1
|
Holtorf C, Mengoni M, Tüting T, Wienke A, Borggrefe J, Surov A, Alter M. [Sarcopenia and immune-related toxicity in patients with malignant melanoma undergoing immune checkpoint inhibition]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024:10.1007/s00105-024-05405-9. [PMID: 39143426 DOI: 10.1007/s00105-024-05405-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/18/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND AND OBJECTIVES Sarcopenia is the generalized loss of muscle strength, mass, and function. The aim was to investigate whether pretherapeutic sarcopenia, as determined by the psoas muscles, affects therapy-mediated toxicity in patients with malignant melanoma undergoing immunotherapy. PATIENTS AND METHODS Measurement of psoas musculature was performed pretherapeutically using computed tomography at the level of the third lumbar vertebra in the axial plane in 75 patients between January 2011 and December 2020. Sarcopenia was defined using the psoas muscle index (PMI). Immune-related toxicity was retrospectively assessed. RESULTS Treatment-related toxicity was recorded in 33 of the 75 patients (44%). Of these, 16 patients (36.2%) experienced dose-limiting severe events (DLT). Pretherapeutic sarcopenia was identified in 25 patients (33.3%). Comparative analysis showed that the patients with a DLT had lower PMI values compared with the patient group without a DLT (4.65 ± 1.33 vs. 5.79 ± 1.67 cm2m-2, p = 0.015) (odds ratio = 0.60, 95% confidence interval 0.40-0.92, p = 0.02). CONCLUSIONS Pretherapeutic sarcopenia measured based on the psoas muscle is not a significant predictor of immune-mediated toxicity in patients with malignant melanoma treated with immune checkpoint inhibitors. Patients with DLT have lower values for the psoas muscle parameters PMI compared to the group of patients without DLT.
Collapse
Affiliation(s)
- Christian Holtorf
- Hautarztpraxis Dr. med. Anke Raschke, Magdeburg, Deutschland
- Universitätsklinik für Dermatologie und Venerologie, Universitätsklinikum Magdeburg, Magdeburg, Deutschland
| | - Miriam Mengoni
- Universitätsklinik für Dermatologie und Venerologie, Universitätsklinikum Magdeburg, Magdeburg, Deutschland
| | - Thomas Tüting
- Universitätsklinik für Dermatologie und Venerologie, Universitätsklinikum Magdeburg, Magdeburg, Deutschland
| | - Andreas Wienke
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität, Halle-Wittenberg, Deutschland
| | - Jan Borggrefe
- Universitätsinstitut für Radiologie, Neuroradiologie und Nuklearmedizin, Johannes-Wesling Klinikum, Ruhr-Universität Bochum, Minden, Deutschland
| | - Alexey Surov
- Universitätsinstitut für Radiologie, Neuroradiologie und Nuklearmedizin, Johannes-Wesling Klinikum, Ruhr-Universität Bochum, Minden, Deutschland
| | - Mareike Alter
- Universitätsklinik für Dermatologie und Venerologie, Ruhr-Universität Bochum, Campus Minden, Johannes-Wesling-Klinikum Minden, Hans-Nolte-Str. 1, 32429, Minden, Deutschland.
| |
Collapse
|
2
|
Sales-Balaguer N, Sorribes-Carreras P, Morillo Macias V. Diagnosis of Sarcopenia and Myosteatosis by Computed Tomography in Patients with Esophagogastric and Pancreatic Cancer. Cancers (Basel) 2024; 16:2738. [PMID: 39123465 PMCID: PMC11311307 DOI: 10.3390/cancers16152738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 07/24/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
The increase in the global incidence of cancer highlights the need to continue advancing in the techniques of diagnosis and nutritional assessment of cancer patients, given the prognostic and therapeutic impact of nutritional status. In this study, sarcopenia was evaluated as an independent predictor of morbidity and mortality. Data from 45 patients diagnosed with esophagogastric or pancreatic cancer were analyzed. Body composition was determined using computed tomography images, and functionality tests were performed. Sarcopenia was present in 22.2% of the patients, while only 31.1% had correct musculature. A reduction in muscle mass or function was observed in 46.7% of the patients. Likewise, the prevalence of myosteatosis reached 60% of the patients. No significant differences were found with regard to the presence of sarcopenia according to BMI classifications, so it is necessary to evaluate the patient with body composition techniques that include the evaluation of the different muscle and fat compartments. In conclusion, a comprehensive intervention is necessary to improve the detection of sarcopenia/myosteatosis and, in the future, to be able to carry out an approach that improves the quality of life and survival rates of patients.
Collapse
Affiliation(s)
- Nerea Sales-Balaguer
- Castelló Provincial Hospital Consortium Foundation, 12002 Castelló de la Plana, Spain
| | - Patricia Sorribes-Carreras
- Nutrition and Dietetics Unit, Provincial Hospital Consortium of Castelló (CHPC), 12002 Castelló de la Plana, Spain;
| | - Virginia Morillo Macias
- Radiotherapy Service, Provincial Hospital Consortium of Castelló (CHPC), 12002 Castelló de la Plana, Spain
| |
Collapse
|
3
|
Yang D, Su L, Zhang L, Zhang Y, Li Y, Huang T, Huang X. Sarcopenia predicts postoperative complications in head and neck cancer: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2024; 281:3959-3975. [PMID: 38647686 DOI: 10.1007/s00405-024-08577-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/19/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE We performed this systematic review and meta-analysis to explore the impact of preoperative sarcopenia on postoperative complication risks after head and neck cancer (HNC) surgery. METHODS We identified eligible studies by searching Ovid-MEDLINE, Ovid-Embase, EBM Reviews-Cochrane Central Register of Controlled Trials, Web of Science Core Collection, and Scopus. This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. RESULTS Twenty-one studies with a total of 3480 patients met our inclusion criteria. The presence of sarcopenia significantly increased the incidence of overall postoperative complications (OR = 1.72, 95% CI 1.23, 2.41; P = 0.002; I2 = 59%). Subgroup analyses showed a higher risk of postoperative complications in the populations in which sarcopenia was diagnosed with low L3-skeletal muscle index (L3-SMI) or low cross-sectional area of the rectus femoris, but not in the group that sarcopenia was diagnosed with low C3-SMI. Preoperative sarcopenia also substantially increased the risk of severe postoperative complications (OR = 2.26), pharyngocutaneous fistulas (OR = 2.15), free flap-related complications (OR = 1.63), and surgical site infections (OR = 1.84). We also found a tendency toward a higher incidence of wound complications and 30-day mortality in patients with sarcopenia. CONCLUSION Preoperative sarcopenia is a negative prognostic indicator for postoperative complications in patients with HNC after surgery. To reduce the incidence of postoperative complications and improve poor prognosis, further attention needs to be paid to the evaluation and management of preoperative sarcopenia.
Collapse
Affiliation(s)
- Dan Yang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Lin Su
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Liying Zhang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yu Zhang
- Department of Biomedical Engineering, Sichuan University Library, Chengdu, 610041, Sichuan, China
| | - Yina Li
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Tingxuan Huang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiaoli Huang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
4
|
Syziu A, Schache A. The prognostic value of pre-treatment sarcopenia in overall survival in head and neck cancer patients: a systematic review. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00221-2. [PMID: 39068047 DOI: 10.1016/j.ijom.2024.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 06/05/2024] [Accepted: 07/12/2024] [Indexed: 07/30/2024]
Abstract
The aim of this study was to determine the prognostic value of pre-treatment sarcopenia, defined radiologically (cervical (C3) or lumbar (L3) region), in adult head and neck cancer (HNC) patients undergoing treatment with curative intent. A systematic search of the PubMed and Scopus databases was performed up to March 2024. Inclusion criteria were adult patients with locally advanced HNC, sarcopenia defined radiologically at the C3 and/or L3 level, and patients receiving primary treatment with curative intent. Risk of bias was assessed using the ROBINS-I tool non-randomised studies. Thirty studies involving a total of 6924 adult patients with HNC were included in this review. Pre-treatment sarcopenia was significantly associated with worse overall survival outcomes in 26 of the 30 studies (87%), across all treatment modalities with curative intent. The most frequent sex-specific SMI cut-off values were <52.4 cm2/m2 for males and <38.5 cm2/m2 for females. The findings of this review suggest that sarcopenia is a strong prognostic factor of overall survival in HNC patients undergoing primary curative treatment. Sarcopenia evaluation appears to be a good prognostic marker in the HNC population. Future nutritional interventional studies might focus on reversing the muscle loss and improving overall outcomes in identified sarcopenic individuals.
Collapse
Affiliation(s)
- A Syziu
- University Hospital Aintree, Fazakerley, Liverpool, UK.
| | - A Schache
- University Hospital Aintree, Fazakerley, Liverpool, UK
| |
Collapse
|
5
|
Surov A, Wienke A, Borggrefe J, Hinnerichs M, Seidensticker R, Öcal O, Schütte K, Zech CJ, Loewe C, van Delden O, Vandecaveye V, Verslype C, Gebauer B, Sengel C, Bargellini I, Iezzi R, Malfertheiner P, Berg T, Klümpen HJ, Benckert J, Gasbarrini A, Amthauer H, Sangro B, Ricke J, Seidensticker M. Skeletal muscle quality predicts overall survival in advanced liver hepatocellular carcinoma treated with SIRT and sorafenib: A subanalysis of the SORAMIC trial. United European Gastroenterol J 2024. [PMID: 39007783 DOI: 10.1002/ueg2.12627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/18/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND AND AIMS Our purpose was to assess the impact of muscle quality on overall survival (OS) in patients with advanced HCC. METHODS This is a subanalysis of the SORAMIC trial. Overall, 363 patients were included. The SIRT/Sorafenib treatment group comprised 182 patients and the sorafenib group 181 patients. Myosteatosis was defined as skeletal muscle density (SMD) < 41 HU for patients with a body mass index up to 24.9 kg/m2 and <33 HU for patients with a body mass index ≥25 kg/m2. Albumin-gauge score was calculated as follows: serum albumin (g/dL) × SMD (HU). To assess the impact of muscle quality on clinical variables and OS, a Cox regression model was used. Hazard ratios are presented together with 95 % confidence intervals (95 % CI). Kaplan-Meier curves were used for survival analysis. RESULTS In the SIRT/sorafenib cohort, low albumin-gauge score was an independent predictor of worse OS, HR = 1.74, CI 95% (1.16-2.62), p = 0.01. In the sorafenib cohort, muscle quality parameters did not predict OS. In alcohol-induced HCC (n = 129), myosteatosis independently predicted OS, HR = 1.85, CI 95% (1.10; 3.12), p = 0.02. In viral-induced HCC (n = 99), parameters of muscle quality did not predict OS. In patients with NASH/Non-alcoholic fatty liver disease (NAFLD) induced HCC, albumin-gauge score was a strong independent predictor of worse OS in the subgroup undergoing combined treatment with SIRT and sorafenib, HR = 9.86, CI 95% (1.12; 86.5), p = 0.04. CONCLUSIONS Myosteatosis predicts independently worse OS in patients with alcohol-induced HCC undergoing combined treatment with SIRT and sorafenib. In patients with NASH/NAFLD induced HCC undergoing treatment with SIRT and sorafenib, albumin-gauge score predicts independently worse OS. IMPACT AND IMPLICATIONS Associations between parameters of muscle quality and OS are different in accordance to the treatment strategy and etiology of HCC. These findings highlight the prognostic potential of skeletal muscle quality in patients with advanced HCC.
Collapse
Affiliation(s)
- Alexey Surov
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biometry and Informatics, University of Halle, Halle, Germany
| | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Mattes Hinnerichs
- University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | | | - Osman Öcal
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Kerstin Schütte
- Department of Internal Medicine and Gastroenterology, Niels-Stensen-Kliniken Marienhospital, Osnabrück, Germany
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover (MHH), Hannover, Deutschland
| | - Christoph J Zech
- Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Christian Loewe
- Section of Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Otto van Delden
- Department of Radiology and Nuclear Medicine, Academic University Medical Centers, Amsterdam, The Netherlands
| | | | - Chris Verslype
- Department of Digestive Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Bernhard Gebauer
- Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany
| | - Christian Sengel
- Radiology Department, Grenoble University Hospital, La Tronche, France
| | - Irene Bargellini
- Department of Vascular and Interventional Radiology, University Hospital of Pisa, Pisa, Italy
| | - Roberto Iezzi
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radiologia, Radioterapia Oncologica ed Ematologia, Roma, Italia
| | | | - Thomas Berg
- Klinik und Poliklinik für Gastroenterologie, Sektion Hepatologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Heinz J Klümpen
- Department of Medical Oncology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Julia Benckert
- Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Antonio Gasbarrini
- Fondazione Policlinico Universitario Gemelli IRCCS, Universita' Cattolica del Sacro Cuore, Roma, Italy
| | - Holger Amthauer
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Bruno Sangro
- Liver Unit, Clínica Universidad de Navarra and CIBEREHD, Pamplona, Spain
| | - Jens Ricke
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Max Seidensticker
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
6
|
Wang Q, Shi P, Cao L, Li H, Chen X, Wang P, Zhang J. Unveiling the detrimental vicious cycle linking skeletal muscle and COVID-19: A systematic review and meta-analysis. J Evid Based Med 2024. [PMID: 38975690 DOI: 10.1111/jebm.12629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 06/18/2024] [Indexed: 07/09/2024]
Abstract
OBJECTIVE Skeletal muscle catabolism supports multiple organs and systems during severe trauma and infection, but its role in COVID-19 remains unclear. This study investigates the interactions between skeletal muscle and COVID-19. METHODS The PubMed, EMbase, and The Cochrane Library databases were systematically searched from January 2020 to August 2023 for cohort studies focusing on the impact of skeletal muscle on COVID-19 prevalence and outcomes, and longitudinal studies examining skeletal muscle changes caused by COVID-19. Skeletal muscle quantity (SMQN) and quality (SMQL) were assessed separately. The random-effect model was predominantly utilized for statistical analysis. RESULTS Seventy studies with moderate to high quality were included. Low SMQN/SMQL was associated with an increased risk of COVID-19 infection (OR = 1.62, p < 0.001). Both the low SMQN and SMQL predicted COVID-19-related mortality (OR = 1.53, p = 0.016; OR = 2.18, p = 0.001, respectively). Mortality risk decreased with increasing SMQN (OR = 0.979, p = 0.009) and SMQL (OR = 0.972, p = 0.034). Low SMQN and SMQL were also linked to the need for intensive care unit/mechanical ventilation, increased COVID-19 severity, and longer hospital stays. Significant skeletal muscle wasting, characterized by reduced volume and strength, was observed during COVID-19 infection and the pandemic. CONCLUSIONS This study reveals a detrimental vicious circle between skeletal muscle and COVID-19. Effective management of skeletal muscle could be beneficial for treating COVID-19 infections and addressing the broader pandemic. These findings have important implications for the management of future virus pandemics. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42023395476.
Collapse
Affiliation(s)
- Qin Wang
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Peipei Shi
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lu Cao
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Haoran Li
- Department of Thoracic Surgery, Thoracic Oncology Institute, Peking University People's Hospital, Beijing, China
| | - Xiankai Chen
- Department of Thoracic Surgical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Peiyu Wang
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Department of Thoracic Surgery, Thoracic Oncology Institute, Peking University People's Hospital, Beijing, China
| | - Jianjiang Zhang
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| |
Collapse
|
7
|
Rodriguez C, Mota JD, Palmer TB, Heymsfield SB, Tinsley GM. Skeletal muscle estimation: A review of techniques and their applications. Clin Physiol Funct Imaging 2024; 44:261-284. [PMID: 38426639 DOI: 10.1111/cpf.12874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
Quantifying skeletal muscle size is necessary to identify those at risk for conditions that increase frailty, morbidity, and mortality, as well as decrease quality of life. Although muscle strength, muscle quality, and physical performance have been suggested as important assessments in the screening, prevention, and management of sarcopenic and cachexic individuals, skeletal muscle size is still a critical objective marker. Several techniques exist for estimating skeletal muscle size; however, each technique presents with unique characteristics regarding simplicity/complexity, cost, radiation dose, accessibility, and portability that are important factors for assessors to consider before applying these modalities in practice. This narrative review presents a discussion centred on the theory and applications of current non-invasive techniques for estimating skeletal muscle size in diverse populations. Common instruments for skeletal muscle assessment include imaging techniques such as computed tomography, magnetic resonance imaging, peripheral quantitative computed tomography, dual-energy X-ray absorptiometry, and Brightness-mode ultrasound, and non-imaging techniques like bioelectrical impedance analysis and anthropometry. Skeletal muscle size can be acquired from these methods using whole-body and/or regional assessments, as well as prediction equations. Notable concerns when conducting assessments include the absence of standardised image acquisition/processing protocols and the variation in cut-off thresholds used to define low skeletal muscle size by clinicians and researchers, which could affect the accuracy and prevalence of diagnoses. Given the importance of evaluating skeletal muscle size, it is imperative practitioners are informed of each technique and their respective strengths and weaknesses.
Collapse
Affiliation(s)
- Christian Rodriguez
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Jacob D Mota
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Ty B Palmer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Steven B Heymsfield
- Metabolism and Body Composition Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| |
Collapse
|
8
|
Surov A, Wienke A, Gutzmer R, Borggrefe J. Prognostic role of the skeletal musculature in oncology: significance, coherences and clinical implications. ROFO-FORTSCHR RONTG 2024; 196:699-706. [PMID: 38134902 DOI: 10.1055/a-2213-2320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Affiliation(s)
- Alexey Surov
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling Medical Center, Ruhr University Bochum, Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin Luther University Halle Wittenberg, Halle, Germany
| | - Ralf Gutzmer
- Department of Dermatology, Johannes Wesling Medical Center, Ruhr University Bochum, Germany
| | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling Medical Center, Ruhr University Bochum, Germany
| |
Collapse
|
9
|
Takahashi M, Sakamoto K, Kogure Y, Nojiri S, Tsuchiya Y, Honjo K, Kawai M, Ishiyama S, Sugimoto K, Nagakari K, Tomiki Y. Use of 3D-CT-derived psoas major muscle volume in defining sarcopenia in colorectal cancer. BMC Cancer 2024; 24:741. [PMID: 38890682 PMCID: PMC11184714 DOI: 10.1186/s12885-024-12524-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 06/14/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Sarcopenia is characterized by reduced skeletal muscle volume and is a condition that is prevalent among elderly patients and associated with poor prognosis as a comorbidity in malignancies. Given the aging population over 80 years old in Japan, an understanding of malignancies, including colorectal cancer (CRC), complicated by sarcopenia is increasingly important. Therefore, the focus of this study is on a novel and practical diagnostic approach of assessment of psoas major muscle volume (PV) using 3-dimensional computed tomography (3D-CT) in diagnosis of sarcopenia in patients with CRC. METHODS The subjects were 150 patients aged ≥ 80 years with CRC who underwent primary tumor resection at Juntendo University Hospital between 2004 and 2017. 3D-CT measurement of PV and conventional CT measurement of the psoas major muscle cross-sectional area (PA) were used to identify sarcopenia (group S) and non-sarcopenia (group nS) cases. Clinicopathological characteristics, operative results, postoperative complications, and prognosis were compared between these groups. RESULTS The S:nS ratios were 15:135 for the PV method and 52:98 for the PA method. There was a strong positive correlation (r = 0.66, p < 0.01) between PVI (psoas major muscle volume index) and PAI (psoas major muscle cross-sectional area index), which were calculated by dividing PV or PA by the square of height. Surgical results and postoperative complications did not differ significantly in the S and nS groups defined using each method. Overall survival was worse in group S compared to group nS identified by PV (p < 0.01), but not significantly different in groups S and nS identified by PA (p = 0.77). A Cox proportional hazards model for OS identified group S by PV as an independent predictor of a poor prognosis (p < 0.05), whereas group S by PA was not a predictor of prognosis (p = 0.60). CONCLUSIONS The PV method for identifying sarcopenia in elderly patients with CRC is more practical and sensitive for prediction of a poor prognosis compared to the conventional method.
Collapse
Affiliation(s)
- Makoto Takahashi
- Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.
| | - Kazuhiro Sakamoto
- Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Yosuke Kogure
- Department of Radiological Technology, Juntendo University Hospital, Tokyo, Japan
| | - Shuko Nojiri
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
| | - Yuki Tsuchiya
- Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Kumpei Honjo
- Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Masaya Kawai
- Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Shun Ishiyama
- Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Kiichi Sugimoto
- Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Kunihiko Nagakari
- Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Yuichi Tomiki
- Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
| |
Collapse
|
10
|
Barajas Ordonez F, Zeller Y, Wolleschak D, Hinnerichs M, Rodríguez-Feria P, Mougiakakos D, Aghayev A, Kardas H, Mikusko M, Borggrefe J, Surov A. Low subcutaneous adipose tissue and myosteatosis are prognostic factors after allogeneic hematopoietic stem cell transplantation. Clin Nutr ESPEN 2024; 61:274-280. [PMID: 38777443 DOI: 10.1016/j.clnesp.2024.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 03/14/2024] [Accepted: 03/29/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Allogeneic hematopoietic stem cell transplantation (allo-HSCT) represents the only curative treatment option for several hematological neoplasms. This study aimed to assess the parameters of body composition as predictors of post-transplant overall survival (OS) and adverse events in patients with leukemia, myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPN). METHODS This was a retrospective study of 122 adult patients who underwent their first allo-HSCT. The CT-based semi-automated measurement of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), visceral-to-subcutaneous fat ratio (VSR), sarcopenia in terms of skeletal muscle index (SMI), and myosteatosis based on the skeletal muscle radiation attenuation (SM-RA) was performed. Cox regression analysis was used to assess the association of body composition parameters with OS. RESULTS In the univariate analysis, low SAT and myosteatosis were associated with lower OS (hazard ratio [HR] 2.02, 95% confidence interval [CI] 1.16-3.51, p = 0.01) and (HR 2.50, 95% CI 1.48-4.25, p =< 0.001), respectively. This association remained significant after adjusting for relevant covariates, with HR 2.32, 95% CI 1.23-4.38, p = 0.01 and HR 2.86, 95% CI 1.51-5.43, p =< 0.001, respectively. On the contrary, VAT, VSR, sarcopenia, and sarcopenic obesity were not statistically significant in OS. Severe post-transplant adverse events were more common in the low SAT group (odds ratio [OR] 3.12, 95% CI 1.32-7.40, p = 0.01) and OR 3.17, 95% CI 1.31-7.70, p =< 0.01 in the age- and sex-adjusted analysis. CONCLUSION Low SAT and myosteatosis may contribute to an increased risk of post-transplant mortality, while low SAT appears to increase the risk of severe post-transplant adverse events.
Collapse
Affiliation(s)
- Felix Barajas Ordonez
- University Clinic for Radiology and Nuclear Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany; Department of Diagnostic and Interventional Radiology, University Hospital RWTH, Aachen, Germany.
| | - Yannic Zeller
- University Clinic for Radiology and Nuclear Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Denise Wolleschak
- Department of Hematology and Oncology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Mattes Hinnerichs
- University Clinic for Radiology and Nuclear Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Pablo Rodríguez-Feria
- Department of International Health, CAPHRI - Care and Public Health Research Institute, Maastricht University, the Netherlands
| | - Dimitrios Mougiakakos
- Department of Hematology and Oncology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Anar Aghayev
- University Clinic for Radiology and Nuclear Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Hakan Kardas
- University Clinic for Radiology and Nuclear Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Martin Mikusko
- Department of Hematology and Oncology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Jan Borggrefe
- Institute for Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital By Muehlenkreiskliniken, Ruhr University Bochum, Minden, Germany
| | - Alexey Surov
- Institute for Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital By Muehlenkreiskliniken, Ruhr University Bochum, Minden, Germany
| |
Collapse
|
11
|
Barajas Ordonez F, Wolleschak D, Zeller Y, Hinnerichs M, Rodríguez-Feria P, Aghayev A, Mikusko M, Borggrefe J, Mougiakakos D, Surov A. Parameters of body composition do not predict survival in patients with multiple myeloma undergoing autologous stem cell transplantation. Leuk Lymphoma 2024; 65:825-832. [PMID: 38384127 DOI: 10.1080/10428194.2024.2319226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/10/2024] [Indexed: 02/23/2024]
Abstract
Studies regarding the influence of body composition parameters as predictors on overall survival (OS) in patients with multiple myeloma (MM) are scarce. OS and progression-free survival (PFS) were retrospectively assessed in 129 patients with MM undergoing autologous stem cell transplantation (ASCT) after a follow-up of 2 years. A computed tomography (CT) based semi-automated assessment of body composition was performed. No statistically significant differences were noted in 2-year OS, PFS, or post-transplant adverse events in the body composition groups of subcutaneous adipose tissue (SAT) (low vs. high-SAT), visceral adipose tissue (VAT) (low vs. high-VAT), visceral-to-subcutaneous fat ratio (VSR) (low vs. high VSR), and sarcopenia in terms of skeletal muscle index (SMI) (non-sarcopenic vs. sarcopenic). In conclusion, adipose and muscle tissue do not limit OS or affect the PFS in patients with MM undergoing ASCT.
Collapse
Affiliation(s)
- Felix Barajas Ordonez
- University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH, Aachen, Germany
| | - Denise Wolleschak
- Department of Hematology and Oncology, University Hospital Magdeburg, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Yannic Zeller
- University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Mattes Hinnerichs
- University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Pablo Rodríguez-Feria
- Department of International Health, CAPHRI - Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Anar Aghayev
- University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Martin Mikusko
- Department of Hematology and Oncology, University Hospital Magdeburg, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Jan Borggrefe
- Institute for Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital by Muehlenkreiskliniken, Ruhr University Bochum, Minden, Germany
| | - Dimitrios Mougiakakos
- Department of Hematology and Oncology, University Hospital Magdeburg, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Alexey Surov
- Institute for Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital by Muehlenkreiskliniken, Ruhr University Bochum, Minden, Germany
| |
Collapse
|
12
|
Mengoni M, Braun AD, Hinnerichs MS, Aghayev A, Tüting T, Surov A. Comprehensive analysis of body composition features in melanoma patients treated with tyrosine kinase inhibitors. J Dtsch Dermatol Ges 2024; 22:783-791. [PMID: 38857075 DOI: 10.1111/ddg.15402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 02/18/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND The introduction of tyrosine kinase inhibitors (TKI) has greatly improved the management of metastatic melanoma. Recent studies have uncovered a relationship between the body mass index (BMI) and outcome of patients with metastatic melanoma. However, conflicting results have challenged the relevance of this finding. In the current work, we aim to dissect body composition features of melanoma patients treated with TKI to evaluate their value as biomarkers. PATIENTS AND METHODS We analyze body composition features via CT scans in a retrospective cohort of 57 patients with non-resectable stage III/IV melanoma receiving first-line treatment with TKI in our department, focusing on the impact of body composition on treatment efficacy and occurrence of adverse events. RESULTS In uni- and multivariate analyses, we identify an association between the visceral adipose tissue gauge index (VATGI) and survival. We furthermore profile additional body composition features including sarcopenia, which was also associated with a shorter overall survival. Finally, we detected an enrichment of cases with fatigue in patients with low VATGI. CONCLUSIONS Our study represents the first exploratory study evaluating the suitability of body composition measurements as biomarkers for melanoma patients treated with TKI. Our data suggest a putative use of VATGI as a biomarker predicting patient outcome.
Collapse
Affiliation(s)
- Miriam Mengoni
- Department of Dermatology, University Hospital Magdeburg, Magdeburg, Germany
| | | | - Mattes Simon Hinnerichs
- Department for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Anar Aghayev
- Department for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Thomas Tüting
- Department of Dermatology, University Hospital Magdeburg, Magdeburg, Germany
| | - Alexey Surov
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
13
|
Owa S, Sasaki T, Ikadai R, Tabata Y, Takeuchi Y, Nishikawa T, Kato M, Higashi S, Sugino Y, Masui S, Nishikawa K, Inoue T. Psoas mass index at the level of the third lumbar vertebra on computed tomography is a prognostic predictor for metastatic castration-sensitive prostate cancer. Int J Clin Oncol 2024; 29:840-846. [PMID: 38587577 DOI: 10.1007/s10147-024-02514-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/13/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Computed tomography-defined low skeletal muscle mass is associated with oncological outcomes in patients with prostate cancer. However, its association with the outcomes of hormone-treated metastatic castration-sensitive prostate cancer remains unclear. We aimed to determine the association between metastatic castration-sensitive prostate cancer and psoas muscle parameters. METHODS We retrospectively reviewed 121 patients with N1 and/or M1 metastatic castration-sensitive prostate cancer who underwent primary androgen deprivation therapy between 2005 and 2021, either by administration of luteinizing hormone-releasing hormone agonist/antagonist or by surgical castration accompanied by bicalutamide, a first-generation antiandrogen. Before treatment administration, the psoas muscle index at the level of the third lumbar vertebra (psoas muscle area [cm2]/height2 [m2]) and the mean Hounsfield units of the psoas muscle were evaluated using non-contrast computed tomography and in relation to oncological outcomes. RESULTS The median follow-up was 56.9 months. Furthermore, during follow-up, 82 (67.7%) and 53 (43.8%) patients progressed to castration-resistant prostate cancer and died, respectively. Multivariate analysis of castration-resistant prostate cancer-free survival and overall survival showed significant differences in the Gleason score, clinical N-stage, and psoas muscle index (median cutoff: 3.044 cm2/m2). CONCLUSIONS Pretreatment psoas muscle index is an independent predictor of poor castration-resistant prostate cancer-free survival and overall survival in patients with N1 and/or M1 metastatic castration-sensitive prostate cancer.
Collapse
Affiliation(s)
- Shunsuke Owa
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Takeshi Sasaki
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Ryota Ikadai
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Yusaku Tabata
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Yushiro Takeuchi
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Taketomo Nishikawa
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Momoko Kato
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Shinichiro Higashi
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Yusuke Sugino
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Satoru Masui
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Kouhei Nishikawa
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Takahiro Inoue
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan.
| |
Collapse
|
14
|
Mengoni M, Braun AD, Hinnerichs MS, Aghayev A, Tüting T, Surov A. Umfassende Analyse des Einflusses der Body Composition auf die Wirksamkeit und das Nebenwirkungsprofil einer Systemtherapie mit Tyrosinkinaseinhibitoren bei Melanompatienten. J Dtsch Dermatol Ges 2024; 22:783-793. [PMID: 38857079 DOI: 10.1111/ddg.15402_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 02/18/2024] [Indexed: 06/11/2024]
Abstract
ZusammenfassungHintergrundDie Einführung von Tyrosinkinaseinhibitoren (TKI) hat die Behandlung von Patienten mit metastasiertem Melanom erheblich verbessert. Aktuelle Studien haben einen Zusammenhang zwischen dem Body‐Mass‐Index (BMI) und dem klinischen Verlauf von Patienten mit metastasiertem Melanom gezeigt. Weitere Studien mit kontroversen Ergebnissen haben jedoch die Interpretation dieser Ergebnisse erschwert. In der aktuellen Arbeit haben wir Parameter der Körperzusammensetzung (Body Composition) von Melanompatienten, die mit TKI behandelt wurden, analysiert, um deren Stellenwert als Biomarker zu evaluieren.Patienten und MethodikIn einer retrospektiven Kohorte bestehend aus 57 Patienten wurden Parameter der Body Composition anhand von CT‐Scans untersucht und deren Einfluss auf das Therapieansprechen und das Auftreten unerwünschter Ereignisse analysiert. Die Studienkohorte umfasste alle Patienten mit metastasiertem, nicht resektablem Melanom im Stadium III/IV, die in unserer Abteilung eine Erstlinientherapie mit TKI erhalten hatten.ErgebnisseMittels uni‐ und multivariater Analysen stellten wir einen Zusammenhang zwischen dem Gauge‐Index des viszeralen Fettgewebes (VATGI) und dem Überleben fest. Darüber hinaus untersuchten wir weitere Parameter der Body Composition, darunter die Sarkopenie, die ebenfalls mit einem kürzeren Gesamtüberleben assoziiert war. Weiterhin konnten wir nachweisen, dass Patienten mit niedrigem VATGI anteilsweise häufiger eine Fatigue aufwiesen.SchlussfolgerungenUnsere Studie ist die erste explorative Studie, die Parameter der Body Composition als Biomarker für Melanompatienten, die mit TKI behandelt werden, untersucht. Unsere Daten deuten darauf hin, dass der VATGI als Biomarker zur Vorhersage des Therapieerfolges verwendet werden könnte.
Collapse
Affiliation(s)
- Miriam Mengoni
- Universitätshautklinik, Universitätsklinikum Magdeburg A. ö. R., Magdeburg
| | | | - Mattes Simon Hinnerichs
- Universitätsklinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A. ö. R., Magdeburg
| | - Anar Aghayev
- Universitätsklinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A. ö. R., Magdeburg
| | - Thomas Tüting
- Universitätshautklinik, Universitätsklinikum Magdeburg A. ö. R., Magdeburg
| | - Alexey Surov
- Universitätsinstitut für Radiologie, Neuroradiologie und Nuklearmedizin, Johannes Wesling Klinikum Minden, Ruhr-Universität Bochum
| |
Collapse
|
15
|
Choi W, Kim CH, Yoo H, Yun HR, Kim DW, Kim JW. Development and validation of a reliable method for automated measurements of psoas muscle volume in CT scans using deep learning-based segmentation: a cross-sectional study. BMJ Open 2024; 14:e079417. [PMID: 38777592 PMCID: PMC11116865 DOI: 10.1136/bmjopen-2023-079417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES We aimed to develop an automated method for measuring the volume of the psoas muscle using CT to aid sarcopenia research efficiently. METHODS We used a data set comprising the CT scans of 520 participants who underwent health check-ups at a health promotion centre. We developed a psoas muscle segmentation model using deep learning in a three-step process based on the nnU-Net method. The automated segmentation method was evaluated for accuracy, reliability, and time required for the measurement. RESULTS The Dice similarity coefficient was used to compare the manual segmentation with automated segmentation; an average Dice score of 0.927 ± 0.019 was obtained, with no critical outliers. Our automated segmentation system had an average measurement time of 2 min 20 s ± 20 s, which was 48 times shorter than that of the manual measurement method (111 min 6 s ± 25 min 25 s). CONCLUSION We have successfully developed an automated segmentation method to measure the psoas muscle volume that ensures consistent and unbiased estimates across a wide range of CT images.
Collapse
Affiliation(s)
- Woorim Choi
- Biomedical Research Center, Asan Medical Center, Songpa-gu, Seoul, Republic of Korea
| | - Chul-Ho Kim
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea
| | - Hyein Yoo
- Biomedical Research Center, Asan Medical Center, Songpa-gu, Seoul, Republic of Korea
| | - Hee Rim Yun
- Coreline Soft Co., Ltd, Mapo-gu, Seoul, Republic of Korea
| | - Da-Wit Kim
- Coreline Soft Co., Ltd, Mapo-gu, Seoul, Republic of Korea
| | - Ji Wan Kim
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea
| |
Collapse
|
16
|
Liu M, Jin Q, Wang H, Li Y. Progressive sarcopenia and myosteatosis predict prognosis of advanced HCC patients treated with immune checkpoint inhibitors. Front Immunol 2024; 15:1396927. [PMID: 38690276 PMCID: PMC11058658 DOI: 10.3389/fimmu.2024.1396927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/05/2024] [Indexed: 05/02/2024] Open
Abstract
Background Immunotherapy stands as a pivotal modality in the therapeutic landscape for the treatment of advanced hepatocellular carcinoma, yet responses vary among patients. This study delves into the potential impact of sarcopenia, myosteatosis and adiposity indicators, as well as their changes during immunotherapy, on treatment response and prognosis in patients with advanced hepatocellular carcinoma treated with immune checkpoint inhibitors. Methods In this retrospective analysis, 116 patients with advanced hepatocellular carcinoma receiving immune checkpoint inhibitors were recruited. Skeletal muscle, intramuscular, subcutaneous, and visceral adipose tissue were assessed by computed tomography at the level of the third lumbar vertebrae before and after 3 months of treatment. Sarcopenia and myosteatosis were evaluated by skeletal muscle index and mean muscle density using predefined threshold values. Patients were stratified based on specific baseline values or median values, along with alterations observed during the treatment course. Overall survival (OS) and progression-free survival (PFS) were compared using the log-rank test and a multifactorial Cox proportional risk model. Results A total of 116 patients were recruited and divided into two cohorts, 81 patients for the training set and 35 patients for the validating set. In the overall cohort, progressive sarcopenia (P=0.021) and progressive myosteatosis (P=0.001) were associated with objective response rates, whereas progressive myosteatosis (P<0.001) was associated with disease control rates. In the training set, baseline sarcopenia, myosteatosis, and subcutaneous and visceral adipose tissue were not significantly associated with PFS and OS. In multivariate analysis adjusting for sex, age, and other factors, progressive sarcopenia(P=0.002) and myosteatosis (P=0.018) remained independent predictors of PFS. Progressive sarcopenia (P=0.005), performance status (P=0.006) and visceral adipose tissue index (P=0.001) were all independent predictors of OS. The predictive models developed in the training set also had good feasibility in the validating set. Conclusion Progressive sarcopenia and myosteatosis are predictors of poor clinical outcomes in patients with advanced hepatocellular carcinoma receiving immune checkpoint inhibitors, and high baseline visceral adiposity is associated with a poorer survival.
Collapse
Affiliation(s)
- Mengchen Liu
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qianna Jin
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Huiyan Wang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunqiao Li
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
17
|
Linder N, Denecke T, Busse H. Body composition analysis by radiological imaging - methods, applications, and prospects. ROFO-FORTSCHR RONTG 2024. [PMID: 38569516 DOI: 10.1055/a-2263-1501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
BACKGROUND This review discusses the quantitative assessment of tissue composition in the human body (body composition, BC) using radiological methods. Such analyses are gaining importance, in particular, for oncological and metabolic problems. The aim is to present the different methods and definitions in this field to a radiological readership in order to facilitate application and dissemination of BC methods. The main focus is on radiological cross-sectional imaging. METHODS The review is based on a recent literature search in the US National Library of Medicine catalog (pubmed.gov) using appropriate search terms (body composition, obesity, sarcopenia, osteopenia in conjunction with imaging and radiology, respectively), as well as our own work and experience, particularly with MRI- and CT-based analyses of abdominal fat compartments and muscle groups. RESULTS AND CONCLUSION Key post-processing methods such as segmentation of tomographic datasets are now well established and used in numerous clinical disciplines, including bariatric surgery. Validated reference values are required for a reliable assessment of radiological measures, such as fatty liver or muscle. Artificial intelligence approaches (deep learning) already enable the automated segmentation of different tissues and compartments so that the extensive datasets can be processed in a time-efficient manner - in the case of so-called opportunistic screening, even retrospectively from diagnostic examinations. The availability of analysis tools and suitable datasets for AI training is considered a limitation. KEY POINTS · Radiological imaging methods are increasingly used to determine body composition (BC).. · BC parameters are usually quantitative and well reproducible.. · CT image data from routine clinical examinations can be used retrospectively for BC analysis.. · Prospectively, MRI examinations can be used to determine organ-specific BC parameters.. · Automated and in-depth analysis methods (deep learning or radiomics) appear to become important in the future.. CITATION FORMAT · Linder N, Denecke T, Busse H. Body composition analysis by radiological imaging - methods, applications, and prospects. Fortschr Röntgenstr 2024; DOI: 10.1055/a-2263-1501.
Collapse
Affiliation(s)
- Nicolas Linder
- Department of Diagnostic and Interventional Radiology, University of Leipzig Medical Center, Leipzig, Germany
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, Sankt Gallen, Switzerland
| | - Timm Denecke
- Department of Diagnostic and Interventional Radiology, University of Leipzig Medical Center, Leipzig, Germany
| | - Harald Busse
- Department of Diagnostic and Interventional Radiology, University of Leipzig Medical Center, Leipzig, Germany
| |
Collapse
|
18
|
Surov A, Meyer HJ, Ehrengut C, Zimmermann S, Schramm D, Hinnerichs M, Bär C, Borggrefe J. Myosteatosis predicts short-term mortality in patients with COVID-19: A multicenter analysis. Nutrition 2024; 120:112327. [PMID: 38341908 DOI: 10.1016/j.nut.2023.112327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/29/2023] [Accepted: 12/06/2023] [Indexed: 02/13/2024]
Abstract
OBJECTIVES Body composition on computed tomography can predict prognosis in patients with COVID-19. The reported data are based on small retrospective studies. The aim of the present study was to analyze the prognostic relevance of skeletal muscle parameter derived from chest computed tomography for prediction of 30-d mortality in patients with COVID-19 in a multicenter setting. METHODS The clinical databases of three centers were screened for patients with COVID-19 between 2020 and 2022. Overall, 447 patients (142 female; 31.7%) were included into the study. The mean age at the time of computed tomography acquisition was 63.8 ± 14.7 y and median age was 65 y. Skeletal muscle area and skeletal muscle density were defined on level T12 of the chest. RESULTS Overall, 118 patients (26.3%) died within the 30-d observation period. Of the patient sample, 255 patients (57.0%) were admitted to an intensive care unit and 122 patients needed mechanical ventilation (27.3%). The mean skeletal muscle area of all patients was 96.1 ± 27.2 cm² (range = 23.2-200.7 cm²). For skeletal muscle density, the mean was 24.3 ± 11.1 Hounsfield units (range = -5.6 to 55.8 Hounsfield units). In survivors, the mean skeletal muscle density was higher compared with the lethal cases (mean 25.8 ± 11.2 versus 20.1 ± 9.6; P < 0.0001). Presence of myosteatosis was independently associated with 30-d mortality: odds ratio = 2.72 (95% CI, 1.71-4.32); P = 0.0001. CONCLUSIONS Myosteatosis is strongly associated with 30-d mortality in patients COVID-19. Patients with COVID-19 with myosteatosis should be considered a risk group.
Collapse
Affiliation(s)
- Alexey Surov
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling Medical Center, Ruhr University Bochum, Germany.
| | - Hans Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Constantin Ehrengut
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Silke Zimmermann
- Department of Laboratory Medicine, University of Leipzig, Leipzig, Germany
| | - Dominik Schramm
- Department of Diagnostic and Interventional Radiology, University of Halle-Wittenberg, Halle (Saale), Germany
| | - Mattes Hinnerichs
- Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Germany
| | - Caroline Bär
- Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Germany
| | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling Medical Center, Ruhr University Bochum, Germany
| |
Collapse
|
19
|
Berg HB, Alavi DT, Beichmann B, Pesonen M, Henriksen C, Paur I, Bøhn SK, Lauritzen PM, Blomhoff R, Henriksen HB. The choice of diagnostic modality influences the proportion of low muscle strength, low muscle mass, and sarcopenia in colorectal cancer patients. Clin Nutr ESPEN 2024; 60:17-23. [PMID: 38479906 DOI: 10.1016/j.clnesp.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND AND AIMS Low muscle strength, low muscle mass, and sarcopenia have a negative impact on health outcomes in colorectal cancer (CRC) patients. Different diagnostic modalities are used to identify these conditions but it is unknown how well the modalities agree. The aim of this study was to compare different diagnostic modalities by means of calculating the proportion of low muscle strength, low muscle mass, and sarcopenia in CRC patients, and to investigate the agreement for sarcopenia between the various modalities. METHODS Men and women participating in the Norwegian Dietary Guidelines and colorectal cancer Survival (CRC-NORDIET) study were included in the analyses. Cut-off values for low muscle strength, low muscle mass, and sarcopenia were defined according to the second consensus set by the European Working Group on Sarcopenia in Older People (EWGSOP2). The diagnostic modalities used to assess muscle strength were handgrip strength and the sit-to-stand test. For muscle mass, computed tomography, dual-energy X-ray absorptiometry (DXA), multi-frequency bioelectrical impedance analysis (MF-BIA), and single-frequency BIA (SF-BIA) were applied. Cohen's kappa was calculated to determine the agreement for low muscle strength and confirmed sarcopenia between diagnostic modalities. RESULTS Five hundred and three men and women (54 % men, mean age of 66 (range 50-80) years old) were included in the analysis. As much as 99 % (n = 70) of the population was identified with low muscle mass by MF-BIA, while the other modalities identified 9-49 % as having low muscle mass. Handgrip strength identified a lower proportion of low muscle strength as compared with the sit-to-stand test (4 % vs. 8 %). When applying various combinations of diagnostic modalities for low muscle strength and low muscle mass, the proportion of sarcopenia was found to be between 0.3 and 11.4 %. There was relatively poor agreement between the different diagnostic modalities with Cohen's Kappa ranging from 0.0 to 0.55, except for the agreement between SF-BIASergi and MF-BIASergi, which was 1. CONCLUSION The proportion of low muscle strength, low muscle mass, and sarcopenia in CRC patients varied considerably depending on the diagnostic modalities used. Further studies are needed to provide modality-specific cut-off values, adjusted to sex, age and body size.
Collapse
Affiliation(s)
- Hedda Beate Berg
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Dena Treider Alavi
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Benedicte Beichmann
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Maiju Pesonen
- Oslo Centre for Biostatistics & Epidemiology (OCBE), Oslo University Hospital, P.O. Box 4950 Nydalen, 0424 Oslo, Norway.
| | - Christine Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Ingvild Paur
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 4950 Nydalen, 0424 Oslo, Norway; Norwegian Advisory Unit on Disease-related Undernutrition, P.O. Box 4950 Nydalen, 0424 Oslo, Norway; Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, P.O. Box 4950 Nydalen, 0424 Oslo, Norway.
| | - Siv Kjølsrud Bøhn
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, P.O. Box 5003 NO-1432 Ås, Norway.
| | - Peter Mæhre Lauritzen
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo and Department of Life Sciences and Health, Oslo Metropolitan University, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway; Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Hege Berg Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| |
Collapse
|
20
|
Deantoni CL, Mirabile A, Chiara A, Giannini L, Midulla M, Del Vecchio A, Fiorino C, Fodor A, Di Muzio NG, Dell’Oca I. Impact of low skeletal muscle mass in oropharyngeal cancer patients treated with radical chemo-radiotherapy: A mono-institutional experience. TUMORI JOURNAL 2024; 110:116-123. [PMID: 37978342 PMCID: PMC11005313 DOI: 10.1177/03008916231212382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/10/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
AIMS Low skeletal muscle mass index (SMI) has recently emerged as an independent prognostic factor in oncological patients and it is linked with poor survival and higher treatment toxicity. The present study aims to determine the possible impact of low SMI on survival and acute toxicity in oropharyngeal patients. METHODS Seventy-six patients with locally advanced oropharyngeal squamous cell carcinoma (stage III-IVC) were treated in our institution with Helical TomoTherapy® (HT - Accuray, Maddison, WI, USA) between 2005 and 2021. All patients received concomitant platinum-based chemotherapy (CT) (at least 200 mg/m2). The SMI was determined using the calculation of cross-sectional area at C3. Twenty patients (26%) presented pre-treatment low SMI, according to Chargi definitions. RESULTS All patients concluded the treatment. Thirteen patients with low SMI (65%) and 22 patients with normal SMI (39%) presented acute toxicity greater than or equal to grade 3, but this difference was not statistically significant (p-value = 0.25). Overall survival was analyzed in 65 patients, excluding those who finished CT-RT less than six months before the analysis. Overall survival was significantly lower in low SMI versus normal SMI patients (p-value = 0.035). Same difference was observed in N0-N2a patients, suggesting an important role of SMI also in lower nodal burden and putatively better prognosis. CONCLUSIONS Although the results are limited to a small population, our case series has the advantage to be very homogeneous in patients and treatment characteristics. In our setting, SMI demonstrated a crucial impact on overall survival. Further investigation with larger samples is necessary to confirm our results to improve patient outcomes.
Collapse
Affiliation(s)
- Chiara L. Deantoni
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Aurora Mirabile
- Department Unit of Oncology, Medical Oncology Department, IRCCS San Raffaele Scientific Institute, Università Vita-Salute, Milano
| | - Anna Chiara
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Giannini
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Martina Midulla
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Del Vecchio
- Department of Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Claudio Fiorino
- Department of Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrei Fodor
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nadia G. Di Muzio
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Italo Dell’Oca
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
21
|
Luo L, Fan Y, Wang Y, Wang Z, Zhou J. Prevalence and clinical outcomes of sarcopenia in patients with esophageal, gastric or colorectal cancers receiving preoperative neoadjuvant therapy: A meta-analysis. Asia Pac J Oncol Nurs 2024; 11:100436. [PMID: 38618524 PMCID: PMC11015508 DOI: 10.1016/j.apjon.2024.100436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/01/2024] [Indexed: 04/16/2024] Open
Abstract
Objective To investigate the prevalence of sarcopenia and its impact on clinical outcomes in patients with esophageal, gastric, or colorectal cancer (EC, GC, and CRC) receiving neoadjuvant therapy through Meta-analysis. Methods We searched the PubMed, Embase databases, and Cochrane Library for the prevalence of sarcopenia and its impact on clinical outcomes in EC, GC, or CRC patients treated with neoadjuvant therapy (NAT) from inception to November 2022. The primary endpoints were the prevalence of sarcopenia and overall survival in patients with EC, GC, or CRC treated with NAT. Secondary outcomes included recurrence-free survival, total postoperative complications, grade 3-4 chemotherapy toxicity, and 30-day mortality after surgery. Results Thirty-one retrospective studies with 3651 subjects were included. In a fixed-effects model, the prevalence of muscle loss was higher in patients with EC, GC, or CRC at 50% (95% CI = 42% to 58%). The results of the multivariate analysis showed that preoperative patients with sarcopenia had a 1.91 times shorter overall survival (95% CI = 1.61-2.27) and a 1.77 times shorter recurrence-free survival time (95% CI = 1.33-2.35) than patients without sarcopenia, and that patients with sarcopenia had a higher risk of total postoperative complications than patients without sarcopenia OR = 1.27 (95% CI = 1.03-1.57). However, the two groups had no statistical difference in grade 3-4 chemotherapy toxicity (P = 0.84) or 30-d postoperative mortality (P = 0.88). Conclusions The prevalence of sarcopenia in patients with EC, GC, or CRC during NAT is high, and it is associated with poorer clinical outcomes. Clinicians should closely monitor the changes in patients' body composition and guide patients to carry out a reasonable diet and appropriate exercise to improve their poor prognosis and quality of life. Systematic review registration CRD42023387817.
Collapse
Affiliation(s)
- Lin Luo
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yidan Fan
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanan Wang
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhen Wang
- Traumatic Orthopedics, Guangzhou Red Cross Hospital, Guangzhou, China
| | - Jian Zhou
- Mammography, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| |
Collapse
|
22
|
Kodali N, Bhattaru A, Blanchard I, Sharma Y, Lipner SR. Assessing melanoma prognosis: the interplay between patient profiles, survival, and BRAF, NRAS, KIT, and TWT mutations in a retrospective multi-study analysis. Melanoma Res 2024:00008390-990000000-00140. [PMID: 38564430 DOI: 10.1097/cmr.0000000000000968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
The incidence and prevalence of melanoma are increasing globally, presenting a significant public health concern. The main genetic drivers of melanoma include BRAF, NRAS, KIT and triple wild-type (TWT) mutations. Little is known about the effects of these mutations on outcomes in terms of demographics and patient characteristics. We examined differences in melanoma mortality risk and mutation count across mutation type and patient disease profile. We extrapolated primary melanoma patient data from 14 studies via the cBioportal database. Patients were divided into demographic groups and classified according to BRAF, NRAS, KIT and TWT mutation status. Analyses included two-sample Student t-test and two-way analysis of variance tests analysis with Tukey's post hoc test. Survival outcomes were compared via Kaplan-Meier curve and Cox regression. NRAS-mutated patients exhibited decreased overall survival compared to BRAF-mutated patients. Male patients had higher mutation counts across all gene groups than females, with the fewest TWT mutations in comparison to BRAF, NRAS and KIT mutations. Males also exhibited increased mortality risk for NRAS, KIT and TWT mutations compared to BRAF mutations. An unknown primary melanoma was associated with increased mortality risk across all gene groups. NRAS-mutated acral melanoma patients had an increased mortality risk compared to NRAS-mutated cutaneous melanoma patients. Older patients had a higher mortality risk than younger patients. Patients with heavier versus lower weights had lower mortality risk, which was more pronounced for BRAF-mutated patients. These relationships highlight the importance of demographic and pathologic relationships to aid in risk assessment and personalize treatment plans.
Collapse
Affiliation(s)
- Nilesh Kodali
- Department of Education, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Abhijit Bhattaru
- Department of Education, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Isabella Blanchard
- Department of Education, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Yash Sharma
- Derpartment of Education, UT Southwestern Medical School, Dallas, Texas
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
| |
Collapse
|
23
|
Nakagawara K, Shiraishi Y, Chubachi S, Tanabe N, Maetani T, Asakura T, Namkoong H, Tanaka H, Shimada T, Azekawa S, Otake S, Fukushima T, Watase M, Terai H, Sasaki M, Ueda S, Kato Y, Harada N, Suzuki S, Yoshida S, Tateno H, Yamada Y, Jinzaki M, Hirai T, Okada Y, Koike R, Ishii M, Kimura A, Imoto S, Miyano S, Ogawa S, Kanai T, Fukunaga K. Integrated assessment of computed tomography density in pectoralis and erector spinae muscles as a prognostic biomarker for coronavirus disease 2019. Clin Nutr 2024; 43:815-824. [PMID: 38350289 DOI: 10.1016/j.clnu.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/12/2024] [Accepted: 02/02/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND & AIMS: Muscle quantification using chest computed tomography (CT) is a useful prognostic biomarker for coronavirus disease 2019 (COVID-19). However, no studies have evaluated the clinical course through comprehensive assessment of the pectoralis and erector spinae muscles. Therefore, we compared the impact of the areas and densities of these muscles on COVID-19 infection outcome. METHODS This multicenter retrospective cohort study was conducted by the COVID-19 Task Force. A total of 1410 patients with COVID-19 were included, and data on the area and density of the pectoralis and erector spinae muscles on chest CT were collected. The impact of each muscle parameter on the clinical outcome of COVID-19 was stratified according to sex. The primary outcome was the percentage of patients with severe disease, including those requiring oxygen supplementation and those who died. Additionally, 167 patients were followed up for changes in muscle parameters at three months and for the clinical characteristics in case of reduced CT density. RESULTS For both muscles, low density rather than muscle area was associated with COVID-19 severity. Regardless of sex, lower erector spinae muscle density was associated with more severe disease than pectoralis muscle density. The muscles were divided into two groups using the receiver operating characteristic curve of CT density, and the population was classified into four (Group A: high CT density for both muscles, Group B: low CT density for pectoralis and high for erector spinae muscle. Group C: high CT density for pectoralis and low for erector spinae muscle, Group D: low CT density for both muscles). In univariate analysis, Group D patients exhibited worse outcomes than Group A (OR: 2.96, 95% CI: 2.03-4.34 in men; OR: 3.02, 95% CI: 2.66-10.4 in women). Multivariate analysis revealed that men in Group D had a significantly more severe prognosis than those in Group A (OR: 1.82, 95% CI: 1.16-2.87). Moreover, Group D patients tended to have the highest incidence of other complications due to secondary infections and acute kidney injury during the clinical course. Longitudinal analysis of both muscle densities over three months revealed that patients with decreased muscle density over time were more likely to have severe cases than those who did not. CONCLUSIONS Muscle density, rather than muscle area, predicts the clinical outcomes of COVID-19. Integrated assessment of pectoralis and erector spinae muscle densities demonstrated higher accuracy in predicting the clinical course of COVID-19 than individual assessments.
Collapse
Affiliation(s)
- Kensuke Nakagawara
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yusuke Shiraishi
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Naoya Tanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Tomoki Maetani
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takanori Asakura
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan; Department of Clinical Medicine (Laboratory of Bioregulatory Medicine), Kitasato University School of Pharmacy, Tokyo, Japan; Department of Respiratory Medicine, Kitasato University, Kitasato Institute Hospital, Tokyo, Japan
| | - Ho Namkoong
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Hiromu Tanaka
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Shimada
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shuhei Azekawa
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shiro Otake
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takahiro Fukushima
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Mayuko Watase
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hideki Terai
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Mamoru Sasaki
- Internal Medicine, JCHO (Japan Community Health Care Organization) Saitama Medical Center, Saitama, Japan
| | - Soichiro Ueda
- Internal Medicine, JCHO (Japan Community Health Care Organization) Saitama Medical Center, Saitama, Japan
| | - Yukari Kato
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Norihiro Harada
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Shoji Suzuki
- Department of Respiratory Medicine, Saitama City Hospital, Saitama, Japan
| | - Shuichi Yoshida
- Department of Respiratory Medicine, Saitama City Hospital, Saitama, Japan
| | - Hiroki Tateno
- Department of Respiratory Medicine, Saitama City Hospital, Saitama, Japan
| | - Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yukinori Okada
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, Japan; Department of Genome Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Laboratory for Systems Genetics, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| | - Ryuji Koike
- Medical Innovation Promotion Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Makoto Ishii
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akinori Kimura
- Institute of Research, Tokyo Medical and Dental University, Tokyo, Japan
| | - Seiya Imoto
- Division of Health Medical Intelligence, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Satoru Miyano
- M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
24
|
Melekh O, Barajas Ordonez F, Melekh B, Rodríguez-Feria P, Pech M, Flintrop W, Surov A. Association between sacroiliac joint forms and subchondral changes in patients with Crohn's disease. Int J Rheum Dis 2024; 27:e15046. [PMID: 38414165 DOI: 10.1111/1756-185x.15046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/30/2023] [Accepted: 01/11/2024] [Indexed: 02/29/2024]
Abstract
AIM To assess the relationship between anatomical variants of sacroiliac joint (SIJ) and subchondral changes detected in magnetic resonance enterography (MRE) in patients with Crohn's disease (CD). METHODS This was a retrospective study of 60 CD patients, who were divided into two groups: with (n = 16) and without SIJ (n = 44) involvement, depending on the presence of inflammatory (bone marrow edema) and structural changes (sclerosis and erosions) in MRE. Anatomical variants of SIJ were assessed in CT of the abdomen and/or pelvis, distinguishing typical form with convex iliac surface and atypical forms. Univariate and multivariate analyses were performed to reveal an association between joint changes and forms. RESULTS Our study included 60 patients (38 males; mean age 38.72 years ± 13.33). Patients with SIJ changes were older (p = .044). No significant differences in CD localization and behavior were found. The most common SIJ lesions were structural changes (in 75% of patients); the main atypical form was the iliosacral complex. The univariate and multivariate analyses showed a significant association of atypical forms with total subchondral changes (odds ratio [OR]: 3.429, 95% confidence interval [CI] 1.043-11.268; p = .042; OR: 5.066, 95% CI: 1.273-20.167; p = .021, respectively), and with structural changes (OR: 4.185, 95% CI: 1.155-15.160; p = .029; OR: 5.986, 95% CI: 1.293-27.700; p = .022, respectively). CONCLUSION Atypical forms of SIJ are a risk factor for the occurrence of structural joint changes in CD patients. An association between bone marrow edema and atypical forms was not found.
Collapse
Affiliation(s)
- Oksana Melekh
- University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Felix Barajas Ordonez
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH, Aachen, Germany
| | - Bohdan Melekh
- University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Pablo Rodríguez-Feria
- Department of International Health, CAPHRI - Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Maciej Pech
- University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Wiebke Flintrop
- Department of Pediatrics, University Hospital Magdeburg, Magdeburg, Germany
| | - Alexey Surov
- Institute for Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital by Muehlenkreiskliniken, Ruhr University Bochum, Minden, Germany
| |
Collapse
|
25
|
Yamamoto S, Ichita C. Potential of Muscle Mass Evaluation for Prognostic Prediction of COVID-19. Chest 2024; 165:e86-e87. [PMID: 38461025 DOI: 10.1016/j.chest.2023.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 03/11/2024] Open
Affiliation(s)
- Shota Yamamoto
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI.
| | - Chikamasa Ichita
- Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, Japan
| |
Collapse
|
26
|
Kutaiba N, Dobson J, Finnis M, Bellomo R. The identification of an optimal body size parameter to adjust skeletal muscle area on chest CT in COVID-19 patients. J Frailty Sarcopenia Falls 2024; 9:16-24. [PMID: 38444548 PMCID: PMC10910254 DOI: 10.22540/jfsf-09-016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 03/07/2024] Open
Abstract
Objectives The most efficient way to adjust skeletal muscle area (SMA) derived from chest CT to body size remains unclear. We hypothesized that vertebral body area (VBA) measurement would allow such efficient adjustment. Methods We conducted a retrospective observational study of chest CT imaging in a cohort of critically ill COVID-19 patients. We measured paravertebral SMA at T5 level and T5 vertebral body anteroposterior length, width, and area. We used linear regression and multivariable modelling to assess the association of VBA with SMA. Results In 48 COVID-19 patients in ICU, T5 VBA could be easily derived from simple width and anteroposterior length linear measurements. T5 VBA (measured manually or estimated from width and length) performed similarly to height (R2 of 0.22) as an adjustment variable for SMA, with R2 of 0.23 and 0.22, respectively. Gender had the strongest correlation with SMA (R2 = 0.28). Adding height or age to a model using gender and VBA did not improve correlation. Conclusions Gender and estimated VBA from simple linear measurements at T5 level on CT images can be utilized for adjustment of SMA without the need for height. Validation of these findings in larger cohorts of critically ill patients is now needed.
Collapse
Affiliation(s)
- Numan Kutaiba
- Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
- Department of Radiology, The University of Melbourne, Parkville, Victoria, Australia
| | - Julie Dobson
- Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
| | - Mark Finnis
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
| | - Rinaldo Bellomo
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Critical Care, The University of Melbourne, Parkville, Victoria, Australia
- Department of Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia
- Data Analytics Research and Evaluation Centre, Austin Hospital, Melbourne, Australia
- Department of Critical Care, Royal Melbourne Hospital, Melbourne, Australia
| |
Collapse
|
27
|
Bunch PM, Rigdon J, Niazi MKK, Barnard RT, Boutin RD, Houston DK, Lenchik L. Association of CT-Derived Skeletal Muscle and Adipose Tissue Metrics with Frailty in Older Adults. Acad Radiol 2024; 31:596-604. [PMID: 37479618 PMCID: PMC10796847 DOI: 10.1016/j.acra.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/18/2023] [Accepted: 06/02/2023] [Indexed: 07/23/2023]
Abstract
RATIONALE AND OBJECTIVES Tools are needed for frailty screening of older adults. Opportunistic analysis of body composition could play a role. We aim to determine whether computed tomography (CT)-derived measurements of muscle and adipose tissue are associated with frailty. MATERIALS AND METHODS Outpatients aged ≥ 55 years consecutively imaged with contrast-enhanced abdominopelvic CT over a 3-month interval were included. Frailty was determined from the electronic health record using a previously validated electronic frailty index (eFI). CT images at the level of the L3 vertebra were automatically segmented to derive muscle metrics (skeletal muscle area [SMA], skeletal muscle density [SMD], intermuscular adipose tissue [IMAT]) and adipose tissue metrics (visceral adipose tissue [VAT], subcutaneous adipose tissue [SAT]). Distributions of demographic and CT-derived variables were compared between sexes. Sex-specific associations of muscle and adipose tissue metrics with eFI were characterized by linear regressions adjusted for age, race, ethnicity, duration between imaging and eFI measurements, and imaging parameters. RESULTS The cohort comprised 886 patients (449 women, 437 men, mean age 67.9 years), of whom 382 (43%) met the criteria for pre-frailty (ie, 0.10 < eFI ≤ 0.21) and 138 (16%) for frailty (eFI > 0.21). In men, 1 standard deviation changes in SMD (β = -0.01, 95% confidence interval [CI], -0.02 to -0.001, P = .02) and VAT area (β = 0.008, 95% CI, 0.0005-0.02, P = .04), but not SMA, IMAT, or SAT, were associated with higher frailty. In women, none of the CT-derived muscle or adipose tissue metrics were associated with frailty. CONCLUSION We observed a positive association between frailty and CT-derived biomarkers of myosteatosis and visceral adiposity in a sex-dependent manner.
Collapse
Affiliation(s)
- Paul M Bunch
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Boulevard,Winston-Salem, NC 27157 (P.M.B., L.L.).
| | - Joseph Rigdon
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Medical Center Boulevard,Winston-Salem, North Carolina (J.R., R.T.B.)
| | - Muhammad Khalid Khan Niazi
- Center for Biomedical Informatics, Wake Forest University School of Medicine, Medical Center Boulevard,Winston-Salem, North Carolina (M.K.K.N.)
| | - Ryan T Barnard
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Medical Center Boulevard,Winston-Salem, North Carolina (J.R., R.T.B.)
| | - Robert D Boutin
- Department of Radiology, Stanford University School of Medicine, Stanford, California (R.D.B.)
| | - Denise K Houston
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Medical Center Boulevard,Winston-Salem, North Carolina (D.K.H.)
| | - Leon Lenchik
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Boulevard,Winston-Salem, NC 27157 (P.M.B., L.L.)
| |
Collapse
|
28
|
van Beers MA, Speksnijder CM, van Gils CH, Frederix GWJ, Dankbaar JW, de Bree R. Prophylactic pectoralis major flap to compensate for increased risk of pharyngocutaneous fistula in laryngectomy patients with low skeletal muscle mass (PECTORALIS): study protocol for a randomized controlled trial. BMC Cancer 2024; 24:76. [PMID: 38225572 PMCID: PMC10788993 DOI: 10.1186/s12885-023-11773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Total laryngectomy (TL) is a surgical procedure commonly performed on patients with advanced laryngeal or hypopharyngeal carcinoma. One of the most common postoperative complications following TL is the development of a pharyngocutaneous fistula (PCF), characterized by a communication between the neopharynx and the skin. PCF can lead to extended hospital stays, delayed oral feeding, and compromised quality of life. The use of a myofascial pectoralis major flap (PMMF) as an onlay technique during pharyngeal closure has shown potential in reducing PCF rates in high risk patients for development of PCF such as patients undergoing TL after chemoradiation and low skeletal muscle mass (SMM). Its impact on various functional outcomes, such as shoulder and neck function, swallowing function, and voice quality, remains less explored. This study aims to investigate the effectiveness of PMMF in reducing PCF rates in patients with low SMM and its potential consequences on patient well-being. METHODS This multicenter study adopts a randomized clinical trial (RCT) design and is funded by the Dutch Cancer Society. Eligible patients for TL, aged ≥ 18 years, mentally competent, and proficient in Dutch, will be enrolled. One hundred and twenty eight patients with low SMM will be centrally randomized to receive TL with or without PMMF, while those without low SMM will undergo standard TL. Primary outcome measurement involves assessing PCF rates within 30 days post-TL. Secondary objectives include evaluating quality of life, shoulder and neck function, swallowing function, and voice quality using standardized questionnaires and functional tests. Data will be collected through electronic patient records. DISCUSSION This study's significance lies in its exploration of the potential benefits of using PMMF as an onlay technique during pharyngeal closure to reduce PCF rates in TL patients with low SMM. By assessing various functional outcomes, the study aims to provide a comprehensive understanding of the impact of PMMF deployment. The anticipated results will contribute valuable insights into optimizing surgical techniques to enhance patient outcomes and inform future treatment strategies for TL patients. TRIAL REGISTRATION NL8605, registered on 11-05-2020; International Clinical Trials Registry Platform (ICTRP).
Collapse
Affiliation(s)
- Maartje A van Beers
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
| | - Caroline M Speksnijder
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Carla H van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Geert W J Frederix
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jan Willem Dankbaar
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands.
| |
Collapse
|
29
|
Yin L, Song C, Cui J, Lin X, Li N, Fan Y, Zhang L, Liu J, Chong F, Cong M, Li Z, Li S, Guo Z, Li W, Shi H, Xu H. Association of possible sarcopenia with all-cause mortality in patients with solid cancer: A nationwide multicenter cohort study. J Nutr Health Aging 2024; 28:100023. [PMID: 38216426 DOI: 10.1016/j.jnha.2023.100023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/25/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVES The concept of possible sarcopenia (PS) was recently introduced to enable timely intervention in settings without the technologies required to make a full diagnosis of sarcopenia. This study aimed to investigate the association between PS and all-cause mortality in patients with solid cancer. DESIGN Retrospective observational study. SETTING AND PARTICIPANTS 13,736 patients with 16 types of solid cancer who were ≥18 years old. MEASUREMENTS The presence of both a low calf circumference (men <34 cm or women <33 cm) and low handgrip strength (men <28 kg or women <18 kg) was considered to indicate PS. Harrell's C-index was used to assess prognostic value and the association of PS with mortality was estimated by calculating multivariable-adjusted hazard ratios (HRs). RESULTS The study enrolled 7207 men and 6529 women (median age = 57.8 years). During a median follow-up of 43 months, 3150 deaths occurred. PS showed higher Harrell's C-index (0.549, 95%CI = [0.541, 0.557]) than the low calf circumference (0.541, 95%CI = [0.531, 0.551], P = 0.037) or low handgrip strength (0.542, 95%CI = [0.532, 0.552], P = 0.026). PS was associated with increased mortality risk in both univariate (HR = 1.587, 95%CI = [1.476, 1.708]) and multivariable-adjusted models (HR = 1.190, 95%CI = [1.094, 1.293]). Sensitivity analyses showed that the association of PS with mortality was robust in different covariate subgroups, which also held after excluding those patients who died within the first 3 months (HR = 1.162, 95%CI = [1.060, 1.273]), 6 months (HR = 1.150, 95%CI = [1.039, 1.274]) and 12 months (HR = 1.139, 95%CI = [1.002, 1.296]) after enrollment. CONCLUSION PS could independently and robustly predict all-cause mortality in patients with solid cancer. These findings imply the importance of including PS assessment in routine cancer care to provide significant prognostic information to help mitigate sarcopenia-related premature deaths.
Collapse
Affiliation(s)
- Liangyu Yin
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, China; Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Chunhua Song
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Jiuwei Cui
- Cancer Center of the First Hospital of Jilin University, Changchun 130021, China
| | - Xin Lin
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, China
| | - Na Li
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, China
| | - Yang Fan
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, China
| | - Ling Zhang
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, China
| | - Jie Liu
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, China
| | - Feifei Chong
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, China
| | - Minghua Cong
- Department of Comprehensive Oncology, National Cancer Center or Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Zengning Li
- Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang 050031, China
| | - Suyi Li
- Department of Nutrition and Metabolism of Oncology, The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Cancer Hospital), Hefei 230031, China
| | - Zengqing Guo
- Department of Medical Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, China
| | - Wei Li
- Cancer Center of the First Hospital of Jilin University, Changchun 130021, China
| | - Hanping Shi
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; Key Laboratory of Cancer FSMP for State Market Regulation, Beijing 100038, China.
| | - Hongxia Xu
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, China.
| |
Collapse
|
30
|
Karim H, Thormann M, Omari J, Surov A, Schinner R, Seidensticker R, Ingenerf M, Ricke J, Schmid-Tannwald C. Diffusion-weighted MRI (DWI) for assessment of response to high-dose-rate CT-guided brachytherapy (HDR-BT) of hepatocellular carcinoma. Acta Radiol 2024; 65:14-22. [PMID: 36843430 DOI: 10.1177/02841851231154498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
BACKGROUND High-dose-rate computed tomography (CT)-guided brachytherapy (HDR-BT) has shown promising results in patients with hepatocellular carcinoma (HCC). While growing evidence shows clear limitations of mRECIST, diffusion-weighted imaging (DWI) has relevant potential in improving the response assessment. PURPOSE To assess whether DWI allows evaluation of short- and long-term tumor response in patients with HCC after HDR-BT. MATERIAL AND METHODS A total of 22 patients with 11 non-responding HCCs (NR-HCC; local tumor recurrence within two years) and 24 responding HCCs (R-HCC; follow-up at least two years) were included in this retrospective bi-center study. HCCs were treated with HDR-BT and patients underwent pre- and post-interventional magnetic resonance imaging (MRI). Analyses of DWI were evaluated and compared between pre-interventional MRI, 1.follow-up after 3 months and 2.follow-up at the time of the local tumor recurrence (in NR-HCC) or after 12 months (in R-HCC). RESULTS ADCmean of R-HCC increased significantly after HDR-BT on the first and second follow-up (ADCmean: 0.87 ± 0.18 × 10-3 mm2/s [pre-interventional]: 1.14 ± 0.23 × 10-3 mm2/s [1. post-interventional]; 1.42 ± 0.32 × 10-3 mm2/s [2. post-interventional]; P < 0.001). ADCmean of NR-HCC did not show a significant increase from pre-intervention to 1. post-interventional MRI (ADCmean: 0.85 ± 0.24 × 10-3 mm2/s and 1.00 ± 0.30 × 10-3 mm2/s, respectively; P = 0.131). ADCmean increase was significant between pre-intervention and 2. follow-up (ADCmean: 1.03 ± 0.19 × 10-3 mm2/s; P = 0.018). There was no significant increase of ADCmean between the first and second follow-up. There was, however, a significant increase of ADCmin after 12 months (ADCmin: 0.87 ± 0.29 × 10-3 mm2/s) compared to pre-interventional MRI and first follow-up (P < 0.005) only in R-HCC. CONCLUSION The tumor response after CT-guided HDR-BT was associated with a significantly higher increase in ADCmean and ADCmin in short- and long-term follow-up.
Collapse
Affiliation(s)
- Homeira Karim
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Maximilian Thormann
- Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Jazan Omari
- Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Alexey Surov
- Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Regina Schinner
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | | | - Maria Ingenerf
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Jens Ricke
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | | |
Collapse
|
31
|
Gullo RL, Partridge SC, Shin HJ, Thakur SB, Pinker K. Update on DWI for Breast Cancer Diagnosis and Treatment Monitoring. AJR Am J Roentgenol 2024; 222:e2329933. [PMID: 37850579 PMCID: PMC11196747 DOI: 10.2214/ajr.23.29933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
DWI is a noncontrast MRI technique that measures the diffusion of water molecules within biologic tissue. DWI is increasingly incorporated into routine breast MRI examinations. Currently, the main applications of DWI are breast cancer detection and characterization, prognostication, and prediction of treatment response to neoadjuvant chemotherapy. In addition, DWI is promising as a noncontrast MRI alternative for breast cancer screening. Problems with suboptimal resolution and image quality have restricted the mainstream use of DWI for breast imaging, but these shortcomings are being addressed through several technologic advancements. In this review, we present an up-to-date assessment of the use of DWI for breast cancer imaging, including a summary of the clinical literature and recommendations for future use.
Collapse
Affiliation(s)
- Roberto Lo Gullo
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Savannah C Partridge
- Department of Radiology, University of Washington School of Medicine, University of Washington, Seattle, WA, USA 98109, USA
| | - Hee Jung Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Sunitha B Thakur
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Katja Pinker
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| |
Collapse
|
32
|
Yan H, Yang H, Jiang P, Dong L, Zhang Z, Zhou Y, Zeng Q, Li P, Sun Y, Zhu S. A radiomics model based on T2WI and clinical indexes for prediction of lateral lymph node metastasis in rectal cancer. Asian J Surg 2024; 47:450-458. [PMID: 37833219 DOI: 10.1016/j.asjsur.2023.09.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/19/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE The aim of this study was to explore the clinical value of a radiomics prediction model based on T2-weighted imaging (T2WI) and clinical indexes in predicting lateral lymph node (LLN) metastasis in rectal cancer patients. METHODS This was a retrospective analysis of 106 rectal cancer patients who had undergone LLN dissection. The clinical risk factors for LLN metastasis were selected by multivariable logistic regression analysis of the clinical indicators of the patients. The LLN radiomics features were extracted from the pelvic T2WI of the patients. The least absolute shrinkage and selection operator algorithm and backward stepwise regression method were adopted for feature selection. Three LLN metastasis prediction models were established through logistic regression analysis based on the clinical risk factors and radiomics features. Model performance was assessed in terms of discriminability and decision curve analysis in the training, verification and test sets. RESULTS The model based on the combined T2WI radiomics features and clinical risk factors demonstrated the highest accuracy, surpassing the models based solely on either T2WI radiomics features or clinical risk factors. Specifically, the model achieved an AUC value of 0.836 in the test set. Decision curve analysis revealed that this model had the greatest clinical utility for the vast majority of the threshold probability range from 0.4 to 1.0. CONCLUSION Combining T2WI radiomics features with clinical risk factors holds promise for the noninvasive assessment of the biological characteristics of the LLNs in rectal cancer, potentially aiding in therapeutic decision-making and optimizing patient outcomes.
Collapse
Affiliation(s)
- Hao Yan
- Department of Oncology, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China
| | - Hongjie Yang
- Nankai University, Tianjin, 300071, China; The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, 300121, China; Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, 300121, China
| | | | - Longchun Dong
- Department of Radiology, Tianjin Union Medical Center, Tianjin, 300121, China
| | - Zhichun Zhang
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, 300121, China; Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, 300121, China
| | - Yuanda Zhou
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, 300121, China; Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, 300121, China
| | - Qingsheng Zeng
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, 300121, China; Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, 300121, China
| | - Peng Li
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, 300121, China; Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, 300121, China
| | - Yi Sun
- Nankai University, Tianjin, 300071, China; The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, 300121, China; Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, 300121, China.
| | - Siwei Zhu
- Department of Oncology, Tianjin Union Medical Center, Nankai University, Tianjin, 300121, China; Nankai University, Tianjin, 300071, China; The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, 300121, China.
| |
Collapse
|
33
|
Yakti FAZ, Abusalah L, Ganji V. Sarcopenia and Mortality in Critically Ill COVID-19 Patients. Life (Basel) 2023; 14:24. [PMID: 38255640 PMCID: PMC10820280 DOI: 10.3390/life14010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/10/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
COVID-19 can manifest as either asymptomatic or progressing to a severe phase in some patients, which may require hospitalization. These patients may experience dyspnea and hypoxia, leading to the development of acute respiratory distress syndrome. Studies have reported an increased risk of severe sarcopenia in COVID-19 patients during and after recovery. This narrative review aimed to summarize and synthesize available studies on the association between sarcopenia and mortality in critically ill COVID-19 patients. A total of 22 studies conducted on hospitalized COVID-19 patients were included in this review. Of those, 17 studies reported a direct association, while 5 studies showed no association between sarcopenia and mortality in severe COVID-19 patients. It is important to maintain muscle quality and quantity in defense against COVID-19. The measurement of lean muscle mass should be included in the risk assessment of severely ill COVID-19 patients as part of the therapy plan.
Collapse
Affiliation(s)
- Fatima Al Zahra Yakti
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (F.A.Z.Y.); (L.A.)
| | - Lana Abusalah
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (F.A.Z.Y.); (L.A.)
| | - Vijay Ganji
- Department of Nutrition and Dietetics, School of Health and Human Sciences, Indiana University Indianapolis, 1050 Wishard Blvd., Indianapolis, IN 46202, USA
| |
Collapse
|
34
|
Kubo M, Yasui-Yamada S, Hayashi H, Kitao M, Wada K, Yamanaka A, Ohmae N, Matsuoka M, Kamimura S, Shimada A, Kitamura Y, Hamada Y. Development and validation of equations for predicting appendicular skeletal muscle mass in male patients with head and neck cancer and normal hydration status. Nutrition 2023; 116:112184. [PMID: 37678015 DOI: 10.1016/j.nut.2023.112184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE Muscle mass is typically assessed by abdominal computed tomography, magnetic resonance imaging, and dual-energy x-ray absorptiometry. However, these tests are not routinely performed in patients with head and neck cancer (HNC), making sarcopenia assessment difficult. The aim of this study was to develop and validate equations for predicting appendicular skeletal muscle mass (ASM) from data obtained in daily medical practice, with bioelectrical impedance analysis (BIA)-measured appendicular skeletal muscle mass (BIA-ASM) as a reference. METHODS This cross-sectional study included 103 men with HNC who were randomly placed into development and validation groups. The prediction equations for BIA-ASM were developed by multiple regression analysis and validated by Bland-Altman analyses. The estimated skeletal muscle mass index (eSMI) was also statistically evaluated to discriminate the cutoff value for BIA-measured SMI according to the Asian Working Groups for Sarcopenia. RESULTS Two practical equations, which included 24-h urinary creatinine excretion volume (24hUCrV), handgrip strength (HGS), body weight (BW), and body height (BHt), were developed: ASM (kg) = -39.46 + (3.557 × 24hUCrV [g]) + (0.08872 × HGS [kg]) + (0.1263 × BW [kg]) + (0.2661 × BHt [cm]) if available for 24hUCrV (adjusted R2 = 0.8905), and ASM (kg) = -42.60 + (0.1643 × HGS [kg]) + (0.1589 × BW [kg]) + (0.2807 × BHt [cm]) if not (adjusted R2 = 0.8589). ASM estimated by these two equations showed a significantly strong correlation with BIA-ASM (R > 0.900). Bland-Altman analyses showed a good agreement, and eSMI accuracy was high (>80%) in both equations. CONCLUSIONS These two equations are a valid option for estimating ASM and diagnosing sarcopenia in patients with HNC in all facilities without special equipment.
Collapse
Affiliation(s)
- Miyu Kubo
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Sonoko Yasui-Yamada
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
| | - Haruka Hayashi
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Midori Kitao
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Kyoko Wada
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Ayaka Yamanaka
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Nao Ohmae
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Momoyo Matsuoka
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Seiichiro Kamimura
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Aki Shimada
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yoshiaki Kitamura
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yasuhiro Hamada
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| |
Collapse
|
35
|
Boriesosdick J, Surov A, Michael A, Mönninghoff C, Niehoff JH, Haag NP, Shahzadi I, Kroeger JR, Schellinger P, Borggrefe J. Sarcopenia is a predictor of patient death in acute ischemic stroke. J Stroke Cerebrovasc Dis 2023; 32:107421. [PMID: 37826941 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107421] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/03/2023] [Accepted: 10/07/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Sarcopenia is proposed as a novel imaging biomarker in several acute conditions regarding outcome and mortality. The aim of the present study was to investigate the prognostic role of the masseter muscles in patients with acute ischemic stroke (AIS). METHODS Overall, 189 patients with AIS that received mechanical thrombectomy were retrospectively enrolled in this study. Outcome and overall survival after 90 days were analyzed. Transversal surface area and density of the masseter muscles were measured. The diagnostic performance for the estimation of a) favorable modified ranking scale 90 days (mRS 90) outcome and b) death at 90 days was calculated using univariate and multivariate logistic regression analysis, followed by receiver operating characteristics and Odds ratios. RESULTS The masseter muscle area provided a significant difference between patients who survived and those who died and between patients who had a favorable outcome (mRS 90 < 3) and those who did not. The cutoff for a favorable mRS 90 was found to be 435.8 mm2 for men and 338.8 mm2 for women, the cutoff for the prediction of death 421.3 mm2 for men and 326.6 mm2 for women. Masseter muscle area was the third strongest predictor in both categories after patient age and NIHSS. CONCLUSIONS Masseter muscle area is an independent predictor of mortality in patients with AIS.
Collapse
Affiliation(s)
- Jan Boriesosdick
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden, Ruhr University Bochum, Hans-Nolte-Str. 1, Minden 32429, Germany
| | - Alexey Surov
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden, Ruhr University Bochum, Hans-Nolte-Str. 1, Minden 32429, Germany
| | - Arwed Michael
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden, Ruhr University Bochum, Hans-Nolte-Str. 1, Minden 32429, Germany
| | - Christoph Mönninghoff
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden, Ruhr University Bochum, Hans-Nolte-Str. 1, Minden 32429, Germany
| | - Julius Henning Niehoff
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden, Ruhr University Bochum, Hans-Nolte-Str. 1, Minden 32429, Germany
| | - Nina Pauline Haag
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden, Ruhr University Bochum, Hans-Nolte-Str. 1, Minden 32429, Germany
| | - Iram Shahzadi
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden, Ruhr University Bochum, Hans-Nolte-Str. 1, Minden 32429, Germany
| | - Jan-Robert Kroeger
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden, Ruhr University Bochum, Hans-Nolte-Str. 1, Minden 32429, Germany
| | - Peter Schellinger
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden, Ruhr University Bochum, Hans-Nolte-Str. 1, Minden 32429, Germany
| | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden, Ruhr University Bochum, Hans-Nolte-Str. 1, Minden 32429, Germany.
| |
Collapse
|
36
|
Schaeffers AWMA, Devriese LA, van Gils CH, Dankbaar JW, Voortman J, de Boer JP, Slingerland M, Hendriks MP, Smid EJ, Frederix GWJ, de Bree R. Low dose cisplatin weekly versus high dose cisplatin every three weeks in primary chemoradiotherapy in head and neck cancer patients with low skeletal muscle mass: The CISLOW-study protocol. PLoS One 2023; 18:e0294147. [PMID: 38011186 PMCID: PMC10681175 DOI: 10.1371/journal.pone.0294147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/09/2023] [Indexed: 11/29/2023] Open
Abstract
Chemoradiotherapy with cisplatin in a triweekly regimen of 100 mg/m2 body surface area, is used to treat locally advanced head and neck squamous cell carcinoma (HNSCC) with curative intent. Cisplatin dose limiting toxicity (CDLT) occurs often and impedes obtaining the planned cumulative cisplatin dose. A cumulative cisplatin dose of 200 mg/m2 or more is warranted for better survival and locoregional control. Patients with a low skeletal muscle mass (SMM) have a three-fold higher risk of developing CDLT than patients with a normal SMM. SMM can be assessed through measurements on routinely performed diagnostic head and neck CT- or MRI-scans. A weekly regimen of 40 mg/m2 body surface area cisplatin is proposed as a less toxic schedule, which possibly decreases the risk of developing CDLT and enables reaching a higher cumulative cisplatin dose. The aim of this multicenter randomized clinical trial (NL76533.041.21, registered in the Netherlands Trial Register) is to identify whether a regimen of weekly cisplatin increases compliance to the planned chemotherapy scheme in HNSCC patients with low SMM. The primary outcome is the difference in compliance rate, defined as absence of CDLT, between low SMM patients receiving either the weekly or triweekly regimen. Secondary outcomes consist of toxicities, the cumulative cisplatin dose, time to recurrence, incidence of recurrence at two years of follow-up, location of recurrence, 2-year overall, disease free and disease specific survival, quality of life, patient's experiences, and cost-effectiveness.
Collapse
Affiliation(s)
- Anouk W. M. A. Schaeffers
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lot A. Devriese
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Carla H. van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jan Willem Dankbaar
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jens Voortman
- Department of Medical Oncology, Amsterdam UMC, Cancer Center Amsterdam, location VUmc, Amsterdam, The Netherlands
| | - Jan Paul de Boer
- Department of Medical Oncology, Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Marije Slingerland
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Ernst J. Smid
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Geert W. J. Frederix
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
37
|
Tabnak P, HajiEsmailPoor Z. Differentiating nasopharyngeal carcinoma from lymphoma in the head and neck region using the apparent diffusion coefficient (ADC) value: a systematic review and meta-analysis. Pol J Radiol 2023; 88:e472-e482. [PMID: 38020498 PMCID: PMC10660142 DOI: 10.5114/pjr.2023.132172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/30/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose This study aimed to assess the applicability of the apparent diffusion coefficient (ADC) for differentiating nasopharyngeal carcinoma (NPC) from lymphomas in the head and neck region. Material and methods Four databases, including PubMed, the Cochrane Library, EMBASE, and Web of Science, were searched systematically to find relevant literature. The search date was updated to 8 September 2022, with no starting time restriction. The methodological quality of the studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Firstly, a random-effects model was used in a meta-analysis of continuous variables with low heterogeneity to determine the overall effect size, which was reported as the standard mean difference (SMD). Then, bivariate random effects modelling was used to calculate the combined sensitivity and specificity. The area under the curve (AUC) for each diffusion parameter was calculated after constructing summary receiver operating characteristic curves. The presence of heterogeneity was evaluated using subgroup and meta-regression analysis. Results Twelve studies involving 181 lymphoma and 449 NPC lesions (N = 630) in the head and neck region were included, of which 5 studies provided sufficient data for pooling diagnostic test accuracy. A meta-analysis of the 12 studies using a random-effects model yielded an SMD of 1.03 (CI = 0.76-1.30; p = 0.00001), implying that NPC lesions had a significantly higher ADC value than lymphoma lesions. By pooling 5 standard DWI studies, the pooled sensitivity and specificity of ADC were 0.90 (95% CI: 0.82-0.95) and 0.63 (95% CI: 0.52-0.72), respectively. The area under the curve (AUC) calculated from the SROC curve was 0.74 (95% CI: 0.70-0.78). Conclusions According to this systematic review and meta-analysis, nasopharyngeal carcinoma has a significantly higher ADC value than lymphomas. Furthermore, while ADC has excellent sensitivity for distinguishing these 2 types of tumours, its specificity is relatively low, yielding a moderate diagnostic performance. Further investigations with larger sample sizes are required.
Collapse
Affiliation(s)
- Peyman Tabnak
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | |
Collapse
|
38
|
Hathaway Q, Ibad HA, Bluemke DA, Pishgar F, Kasaiean A, Klein JG, Cogswell R, Allison M, Budoff MJ, Barr RG, Post W, Bredella MA, Lima JAC, Demehri S. Predictive Value of Deep Learning-derived CT Pectoralis Muscle and Adipose Measurements for Incident Heart Failure: Multi-Ethnic Study of Atherosclerosis. Radiol Cardiothorac Imaging 2023; 5:e230146. [PMID: 37908549 PMCID: PMC10613925 DOI: 10.1148/ryct.230146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Purpose To develop a deep learning algorithm capable of extracting pectoralis muscle and adipose measurements and to longitudinally investigate associations between these measurements and incident heart failure (HF) in participants from the Multi-Ethnic Study of Atherosclerosis (MESA). Materials and Methods MESA is a prospective study of subclinical cardiovascular disease characteristics and risk factors for progression to clinically overt disease approved by institutional review boards of six participating centers (ClinicalTrials.gov identifier: NCT00005487). All participants with adequate imaging and clinical data from the fifth examination of MESA were included in this study. Hence, in this secondary analysis, manual segmentations of 600 chest CT examinations (between the years 2010 and 2012) were used to train and validate a convolutional neural network, which subsequently extracted pectoralis muscle and adipose (intermuscular adipose tissue (IMAT), perimuscular adipose tissue (PAT), extramyocellular lipids and subcutaneous adipose tissue) area measurements from 3031 CT examinations using individualized thresholds for adipose segmentation. Next, 1781 participants without baseline HF were longitudinally investigated for associations between baseline pectoralis muscle and adipose measurements and incident HF using crude and adjusted Cox proportional hazards models. The full models were adjusted for variables in categories of demographic (age, race, sex, income), clinical/laboratory (including physical activity, BMI, and smoking), CT (coronary artery calcium score), and cardiac MRI (left ventricular ejection fraction and mass (% of predicted)) data. Results In 1781 participants (median age, 68 (IQR,61, 75) years; 907 [51%] females), 41 incident HF events occurred over a median 6.5-year follow-up. IMAT predicted incident HF in unadjusted (hazard ratio [HR]:1.14; 95% CI: 1.03-1.26) and fully adjusted (HR:1.16, 95% CI: 1.03-1.31) models. PAT also predicted incident HF in crude (HR:1.19; 95% CI: 1.06-1.35) and fully adjusted (HR:1.25; 95% CI: 1.07-1.46) models. Conclusion The study demonstrates that fast and reliable deep learning-derived pectoralis muscle and adipose measurements are obtainable from conventional chest CT, which may be predictive of incident HF.©RSNA, 2023.
Collapse
Affiliation(s)
| | | | - David A. Bluemke
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Farhad Pishgar
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Arta Kasaiean
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Joshua G. Klein
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Rebecca Cogswell
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Matthew Allison
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Matthew J. Budoff
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - R. Graham Barr
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Wendy Post
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Miriam A. Bredella
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - João A. C. Lima
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Shadpour Demehri
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| |
Collapse
|
39
|
List MA, Knackstedt M, Liu L, Kasabali A, Mansour J, Pang J, Asarkar AA, Nathan C. Enhanced recovery after surgery, current, and future considerations in head and neck cancer. Laryngoscope Investig Otolaryngol 2023; 8:1240-1256. [PMID: 37899849 PMCID: PMC10601592 DOI: 10.1002/lio2.1126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 11/15/2022] [Indexed: 10/31/2023] Open
Abstract
Objectives Review of the current and relevant literature to develop a list of evidence-based recommendations that can be implemented in head and neck surgical practices. To provide rationale for the multiple aspects of comprehensive care for head and neck surgical patients. To improve postsurgical outcomes for head and neck surgical patients. Methods Extensive review of the medical literature was performed and relevant studies in both the head and neck surgery and other surgical specialties were considered for inclusion. Results A total of 18 aspects of perioperative care were included in this review. The literature search included 276 publications considered to be the most relevant and up to date evidence. Each topic is concluded with recommendation grade and quality of evidence for the recommendation. Conclusion Since it's conception, enhanced recovery after surgery (ERAS) protocols have continued to push for comprehensive and evidence based postsurgical care to improve patient outcomes. Head and neck oncology is one of the newest fields to develop a protocol. Due to the complexity of this patient population and their postsurgical needs, a multidisciplinary approach is needed to facilitate recovery while minimizing complications. Current and future advances in head and neck cancer research will serve to strengthen and add new principles to a comprehensive ERAS protocol. Level of Evidence 2a.
Collapse
Affiliation(s)
- Marna A. List
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - Mark Knackstedt
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - Lucy Liu
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - Ahmad Kasabali
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
- College of MedicineLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - Jobran Mansour
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - John Pang
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - Ameya A. Asarkar
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - Cherie‐Ann Nathan
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
- Feist‐Weiller Cancer CenterShreveportLouisianaUSA
| |
Collapse
|
40
|
Saalfeld S, Kreher R, Hille G, Niemann U, Hinnerichs M, Öcal O, Schütte K, Zech CJ, Loewe C, van Delden O, Vandecaveye V, Verslype C, Gebauer B, Sengel C, Bargellini I, Iezzi R, Berg T, Klümpen HJ, Benckert J, Gasbarrini A, Amthauer H, Sangro B, Malfertheiner P, Preim B, Ricke J, Seidensticker M, Pech M, Surov A. Prognostic role of radiomics-based body composition analysis for the 1-year survival for hepatocellular carcinoma patients. J Cachexia Sarcopenia Muscle 2023; 14:2301-2309. [PMID: 37592827 PMCID: PMC10570090 DOI: 10.1002/jcsm.13315] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/17/2023] [Accepted: 07/11/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Parameters of body composition have prognostic potential in patients with oncologic diseases. The aim of the present study was to analyse the prognostic potential of radiomics-based parameters of the skeletal musculature and adipose tissues in patients with advanced hepatocellular carcinoma (HCC). METHODS Radiomics features were extracted from a cohort of 297 HCC patients as post hoc sub-study of the SORAMIC randomized controlled trial. Patients were treated with selective internal radiation therapy (SIRT) in combination with sorafenib or with sorafenib alone yielding two groups: (1) sorafenib monotherapy (n = 147) and (2) sorafenib and SIRT (n = 150). The main outcome was 1-year survival. Segmentation of muscle tissue and adipose tissue was used to retrieve 881 features. Correlation analysis and feature cleansing yielded 292 features for each patient group and each tissue type. We combined 9 feature selection methods with 10 feature set compositions to build 90 feature sets. We used 11 classifiers to build 990 models. We subdivided the patient groups into a train and validation cohort and a test cohort, that is, one third of the patient groups. RESULTS We used the train and validation set to identify the best feature selection and classification model and applied it to the test set for each patient group. Classification yields for patients who underwent sorafenib monotherapy an accuracy of 75.51% and area under the curve (AUC) of 0.7576 (95% confidence interval [CI]: 0.6376-0.8776). For patients who underwent treatment with SIRT and sorafenib, results are accuracy = 78.00% and AUC = 0.8032 (95% CI: 0.6930-0.9134). CONCLUSIONS Parameters of radiomics-based analysis of the skeletal musculature and adipose tissue predict 1-year survival in patients with advanced HCC. The prognostic value of radiomics-based parameters was higher in patients who were treated with SIRT and sorafenib.
Collapse
Affiliation(s)
- Sylvia Saalfeld
- Research Campus STIMULATE at the University of MagdeburgMagdeburgGermany
- Department of Simulation and GraphicsUniversity of MagdeburgMagdeburgGermany
| | - Robert Kreher
- Research Campus STIMULATE at the University of MagdeburgMagdeburgGermany
- Department of Simulation and GraphicsUniversity of MagdeburgMagdeburgGermany
| | - Georg Hille
- Research Campus STIMULATE at the University of MagdeburgMagdeburgGermany
- Department of Simulation and GraphicsUniversity of MagdeburgMagdeburgGermany
| | - Uli Niemann
- University LibraryUniversity of MagdeburgMagdeburgGermany
| | - Mattes Hinnerichs
- Department of Radiology and Nuclear MedicineOvGU MagdeburgMagdeburgGermany
| | - Osman Öcal
- Department of RadiologyLMU University HospitalMunichGermany
| | - Kerstin Schütte
- Department of Internal Medicine and GastroenterologyNiels‐Stensen‐Kliniken MarienhospitalOsnabrückGermany
- Klinik für Gastroenterologie, Hepatologie und EndokrinologieMedizinische Hochschule Hannover (MHH)HannoverGermany
| | - Christoph J. Zech
- Department of Radiology and Nuclear MedicineUniversity Hospital Basel, University of BaselBaselSwitzerland
| | - Christian Loewe
- Section of Cardiovascular and Interventional Radiology, Department of Bioimaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
| | - Otto van Delden
- Department of Radiology and Nuclear MedicineAcademic University Medical CentersAmsterdamThe Netherlands
| | | | - Chris Verslype
- Department of Digestive OncologyUniversity Hospitals LeuvenLeuvenBelgium
| | - Bernhard Gebauer
- Department of RadiologyCharité – University Medicine BerlinBerlinGermany
| | - Christian Sengel
- Department of RadiologyGrenoble University HospitalLa TroncheFrance
| | - Irene Bargellini
- Diagnostic and Interventional RadiologyCandiolo Cancer InstituteTurinItaly
| | - Roberto Iezzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radiologia d'Urgenza e Interventistica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed EmatologiaRomeItaly
- Università Cattolica del Sacro CuoreRomeItaly
| | - Thomas Berg
- Klinik und Poliklinik für Gastroenterologie, Sektion HepatologieUniversitätsklinikum LeipzigLeipzigGermany
| | - Heinz J. Klümpen
- Department of Medical OncologyAmsterdam University Medical CentersAmsterdamThe Netherlands
| | - Julia Benckert
- Department of Hepatology and GastroenterologyCampus Virchow Klinikum, Charité – Universitätsmedizin BerlinBerlinGermany
| | - Antonio Gasbarrini
- Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro CuoreRomeItaly
| | - Holger Amthauer
- Department of Nuclear MedicineCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu BerlinBerlinGermany
| | - Bruno Sangro
- Liver UnitClínica Universidad de Navarra and CIBEREHDPamplonaSpain
| | | | - Bernhard Preim
- Research Campus STIMULATE at the University of MagdeburgMagdeburgGermany
- Department of Simulation and GraphicsUniversity of MagdeburgMagdeburgGermany
| | - Jens Ricke
- Department of RadiologyLMU University HospitalMunichGermany
| | | | - Maciej Pech
- Department of Radiology and Nuclear MedicineOvGU MagdeburgMagdeburgGermany
| | - Alexey Surov
- Department of Radiology, Neuroradiology and Nuclear MedicineJohannes Wesling University Hospital, Ruhr University BochumBochumGermany
| |
Collapse
|
41
|
Alavi DT, Henriksen HB, Lauritzen PM, Zucknick M, Bøhn SK, Henriksen C, Paur I, Smeland S, Blomhoff R. Effect of a one-year personalized intensive dietary intervention on body composition in colorectal cancer patients: Results from a randomized controlled trial. Clin Nutr ESPEN 2023; 57:414-422. [PMID: 37739688 DOI: 10.1016/j.clnesp.2023.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 06/28/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIMS Changes in body composition may affect colorectal cancer (CRC) patient's risk of cancer recurrence, secondary cancer, and other chronic diseases. The suggested interventions for changes in body composition such as low muscle mass or high fat mass, are diet and physical activity. Nevertheless, there is limited evidence of how dietary intervention alone can impact body composition. This study aimed to investigate the effect of a 6 and 12 month dietary intervention with a focus on healthy eating according to Norwegian food-based dietary guidelines on weight and body composition in patients with CRC stage I-III, post-surgery. METHODS This study included participants from the randomized controlled trial CRC-NORDIET study 2-9 months after surgery. The intervention group received an intensive dietary intervention, while the control group underwent similar measurements, but no dietary intervention. Body composition was measured with Lunar iDXA, and the results were analyzed using linear mixed models. RESULTS A total of 383 participants were included, 192 in the intervention group and 191 in the control group. After 6 months, the intervention group showed a 0.7 kg lower mean weight gain (p = 0.020) and 0.6 kg lower fat mass gain (p = 0.019) than the control group, but no difference at 12 months. Moreover, the fat mass increase was 0.5 percentage points lower at 6 months (p = 0.012), and 0.7 percentage points lower at 12 months (p = 0.011) in the intervention group compared to the controls. At 6 months, the intervention group had 63 g lower gain of visceral adipose tissue compared to the control group (p = 0.031). No differences were seen for fat-free mass or subcutaneous adipose tissue at any time point. The intervention group showed a lower increase in the ratio between fat mass and fat-free mass at both 6 months (p = 0.025) and 12 months (p = 0.021). CONCLUSION The dietary intervention reduced the increases in total weight and fat masses, without changing fat-free mass. Although the individual changes are small, the dietary intervention may have resulted in an overall more favourable body composition profile. These findings suggest that dietary intervention may be part of a treatment strategy for prevention of weight and fat mass gain in CRC survivors.
Collapse
Affiliation(s)
- Dena Treider Alavi
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| | - Hege Berg Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| | - Peter Mæhre Lauritzen
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Manuela Zucknick
- Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| | - Siv Kjølsrud Bøhn
- Department of Chemistry, Biotechnology and Food Sciences, Norwegian University of Life Sciences, Ås, Norway.
| | - Christine Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| | - Ingvild Paur
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway, Norwegian Advisory Unit for Disease-related Undernutrition, Oslo University Hospital, Oslo, Norway; Department of Clinical Services, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.
| | - Sigbjørn Smeland
- Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.
| |
Collapse
|
42
|
Erlandson KM, Umbleja T, Lu MT, Taron J, Ribaudo HJ, Overton ET, Presti RM, Haas DW, Sax PE, Yin MT, Zhai BK, Louis R, Upadhyay N, Eslami P, Douglas PS, Zanni MV, Fitch KV, Fulda ES, Fichtenbaum CJ, Malvestutto CD, Grinspoon SK, Brown TT. Associations of Muscle Density and Area With Coronary Artery Plaque and Physical Function. J Acquir Immune Defic Syndr 2023; 94:174-184. [PMID: 37368931 PMCID: PMC10527277 DOI: 10.1097/qai.0000000000003244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 06/01/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE Skeletal muscle quality and mass are important for maintaining physical function during advancing age. We leveraged baseline data from Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) to evaluate whether paraspinal muscle density and muscle area are associated with cardiac or physical function outcomes in people with HIV (PWH). METHODS REPRIEVE is a double-blind randomized trial evaluating the effect of pitavastatin for primary prevention of major adverse cardiovascular events in PWH. This cross-sectional analysis focuses on participants who underwent coronary computed tomography at baseline. Lower thoracic paraspinal muscle density (Hounsfield units [HU]) and area (cm 2 ) were assessed on noncontrast computed tomography. RESULTS Of 805 PWH, 708 had paraspinal muscle measurements. The median age was 51 years and 17% were natal female patients. The median muscle density was 41 HU (male) and 30 HU (female); area 13.2 cm 2 /m (male) and 9.9 cm 2 /m (female). In adjusted analyses, greater density (less fat) was associated with a lower prevalence of any coronary artery plaque, coronary artery calcium score >0, and high plaque burden ( P = 0.06); area was not associated with plaque measures. Among 139 patients with physical function measures, greater area (but not density) was associated with better performance on a short physical performance battery and grip strength. CONCLUSIONS Among PWH, greater paraspinal muscle density was associated with a lower prevalence of coronary artery disease while greater area was associated with better physical performance. Whether changes in density or area are associated with changes in CAD or physical performance will be evaluated through longitudinal analyses in REPRIEVE.
Collapse
Affiliation(s)
- Kristine M Erlandson
- Division of Infectious Diseases, Department of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO
| | - Triin Umbleja
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Michael T Lu
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Jana Taron
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Faculty of Medicine, Department of Radiology, University of Freiburg Medical Center, University of Freiburg, Freiburg, Germany
| | - Heather J Ribaudo
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Edgar T Overton
- Division of Infectious Diseases, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | - Rachel M Presti
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - David W Haas
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
- Department of Internal Medicine, Meharry Medical College, Nashville, TN
| | - Paul E Sax
- Division of Infectious Disease, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Michael T Yin
- Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center, New York, NY
| | - Bingxue Kris Zhai
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Rochelle Louis
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Namrata Upadhyay
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Parastou Eslami
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Pamela S Douglas
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - Markella V Zanni
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Kathleen V Fitch
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Evelynne S Fulda
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Carl J Fichtenbaum
- Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Carlos D Malvestutto
- Division of Infectious Diseases, Ohio State University Medical Center, Columbus, OH; and
| | - Steven K Grinspoon
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Todd T Brown
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| |
Collapse
|
43
|
McGale J, Hama J, Yeh R, Vercellino L, Sun R, Lopci E, Ammari S, Dercle L. Artificial Intelligence and Radiomics: Clinical Applications for Patients with Advanced Melanoma Treated with Immunotherapy. Diagnostics (Basel) 2023; 13:3065. [PMID: 37835808 PMCID: PMC10573034 DOI: 10.3390/diagnostics13193065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 10/15/2023] Open
Abstract
Immunotherapy has greatly improved the outcomes of patients with metastatic melanoma. However, it has also led to new patterns of response and progression, creating an unmet need for better biomarkers to identify patients likely to achieve a lasting clinical benefit or experience immune-related adverse events. In this study, we performed a focused literature survey covering the application of artificial intelligence (AI; in the form of radiomics, machine learning, and deep learning) to patients diagnosed with melanoma and treated with immunotherapy, reviewing 12 studies relevant to the topic published up to early 2022. The most commonly investigated imaging modality was CT imaging in isolation (n = 9, 75.0%), while patient cohorts were most frequently recruited retrospectively and from single institutions (n = 7, 58.3%). Most studies concerned the development of AI tools to assist in prognostication (n = 5, 41.7%) or the prediction of treatment response (n = 6, 50.0%). Validation methods were disparate, with two studies (16.7%) performing no validation and equal numbers using cross-validation (n = 3, 25%), a validation set (n = 3, 25%), or a test set (n = 3, 25%). Only one study used both validation and test sets (n = 1, 8.3%). Overall, promising results have been observed for the application of AI to immunotherapy-treated melanoma. Further improvement and eventual integration into clinical practice may be achieved through the implementation of rigorous validation using heterogeneous, prospective patient cohorts.
Collapse
Affiliation(s)
- Jeremy McGale
- Department of Radiology, New York-Presbyterian Hospital, New York, NY 10032, USA
| | - Jakob Hama
- Queens Hospital Center, Icahn School of Medicine at Mt. Sinai, Queens, NY 10029, USA
| | - Randy Yeh
- Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Laetitia Vercellino
- Nuclear Medicine Department, INSERM UMR S942, Hôpital Saint-Louis, Assistance-Publique, Hôpitaux de Paris, Université Paris Cité, 75010 Paris, France
| | - Roger Sun
- Department of Radiation Oncology, Gustave Roussy, 94800 Villejuif, France
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS—Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Samy Ammari
- Department of Medical Imaging, BIOMAPS, UMR1281 INSERM, CEA, CNRS, Gustave Roussy, Université Paris-Saclay, 94800 Villejuif, France
- ELSAN Department of Radiology, Institut de Cancérologie Paris Nord, 95200 Sarcelles, France
| | - Laurent Dercle
- Department of Radiology, New York-Presbyterian Hospital, New York, NY 10032, USA
| |
Collapse
|
44
|
Wagner D, Wienerroither V, Scherrer M, Thalhammer M, Faschinger F, Lederer A, Hau HM, Sucher R, Kornprat P. Value of sarcopenia in the resection of colorectal liver metastases-a systematic review and meta-analysis. Front Oncol 2023; 13:1241561. [PMID: 37841447 PMCID: PMC10569723 DOI: 10.3389/fonc.2023.1241561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/07/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Sarcopenia is defined as a decline in muscle function as well as muscle mass. Sarcopenia itself and sarcopenic obesity, defined as sarcopenia in obese patients, have been used as surrogates for a worse prognosis in colorectal cancer. This review aims to determine if there is evidence for sarcopenia as a prognostic parameter in colorectal liver metastases (CRLM). Methods PubMed, Embase, Cochrane Central, Web of Science, SCOPUS, and CINAHL databases were searched for articles that were selected in accordance with the PRISMA guidelines. The primary outcomes were overall survival (OS) and disease-free survival (DFS). A random effects meta-analysis was conducted. Results After eliminating duplicates and screening abstracts (n = 111), 949 studies were screened, and 33 publications met the inclusion criteria. Of them, 15 were selected after close paper review, and 10 were incorporated into the meta-analysis, which comprised 825 patients. No significant influence of sarcopenia for OS (odds ratio (OR), 2.802 (95% confidence interval (CI), 1.094-1.11); p = 0.4) or DFS (OR, 1.203 (95% CI, 1.162-1.208); p = 0.5) was found, although a trend was defined toward sarcopenia. Sarcopenia significantly influenced postoperative complication rates (OR, 7.905 (95% CI, 1.876-3.32); p = 0.001) in two studies where data were available. Conclusion Existing evidence on the influence of sarcopenia on postoperative OS as well as DFS in patients undergoing resection for CRLM exists. We were not able to confirm that sarcopenic patients have a significantly worse OS and DFS in our analysis, although a trend toward this hypothesis was visible. Sarcopenia seems to influence complication rates but prospective studies are needed.
Collapse
|
45
|
Colloca GF, Bellieni A, Di Capua B, Iervolino M, Bracci S, Fusco D, Tagliaferri L, Landi F, Valentini V. Sarcopenia Diagnosis and Management in Hematological Malignancies and Differences with Cachexia and Frailty. Cancers (Basel) 2023; 15:4600. [PMID: 37760569 PMCID: PMC10527381 DOI: 10.3390/cancers15184600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Sarcopenia is a geriatric syndrome characterized by a progressive loss of systemic muscle mass and decreased muscle strength or physical function. Several conditions have a role in its pathogenesis, significantly impacting adverse outcomes such as falls, functional decline, frailty, disability, multiple hospitalizations, and mortality. In the oncological setting, sarcopenia is associated with an increased risk of treatment toxicity, postoperative complications, and a higher mortality rate related to other causes (e.g., pneumonia). In the hematological field, even more so, sarcopenia predicts toxicity and response to treatments. In patients with hematologic malignancy, low muscle mass is associated with adverse outcomes and is a predictor of overall survival and non-relapse mortality. Therefore, it is essential to correctly recognize sarcopenia, evaluate the risk factors and their impact on the patient's trajectory, and effectively treat sarcopenia. Sarcopenia is a reversible condition. The most effective intervention for reversing it is physical exercise combined with nutrition. The objective of clinical assessment focused on sarcopenia is to be able to carry out a "tailor-made treatment".
Collapse
Affiliation(s)
- Giuseppe Ferdinando Colloca
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.C.); (S.B.); (V.V.)
| | - Andrea Bellieni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.C.); (S.B.); (V.V.)
| | - Beatrice Di Capua
- Centro di Eccellenza Oncologia Radioterapica e Medica e Radioterapia, Ospedale Fatebenefratelli Isola Tiberina—Gemelli Isola, 00186 Rome, Italy
| | - Marialuisa Iervolino
- Dipartimento Universitario di Scienze Geriatriche ed Ortopediche, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Serena Bracci
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.C.); (S.B.); (V.V.)
| | - Domenico Fusco
- Dipartimento di Scienze dell’Invecchiamento, Ortopediche e Reumatologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (D.F.); (F.L.)
| | - Luca Tagliaferri
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.C.); (S.B.); (V.V.)
| | - Francesco Landi
- Dipartimento di Scienze dell’Invecchiamento, Ortopediche e Reumatologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (D.F.); (F.L.)
| | - Vincenzo Valentini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.C.); (S.B.); (V.V.)
| |
Collapse
|
46
|
Yang Z, Choi I, Choi J, Jung J, Ryu M, Yong HS. Deep learning-based pectoralis muscle volume segmentation method from chest computed tomography image using sagittal range detection and axial slice-based segmentation. PLoS One 2023; 18:e0290950. [PMID: 37669295 PMCID: PMC10479911 DOI: 10.1371/journal.pone.0290950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 08/19/2023] [Indexed: 09/07/2023] Open
Abstract
The pectoralis muscle is an important indicator of respiratory muscle function and has been linked to various parenchymal biomarkers, such as airflow limitation severity and diffusing capacity for carbon monoxide, which are widely used in diagnosing parenchymal diseases, including asthma and chronic obstructive pulmonary disease. Pectoralis muscle segmentation is a method for measuring muscle volume and mass for various applications. The segmentation method is based on deep-learning techniques that combine a muscle area detection model and a segmentation model. The training dataset for the detection model comprised multichannel images of patients, whereas the segmentation model was trained on 7,796 cases of the computed tomography (CT) image dataset of 1,841 patients. The dataset was expanded incrementally through an active learning process. The performance of the model was evaluated by comparing the segmentation results with manual annotations by radiologists and the volumetric differences between the CT image datasets of the same patients. The results indicated that the machine learning model is promising in segmenting the pectoralis major muscle, with good agreement between the automatic segmentation and manual annotations by radiologists. The training accuracy and loss values of the validation set were 0.9954 and 0.0725, respectively, and for segmentation, the loss value was 0.0579. This study shows the potential clinical usefulness of the machine learning model for pectoralis major muscle segmentation as a quantitative biomarker for various parenchymal and muscular diseases.
Collapse
Affiliation(s)
- Zepa Yang
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Insung Choi
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Juwhan Choi
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jongha Jung
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Minyeong Ryu
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Hwan Seok Yong
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| |
Collapse
|
47
|
Emekli E, Bostancı Can EZ. Prognostic Value of Diaphragm Diameter, Muscle Volume, and Bone Mineral Density in Critically Ill COVID-19 Patients. J Intensive Care Med 2023; 38:847-855. [PMID: 37050868 PMCID: PMC10099913 DOI: 10.1177/08850666231169494] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/22/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023]
Abstract
Objective: We aimed to analyze the prognostic value of muscle volume (MV), bone mineral density (BMD), and diaphragm diameter (DD) in COVID-19. Method: The study included 498 patients admitted to the intensive care unit (ICU) with a positive polymerase chain reaction test for COVID-19 from March 11, 2020, through August 31, 2022. The patients' laboratory and demographic data of the patients at the time of ICU admission were recorded. MV, DD, and BMD measurements were performed using computed tomography examinations. Muscle index (MI) was calculated as MV/height2. Quartiles were determined for all 4 measurements. Patients in the lowest quartile were recorded as having low MV, MI, DD, and BMD values. The parameters were evaluated for the whole group and compared according to gender and mortality. The multiple regression analysis was performed for the prediction of mortality. Results: In the mortality group, the male and female patients had significantly statistically lower values in MV (P < .001 and P = .002, respectively), MI (P < .001 and P = .005, respectively), DD (P < .001 and P < .001, respectively), and BMD (P = .002 and P < .001, respectively). In the multiple regression analysis, low MI (OR: 2.03, 95% CI: 1.14-3.61, P = .016) and DD (OR: 10.47, 95% CI: 5.59-19.59, P < .001) values remained significant for the prediction of mortality. Conclusion: BMD is a risk factor for mortality in patients with severe COVID-19, but cannot be used as an independent predictor. However, MI and DD can be used as independent predictors of mortality even in severe cases.
Collapse
Affiliation(s)
- Emre Emekli
- Department of Radiology, Etimesgut
Şehit Sait Ertürk State Hospital, Ankara, Turkey
| | - Emine Zülal Bostancı Can
- Department of Anesthesiology and
Reanimation, Etimesgut Şehit Sait Ertürk State Hospital, Ankara, Turkey
| |
Collapse
|
48
|
Kovač MB, Pavlin T, Čavka L, Ribnikar D, Spazzapan S, Templeton AJ, Šeruga B. The trajectory of sarcopenia following diagnosis of prostate cancer: A systematic review and meta-analysis. J Geriatr Oncol 2023; 14:101594. [PMID: 37482497 DOI: 10.1016/j.jgo.2023.101594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/07/2023] [Accepted: 07/17/2023] [Indexed: 07/25/2023]
Abstract
INTRODUCTION Sarcopenia is a common skeletal muscle disorder in older people. Here we explore the prevalence of sarcopenia and its impact on men with prostate cancer. MATERIALS AND METHODS We searched PubMed, Embase, and Web of Science databases for relevant studies with an explicit definition of sarcopenia in men with prostate cancer which were published between years 2000 and 2022. Prevalence of sarcopenia and its association with time to biochemical recurrence (BCR), progression-free survival (PFS), non-cancer mortality, overall survival (OS), and treatment-related complications in men with prostate cancer were explored. The summary prevalence, hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated. RESULTS A total of 24 studies comprising 3,616 patients with early and advanced prostate cancer were included. The prevalence of sarcopenia and sarcopenic obesity was 43.8% (95% CI 19.2%-68.5%) and 24.0% (95% CI 5.0%-43.1%), respectively. Sarcopenia was not associated with a shorter time to BCR (HR 0.89, 95% CI 0.64-1.23, p = 0.48), a shorter PFS (HR 1.20, 95% CI 0.73-1.97, p = 0.48), or a shorter OS (HR 1.29, 95% CI 0.90-1.85, p = 0.16). In contrast, sarcopenia was significantly associated with a higher non-cancer mortality (HR 1.85, 95% CI 1.23-2.80, p = 0.003). In four out of five studies eligible for assessment, sarcopenia was not associated with an increased risk of treatment-related complications. DISCUSSION Sarcopenia increases the risk of death from other causes in men with prostate cancer. Patients with prostate cancer should be assessed and managed for sarcopenia in everyday clinical practice.
Collapse
Affiliation(s)
- Milena Blaž Kovač
- Ljubljana Community Health Centre, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tina Pavlin
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Luka Čavka
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia; Department of Oncology, University Medical Center Maribor, Maribor, Slovenia
| | - Domen Ribnikar
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Simon Spazzapan
- S.O.C. Oncologia Medica e Prevenzione Oncologica, Centro di Riferimento Oncologico IRCCS, Aviano, Italy
| | - Arnoud J Templeton
- St. Clara Research, St. Claraspital Basel and Faculty of Medicine, University of Basel, Switzerland
| | - Boštjan Šeruga
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
| |
Collapse
|
49
|
Mengoni M, Braun AD, Hinnerichs MS, Tüting T, Surov A. Subcutaneous Fat Abundance and Density Are Associated with an Enhanced Response to Immunotherapy in Metastatic Melanoma: A Retrospective Cohort Study. Acad Radiol 2023; 30 Suppl 1:S257-S267. [PMID: 37331867 DOI: 10.1016/j.acra.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/07/2023] [Accepted: 05/08/2023] [Indexed: 06/20/2023]
Abstract
RATIONALE AND OBJECTIVES Despite the impressive efficacy of immune checkpoint inhibitors (ICIs) in the treatment of metastatic melanoma, not all patients respond to therapy. In addition, ICI harbors the risk for serious adverse events (AEs), highlighting the need for novel biomarkers predicting treatment response and occurrence of AEs. Recently, the identification of enhanced response to ICI in obese patients has indicated that body composition might influence treatment efficacy. The aim of the current study is to assess radiologic measurements of body composition as biomarkers for treatment response and AEs to ICI in melanoma. MATERIALS AND METHODS In the current work, we analyze adipose tissue abundance and density, as well as muscle mass via computed tomography scans in a retrospective cohort of 100 patients with non-resectable stage III/IV melanoma receiving first-line treatment with ICI in our department. From these, we investigate the impact of the subcutaneous adipose tissue gauge index (SATGI) and other parameters of body composition on treatment efficacy and occurrence of AEs. RESULTS Low SATGI was associated with prolonged progression-free survival (PFS) in univariate and multivariate analyses (hazard ratio 2.56 [95% CI 1.18-5.55], P = .02), as well as an enhanced objective response rate (50.0% vs 27.1%; P = .02). Further analysis with a random forest survival model highlighted a nonlinear relationship between SATGI and PFS with a clear separation into high- and low-risk cohorts separated by the median. Finally, a significant enrichment of cases with vitiligo, but no other AEs, was observed in the SATGI-low cohort (11.5% vs 0%; P = .03). CONCLUSION We identify SATGI as a biomarker predicting treatment response to ICI without increased risk for severe AEs in melanoma.
Collapse
Affiliation(s)
- Miriam Mengoni
- Department of Dermatology, University Hospital Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany.
| | - Andreas Dominik Braun
- Department of Dermatology, University Hospital Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Mattes Simon Hinnerichs
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Thomas Tüting
- Department of Dermatology, University Hospital Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Alexey Surov
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany; Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University, Bochum, Germany
| |
Collapse
|
50
|
Surov A, Strobel A, Borggrefe J, Wienke A. Low skeletal muscle mass predicts treatment response in oncology: a meta-analysis. Eur Radiol 2023; 33:6426-6437. [PMID: 36929392 DOI: 10.1007/s00330-023-09524-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/24/2022] [Accepted: 02/04/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES Low skeletal muscle mass (LSMM) predicts relevant clinical outcomes in oncologic patients. The purpose of this study was to perform a meta-analysis of data regarding associations between LSMM and treatment response (TR) in oncology. METHODS MEDLINE, Cochrane, and SCOPUS databases were screened for relationships between LSMM and TR in oncologic patients up to November 2022. Overall, 35 studies met the inclusion criteria. The meta-analysis was performed using RevMan 5.4 software. RESULTS The collected 35 studies comprised 3858 patients. In 1682 patients (43.6%), LSMM was diagnosed. In the overall sample, LSMM predicted a negatively objective response rate (ORR), OR = 0.70, 95% CI = (0.54-0.91), p = 0.007, and disease control rate (DCR), OR = 0.69, 95% CI = (0.50-0.95), p = 0.02. In the curative setting, LSMM predicted a negatively ORR, OR = 0.24, 95% CI = (0.12-0.50), p = 0.0001, but not DCR, OR = 0.60, 95% CI = (0.31-1.18), p = 0.14. In palliative treatment with conventional chemotherapies, LSMM did not predict ORR: OR = 0.94, 95% CI (0.57-1.55), p = 0.81, and DCR: OR = 1.13, 95% CI (0.38-3.40), p = 0.82. In palliative treatment with tyrosine kinase inhibitors (TKI), LSMM did not predict TR: ORR, OR = 0.74, 95% CI (0.44-1.26), p = 0.27, and DCR, OR = 1.04, 95% CI (0.53-2.05), p = 0.90. In palliative immunotherapy, LSMM tended to predict ORR, OR = 0.74, 95% CI = (0.54-1.01), p = 0.06, and predicted DCR, OR = 0.53, 95% CI = (0.37-0.76), p = 0.0006. CONCLUSION LSMM is a risk factor for poor TR in curative chemotherapy in the adjuvant and/or neoadjuvant setting. LSMM is a risk factor for treatment failure in treatment with immunotherapy. Finally, LSMM does not influence TR in palliative treatment with conventional chemotherapy and/or TKIs. KEY POINTS • Low skeletal muscle mass (LSMM) predicts treatment response (TR) to chemotherapy in the adjuvant and/or neoadjuvant setting. • LSMM predicts TR in immunotherapy. • LSMM does not influence TR in palliative chemotherapy.
Collapse
Affiliation(s)
- Alexey Surov
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University, Bochum, Germany.
| | - Alexandra Strobel
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University, Bochum, Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| |
Collapse
|