%). Thirty-five patients had metastatic malignant disease visible on CT. Twenty-two patients of the study group had sarcopenic psoas muscle density (40.5%), and eight patients of the control group had sarcopenia (14.3%). Differences for the presence of sarcopenia between the study and control group were statistically significant (p < 0.05). Values for psoas muscle density between the groups were also statistically significant (p < 0.05). Regression analysis showed that sarcopenia, defined by low muscle density, was positively correlated with the presence of malignant disease (p = 0.003) and the age of the patient (p = 0.001).

Conclusion: Sarcopenia is significantly higher in patients with a malignant tumor diagnosis when compared with a group without malignant tumor disease. Due to the importance of sarcopenia as a prognostic factor in these patients, and the possibility of assessment with routine CT examination, low psoas muscle density should be mentioned routinely in every CT report of patients with a cancer diagnosis.