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Tang J, Dong Z, Yang L, Yang P, Zhao W, Deng L, Xue J, Cui Y, Li Q, Tang L, Sheng J, Zhang Y, Zhang H, Chen T, Dong B, Lv X. The relationship between prognosis and temporal muscle thickness in 102 patients with glioblastoma. Sci Rep 2024; 14:13958. [PMID: 38886495 PMCID: PMC11183225 DOI: 10.1038/s41598-024-64947-z] [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: 09/24/2023] [Accepted: 06/14/2024] [Indexed: 06/20/2024] Open
Abstract
Temporal muscle thickness measured on 3D MRI has recently been linked to prognosis in glioblastoma patients and may serve as an independent prognostic indicator. This single-center study looked at temporal muscle thickness and prognosis in patients with primary glioblastoma. Overall survival was the major study outcome. For a retrospective analysis from 2010 to 2020, clinical data from 102 patients with glioblastoma at the Department of Oncology Radiotherapy of the First Affiliated Hospital of Dalian Medical University were gathered. Fifty-five cases from 2016 to 2020 contained glioblastoma molecular typing data, of which 45 were IDH wild-type glioblastomas and were analysed separately. TMT was measured on enhanced T1-weighted magnetic resonance images in patients with newly diagnosed glioblastoma.Overall patient survival (OS) was calculated by the Kaplan-Meier method and survival curves were plotted using the log-rank-sum test to determine differences between groups, and multifactorial analyses were performed using a Cox proportional-risk model.The median TMT for 102 patients was 6.775 mm (range: 4.95-10.45 mm). Patients were grouped according to median TMT, and the median overall survival (23.0 months) was significantly longer in the TMT > median group than in the TMT median group (P 0.001; Log-rank test). Analysing 45 patients with IDH wild type alone, the median overall survival (12 months) of patients in the TMT > median group was significantly longer than that of patients in the TMT ≤ median group (8 months) (P < 0.001; Log-rank test).TMT can serve as an independent prognostic factor for glioblastoma.
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Affiliation(s)
- Jinhai Tang
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Zhenghao Dong
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lei Yang
- Department of Radiation Oncology, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ping Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Wanying Zhao
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Lvdan Deng
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Juan Xue
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yijie Cui
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Qizheng Li
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Lufan Tang
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Junxiu Sheng
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yu Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Huimin Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Tongtong Chen
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Bin Dong
- Department of Neurosurgery, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
| | - Xiupeng Lv
- Department of Radiation Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
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Olukoya O, Osunronbi T, Jesuyajolu DA, Uwaga BC, Vaughan A, Aluko O, Ayantayo TO, Daniel JO, David SO, Jagunmolu HA, Kanu A, Kayode AT, Olajide TN, Thorne L. The prognostic utility of temporalis muscle thickness measured on magnetic resonance scans in patients with intra-axial malignant brain tumours: A systematic review and meta-analysis. World Neurosurg X 2024; 22:100318. [PMID: 38440376 PMCID: PMC10911852 DOI: 10.1016/j.wnsx.2024.100318] [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: 08/25/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
Introduction Sarcopenia is associated with worsened outcomes in solid cancers. Temporalis muscle thickness (TMT) has emerged as a measure of sarcopenia. Hence, this study aims to evaluate the relationship between TMT and outcome measures in patients with malignant intra-axial neoplasms. Method We searched Medline, Embase, Scopus and Cochrane databases for relevant studies. Event ratios with 95% confidence intervals (CI) were analysed using the RevMan 5.4 software. Where meta-analysis was impossible, vote counting was used to determine the effect of TMT on outcomes. The GRADE framework was used to determine the certainty of the evidence. Results Four outcomes were reported for three conditions across 17 studies involving 4430 patients. Glioblastoma: thicker TMT was protective for overall survival (OS) (HR 0.59; 95% CI 0.46-0.76) (GRADE low), progression free survival (PFS) (HR 0.40; 95% CI 0.26-0.62) (GRADE high), and early discontinuation of treatment (OR 0.408; 95% CI 0.168-0.989) (GRADE high); no association with complications (HR 0.82; 95% CI 0.60-1.10) (GRADE low). Brain Metastases: thicker TMT was protective for OS (HR 0.73; 95% CI 0.67-0.78) (GRADE moderate); no association with PFS (GRADE low). Primary CNS Lymphoma: TMT was protective for overall survival (HR 0.34; 95% CI 0.19-0.60) (GRADE moderate) and progression free survival (HR 0.23; 95% CI 0.09-0.56) (GRADE high). Conclusion TMT has significant prognostic potential in intra-axial malignant neoplasms, showing a moderate to high certainty for its association with outcomes following GRADE evaluation. This will enable shared decision making between patients and clinicians.
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Affiliation(s)
- Olatomiwa Olukoya
- Neurosurgery Department, Surgery Interest Group of Africa, Lagos, Nigeria
- The National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Temidayo Osunronbi
- Neurosurgery Department, Surgery Interest Group of Africa, Lagos, Nigeria
- Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | | | - Blossom C. Uwaga
- Neurosurgery Department, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Ayomide Vaughan
- Neurosurgery Department, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Oluwabusayo Aluko
- Neurosurgery Department, Surgery Interest Group of Africa, Lagos, Nigeria
| | | | | | - Samuel O. David
- Neurosurgery Department, Surgery Interest Group of Africa, Lagos, Nigeria
| | | | - Alieu Kanu
- Neurosurgery Department, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Ayomide T. Kayode
- Neurosurgery Department, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Tobi N. Olajide
- Neurosurgery Department, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Lewis Thorne
- The National Hospital for Neurology and Neurosurgery, London, United Kingdom
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Zapaishchykova A, Liu KX, Saraf A, Ye Z, Catalano PJ, Benitez V, Ravipati Y, Jain A, Huang J, Hayat H, Likitlersuang J, Vajapeyam S, Chopra RB, Familiar AM, Nabavidazeh A, Mak RH, Resnick AC, Mueller S, Cooney TM, Haas-Kogan DA, Poussaint TY, Aerts HJWL, Kann BH. Automated temporalis muscle quantification and growth charts for children through adulthood. Nat Commun 2023; 14:6863. [PMID: 37945573 PMCID: PMC10636102 DOI: 10.1038/s41467-023-42501-1] [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: 07/21/2023] [Accepted: 10/12/2023] [Indexed: 11/12/2023] Open
Abstract
Lean muscle mass (LMM) is an important aspect of human health. Temporalis muscle thickness is a promising LMM marker but has had limited utility due to its unknown normal growth trajectory and reference ranges and lack of standardized measurement. Here, we develop an automated deep learning pipeline to accurately measure temporalis muscle thickness (iTMT) from routine brain magnetic resonance imaging (MRI). We apply iTMT to 23,876 MRIs of healthy subjects, ages 4 through 35, and generate sex-specific iTMT normal growth charts with percentiles. We find that iTMT was associated with specific physiologic traits, including caloric intake, physical activity, sex hormone levels, and presence of malignancy. We validate iTMT across multiple demographic groups and in children with brain tumors and demonstrate feasibility for individualized longitudinal monitoring. The iTMT pipeline provides unprecedented insights into temporalis muscle growth during human development and enables the use of LMM tracking to inform clinical decision-making.
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Affiliation(s)
- Anna Zapaishchykova
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kevin X Liu
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anurag Saraf
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Zezhong Ye
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul J Catalano
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Viviana Benitez
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Yashwanth Ravipati
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Arnav Jain
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Julia Huang
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Hasaan Hayat
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Michigan State University, East Lansing, MI, USA
| | - Jirapat Likitlersuang
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sridhar Vajapeyam
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
| | - Rishi B Chopra
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ariana M Familiar
- Children's Hospital of Philadelphia, Philadelphia, USA
- University of Pennsylvania, Pennsylvania, USA
| | - Ali Nabavidazeh
- Children's Hospital of Philadelphia, Philadelphia, USA
- University of Pennsylvania, Pennsylvania, USA
| | - Raymond H Mak
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Adam C Resnick
- Children's Hospital of Philadelphia, Philadelphia, USA
- University of Pennsylvania, Pennsylvania, USA
| | - Sabine Mueller
- Department of Neurology, Neurosurgery and Pediatrics, University of California, San Francisco, USA
| | - Tabitha M Cooney
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Daphne A Haas-Kogan
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tina Y Poussaint
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
| | - Hugo J W L Aerts
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology and Nuclear Medicine, CARIM & GROW, Maastricht University, Maastricht, the Netherlands
| | - Benjamin H Kann
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA.
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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Tang J, Dong Z, Sheng J, Yang P, Zhao W, Xue J, Li Q, Lv L, Lv X. Advances in the relationship between temporal muscle thickness and prognosis of patients with glioblastoma: a narrative review. Front Oncol 2023; 13:1251662. [PMID: 37771443 PMCID: PMC10525700 DOI: 10.3389/fonc.2023.1251662] [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: 07/02/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
The most dangerous variety of glioma, glioblastoma, has a high incidence and fatality rate. The prognosis for patients is still bleak despite numerous improvements in treatment approaches. We urgently need to develop clinical parameters that can evaluate patients' conditions and predict their prognosis. Various parameters are available to assess the patient's preoperative performance status and degree of frailty, but most of these parameters are subjective and therefore subject to interobserver variability. Sarcopenia can be used as an objective metric to measure a patient's physical status because studies have shown that it is linked to a bad prognosis in those with cancers. For the purpose of identifying sarcopenia, temporal muscle thickness has demonstrated to be a reliable alternative for a marker of skeletal muscle content. As a result, patients with glioblastoma may use temporal muscle thickness as a potential marker to correlate with the course and fate of their disease. This narrative review highlights and defines the viability of using temporal muscle thickness as an independent predictor of survival in glioblastoma patients, and it evaluates recent research findings on the association between temporal muscle thickness and prognosis of glioblastoma patients.
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Affiliation(s)
- Jinhai Tang
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Zhenghao Dong
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Junxiu Sheng
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Ping Yang
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Wanying Zhao
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Juan Xue
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Qizheng Li
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Li Lv
- Department of Pathology, the Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Xiupeng Lv
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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5
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Yang YW, Zhou YW, Xia X, Jia SL, Zhao YL, Zhou LX, Cao Y, Ge ML. Prognostic value of temporal muscle thickness, a novel radiographic marker of sarcopenia, in patients with brain tumor: A systematic review and meta-analysis. Nutrition 2023; 112:112077. [PMID: 37236042 DOI: 10.1016/j.nut.2023.112077] [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: 02/14/2023] [Revised: 04/24/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
Sarcopenia has been identified as a prognostic factor among certain types of cancer. However, it is unclear whether there is prognostic value of temporalis muscle thickness (TMT), a potential surrogate for sarcopenia, in adults patients with brain tumors. Therefore, we searched the Medline, Embase, and PubMed to systematically review and meta-analyze the relationship between TMT and overall survival, progression-free survival, and complications in patients with brain tumors and the hazard ratio (HR) or odds ratios (OR), and 95% confidence interval (CI) were evaluated. The quality in prognostic studies (QUIPS) instrument was employed to evaluate study quality. Nineteen studies involving 4570 patients with brain tumors were included for qualitative and quantitative analysis. Meta-analysis revealed thinner TMT was associated with poor overall survival (HR, 1.72; 95% CI, 1.45-2.04; P < 0.01) in patients with brain tumors. Sub-analyses showed that the association existed for both primary brain tumors (HR, 2.02; 95% CI, 1.55-2.63) and brain metastases (HR, 1.39; 95% CI, 1.30-1.49). Moreover, thinner TMT also was the independent predictor of progression-free survival in patients with primary brain tumors (HR, 2.88; 95% CI, 1.85-4.46; P < 0.01). Therefore, to improve clinical decision making it is important to integrate TMT assessment into routine clinical settings in patients with brain tumors.
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Affiliation(s)
- Yan-Wu Yang
- Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi-Wu Zhou
- Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xin Xia
- Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shu-Li Jia
- Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yun-Li Zhao
- Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li-Xing Zhou
- Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu Cao
- Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mei-Ling Ge
- Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Bonm AV, Menghini A, Drolet CE, Graber JJ. Temporalis muscle thickness predicts early relapse and short survival in primary CNS lymphoma. Neurooncol Pract 2023; 10:162-168. [PMID: 36970167 PMCID: PMC10037939 DOI: 10.1093/nop/npac087] [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: 11/22/2022] Open
Abstract
Background Most patients with primary CNS lymphoma (PCNSL) achieve durable remission whereas a minority die in the first year. Sarcopenia is a powerful predictor of mortality in the brain and systemic cancers. Temporalis muscle thickness (TMT) is a validated radiographic measure of sarcopenia. We hypothesized that patients with thin TMT at diagnosis would have early progression and short survival. Methods Two blinded operators retrospectively measured TMT in 99 consecutive brain MRIs from untreated patients with PCNSL. Results We generated a receiver operator characteristic curve and chose a single threshold defining thin TMT in all patients as <5.65 mm, at which specificity and sensitivity for 1-year progression were 98.4% and 29.7% and for 1-year mortality were 97.4% and 43.5% respectively. Those with thin TMT were both more likely to progress (P < .001) and had higher rates of mortality (P < .001). These effects were independent of the effect of age, sex, and Eastern Cooperative Oncology Group performance status in a cox regression. Memorial Sloan Kettering Cancer Center score did not predict progression-free survival or overall survival as well as TMT. Patients with thin TMT received fewer cycles of high-dose methotrexate and were less likely to receive consolidation but neither variable could be included in the Cox regression due to violation of the proportional hazards assumption. Conclusions We conclude that PCNSL patients with thin TMT are at high risk for early relapse and short survival. Future trials should stratify patients by TMT to avoid confounding.
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Affiliation(s)
- Alipi V Bonm
- Department of Neurology, Virginia Mason Franciscan Health, Seattle, Washington, USA
| | - Anthony Menghini
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Caroline E Drolet
- Center for Neurosciences and Spine, Virginia Mason Franciscan Health, Seattle, Washington, USA
| | - Jerome J Graber
- Departments of Neurology and Neurosurgery, Alvord Brain Tumor Center, University of Washington, Seattle, Washington, USA
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7
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Sütcüoğlu O, Erdal ZS, Akdoğan O, Çeltikçi E, Özdemir N, Özet A, Uçar M, Yazıcı O. The possible relation between temporal muscle mass and glioblastoma multiforme prognosis via sarcopenia perspective. Turk J Med Sci 2023; 53:413-419. [PMID: 36945944 PMCID: PMC10388072 DOI: 10.55730/1300-0144.5599] [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: 08/17/2022] [Accepted: 11/20/2022] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND The optimal sarcopenia measurement method in patients with a diagnosis of glioblastoma multiforme (GBM) is unknown. It has been found that temporal muscle thickness (TMT) may reflect sarcopenia and be associated with survival, but the relationship between temporal muscle area (TMA) and GBM prognosis has never been evaluated before. The primary outcome of the study was to evaluate the relationship between TMA/TMT and overall survival (OS) time in newly diagnosed GBM patients. METHODS The data of patients who presented at the university hospital between January 2009 and January 2019 with a confirmed diagnosis of glioblastoma multiforme at the time of diagnosis were analyzed retrospectively. Temporal muscle thickness and TMA were measured retrospectively from preoperative MRIs of patients diagnosed with GBM. Due to the small number of patients and the failure to determine a cut-off value with acceptable sensitivity and specificity using ROC analysis, the median values were chosen as the cut-off value. The patients were basically divided into two according to their median TMT (6.6 mm) or TMA (452 mm2 ) values, and survival analysis was performed with the Kaplan-Meier analysis. RESULTS The median TMT value was 6.6 mm, and the median TMA value was 452 mm2 . The median overall survival (OS) was calculated as 25.8 months in patients with TMT < 6.6 mm, and 15.8 months in patients with TMT ≥ 6.6 mm (p = 0.29). The median overall survival (OS) of patients with TMA < 452mm2 was 26.3 months, and the group with TMA ≥ 452mm2 was 14.6 months (p = 0.06). The median disease-free survival was 18.3 months (%95 CI: 13.2-23.4) in patients with TMT < 6.6mm, while mDFS was 10.9 (%95 CI: 8.0-13.8) months in patients with TMT ≥ 6.6mm (p = 0.21). The median disease-free survival was found to be 21.0 months (%95 CI: 15.8-26.1) in patients with TMA < 452 mm2 and 10.5 months (%95 CI: 7.8-13.2) in patients with TMA ≥ 452 mm2 (p = 0.018). DISCUSSION No association could be demonstrated between TMT or TMA and OS of GBM patients. In addition, the median DFS was found to be longer in patients with low TMA. There is an unmet need to determine the optimal method of sarcopenia in GBM patients.
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Affiliation(s)
- Osman Sütcüoğlu
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Zeynep Sezgi Erdal
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Orhun Akdoğan
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Emrah Çeltikçi
- Department of Neurosurgery, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nuriye Özdemir
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ahmet Özet
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Murat Uçar
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ozan Yazıcı
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
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8
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Temporal muscle thickness as an independent prognostic marker in glioblastoma patients—a systematic review and meta-analysis. Neurosurg Rev 2022; 45:3619-3628. [DOI: 10.1007/s10143-022-01892-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/03/2022] [Accepted: 11/02/2022] [Indexed: 11/11/2022]
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9
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Deep learning-based quantification of temporalis muscle has prognostic value in patients with glioblastoma. Br J Cancer 2021; 126:196-203. [PMID: 34848854 PMCID: PMC8770629 DOI: 10.1038/s41416-021-01590-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/25/2021] [Accepted: 10/06/2021] [Indexed: 01/19/2023] Open
Abstract
Background Glioblastoma is the commonest malignant brain tumour. Sarcopenia is associated with worse cancer survival, but manually quantifying muscle on imaging is time-consuming. We present a deep learning-based system for quantification of temporalis muscle, a surrogate for skeletal muscle mass, and assess its prognostic value in glioblastoma. Methods A neural network for temporalis segmentation was trained with 366 MRI head images from 132 patients from 4 different glioblastoma data sets and used to quantify muscle cross-sectional area (CSA). Association between temporalis CSA and survival was determined in 96 glioblastoma patients from internal and external data sets. Results The model achieved high segmentation accuracy (Dice coefficient 0.893). Median age was 55 and 58 years and 75.6 and 64.7% were males in the in-house and TCGA-GBM data sets, respectively. CSA was an independently significant predictor for survival in both the in-house and TCGA-GBM data sets (HR 0.464, 95% CI 0.218–0.988, p = 0.046; HR 0.466, 95% CI 0.235–0.925, p = 0.029, respectively). Conclusions Temporalis CSA is a prognostic marker in patients with glioblastoma, rapidly and accurately assessable with deep learning. We are the first to show that a head/neck muscle-derived sarcopenia metric generated using deep learning is associated with oncological outcomes and one of the first to show deep learning-based muscle quantification has prognostic value in cancer.
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10
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Guven DC, Aksun MS, Cakir IY, Kilickap S, Kertmen N. The association of BMI and sarcopenia with survival in patients with glioblastoma multiforme. Future Oncol 2021; 17:4405-4413. [PMID: 34409854 DOI: 10.2217/fon-2021-0681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background: The association between obesity and sarcopenia (via temporal muscle thickness) with overall survival (OS) has been evaluated in several glioblastoma multiforme studies, however, the data are inconclusive. Methods: The authors conducted meta-analyses via the generic inverse-variance method with a random-effects model. Results: In the pooled analysis of five studies, including 973 patients, patients with lower temporal muscle thickness had significantly decreased OS (HR: 1.62, 95% CI: 1.16-2.28, p = 0.005). The pooled analysis of five studies, including 2131 patients, demonstrated decreased OS in patients with lower BMI compared with patients with obesity (HR: 1.45, 95% CI: 1.12-1.88, p = 0.005). Conclusion: Readily available body composition parameters could be used for prognosis prediction and to aid in treatment decisions in patients with glioblastoma multiforme.
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Affiliation(s)
| | - Melek Seren Aksun
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara 06230, Turkey
| | - Ibrahim Yahya Cakir
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara 06230, Turkey
| | - Saadettin Kilickap
- Hacettepe University Cancer Institute, Ankara 06100, Turkey.,Department of Medical Oncology, Istinye University, Istanbul 34010, Turkey
| | - Neyran Kertmen
- Hacettepe University Cancer Institute, Ankara 06100, Turkey
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11
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Huq S, Khalafallah AM, Ruiz-Cardozo MA, Botros D, Oliveira LAP, Dux H, White T, Jimenez AE, Gujar SK, Sair HI, Pillai JJ, Mukherjee D. A novel radiographic marker of sarcopenia with prognostic value in glioblastoma. Clin Neurol Neurosurg 2021; 207:106782. [PMID: 34186275 DOI: 10.1016/j.clineuro.2021.106782] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Sarcopenia is an important prognostic consideration in surgical oncology that has received relatively little attention in brain tumor patients. Temporal muscle thickness (TMT) has recently been proposed as a novel radiographic marker of sarcopenia that can be efficiently obtained within existing workflows. We investigated the prognostic value of TMT in primary and progressive glioblastoma. METHODS TMT measurements were performed on magnetic resonance images of 384 patients undergoing 541 surgeries for glioblastoma. Relationships between TMT and clinical characteristics were examined on bivariate analysis. Optimal TMT cutpoints were established using maximally selected rank statistics. Predictive value of TMT upon postoperative survival (PS) was assessed using Cox proportional hazards regression adjusted for age, sex, Karnofsky performance status (KPS), Stupp protocol completion, extent of resection, and tumor molecular markers. RESULTS Average TMT for the primary and progressive glioblastoma cohorts was 9.55 mm and 9.40 mm, respectively. TMT was associated with age (r = -0.14, p = 0.0008), BMI (r = 0.29, p < 0.0001), albumin (r = 0.11, p = 0.0239), and KPS (r = 0.11, p = 0.0101). Optimal TMT cutpoints for the primary and progressive cohorts were ≤ 7.15 mm and ≤ 7.10 mm, respectively. High TMT was associated with increased Stupp protocol completion (p = 0.001). On Cox proportional hazards regression, high TMT predicted increased PS in progressive [HR 0.47 (95% confidence interval (CI)) 0.25-0.90), p = 0.023] but not primary [HR 0.99 (95% CI 0.64-1.51), p = 0.949] glioblastoma. CONCLUSIONS TMT correlates with important prognostic variables in glioblastoma and predicts PS in patients with progressive, but not primary, disease. TMT may represent a pragmatic neurosurgical biomarker in glioblastoma that could inform treatment planning and perioperative optimization.
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Affiliation(s)
- Sakibul Huq
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Adham M Khalafallah
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Miguel A Ruiz-Cardozo
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - David Botros
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Leonardo A P Oliveira
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Hayden Dux
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Taija White
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Adrian E Jimenez
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Sachin K Gujar
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Neuroradiology, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Haris I Sair
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Neuroradiology, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Jay J Pillai
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA; The Russell H. Morgan Department of Radiology and Radiological Science, Division of Neuroradiology, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Debraj Mukherjee
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA.
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12
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Muglia R, Simonelli M, Pessina F, Morenghi E, Navarria P, Persico P, Lorenzi E, Dipasquale A, Grimaldi M, Scorsetti M, Santoro A, Politi LS. Prognostic relevance of temporal muscle thickness as a marker of sarcopenia in patients with glioblastoma at diagnosis. Eur Radiol 2020; 31:4079-4086. [PMID: 33201284 DOI: 10.1007/s00330-020-07471-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/16/2020] [Accepted: 11/04/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Temporal muscle thickness (TMT) is a surrogate marker of sarcopenia, correlated with survival expectancy in patients suffering from brain metastases and recurrent or treated glioblastoma. We evaluated the prognostic relevance of TMT measured on brain MRIs acquired at diagnosis in patients affected by glioblastoma. METHODS We retrospectively enrolled 51 patients in our Institution affected by methylated MGMT promoter, IDH1-2 wild-type glioblastoma, who underwent complete surgical resection and subsequent radiotherapy with concomitant and maintenance temozolomide, from January 1, 2015, to April 30, 2017. The last clinical/radiological follow-up date was set to September 3, 2019. TMT was measured bilaterally on reformatted post-contrast 3D MPRAGE images, acquired on our 3-T scanner no more than 2 days before surgery. The median, 25th, and 75th percentile TMT values were identified and population was subdivided accordingly; afterwards, statistical analyses were performed to verify the association among overall survival (OS) and TMT, sex, age, and ECOG performance status. RESULTS In our cohort, the median OS was 20 months (range 3-51). Patients with a TMT ≥ 8.4 mm (median value) did not show a statistically significant increase in OS (Cox regression model: HR 1.34, 95% CI 0.68-2.63, p = 0.403). Similarly, patients with a TMT ≥ 9.85 mm (fourth quartile) did not differ in OS compared to those with TMT ≤ 7 mm (first quartile). The statistical analyses confirmed a significant association among TMT and sex (p = 0.0186), but none for age (p = 0.642) and performance status (p = 0.3982). CONCLUSIONS In our homogeneous cohort of patients with glioblastoma at diagnosis, TMT was not associated with prognosis, age, or ECOG performance status. KEY POINTS • Temporal muscle thickness (TMT) is a surrogate marker of sarcopenia and has been correlated with survival expectancy in patients suffering from brain metastases and recurrent or treated glioblastoma. • We appraised the correlation among TMT and survival, sex, age at surgery, and performance status, measured on brain MRIs of patients affected by glioblastoma at diagnosis. • TMT did not show any significant correlation with prognosis, age at surgery, or performance status, and its usefulness might be restricted only to patients with brain metastases and recurrent or treated glioblastoma.
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Affiliation(s)
- Riccardo Muglia
- Training School in Radiology, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
| | - Matteo Simonelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- Oncology and Hematology Unit, Humanitas Clinical and Research Center - IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Federico Pessina
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Emanuela Morenghi
- Biostatistic Unit, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
| | - Pierina Navarria
- Department of Radiotherapy, Humanitas Clinical and Research Center - IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Pasquale Persico
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- Oncology and Hematology Unit, Humanitas Clinical and Research Center - IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Elena Lorenzi
- Oncology and Hematology Unit, Humanitas Clinical and Research Center - IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Angelo Dipasquale
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- Oncology and Hematology Unit, Humanitas Clinical and Research Center - IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Marco Grimaldi
- Department of Neuroradiology, Humanitas Clinical and Research Center - IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Marta Scorsetti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- Department of Radiotherapy, Humanitas Clinical and Research Center - IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- Oncology and Hematology Unit, Humanitas Clinical and Research Center - IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Letterio S Politi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy.
- Department of Neuroradiology, Humanitas Clinical and Research Center - IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy.
- Hematology & Oncology Division and Radiology Department, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA.
- Radiology Department and Advanced MRI Center, University of Massachusetts Medical School and Medical Center, 55 Lake Avenue N, Worcester, MA, 01655, USA.
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