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Wang R, Fu S, Huang R, Qiu C, Tang Y, Liu Y. The Diagnostic Value of Musculoskeletal Ultrasound in the Quantitative Evaluation of Skeletal Muscle in Chronic Thyrotoxic Myopathy: A Single-Center Study in China. Int J Gen Med 2024; 17:3541-3554. [PMID: 39170733 PMCID: PMC11338175 DOI: 10.2147/ijgm.s472442] [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: 06/02/2024] [Accepted: 07/31/2024] [Indexed: 08/23/2024] Open
Abstract
Objective This study aimed to evaluate the quadriceps femoris in patients with chronic thyrotoxic myopathy (CTM) using musculoskeletal ultrasound and to explore its practical clinical value for the diagnosis of CTM. Methods A total of 241 subjects recruited from the First Affiliated Hospital of Guangxi Medical University were surveyed for detailed medical history and underwent grip strength tests, fixed-distance walking, and quadriceps femoris ultrasound examinations. Differences in muscle parameters between the CTM, non-CTM, and healthy groups were analyzed. An Receiver operating characteristic (ROC) curve was established to analyze the predictive value of various ultrasound measurements for CTM, and Spearman correlation analysis and binary logistic regression were applied to explore the factors associated CTM. Results The quadriceps femoris contraction index, muscle thickness, muscle cross-sectional area, and pennation angle in the CTM group were significantly lower than those in the non-CTM and healthy groups (p<0.01). The ROC curve prediction showed that the pennation angle had the best sensitivity and specificity for diagnosing myogenesis, with an area under the curve of 89%. Moreover, the pennation angle of the CTM group was positively correlated with step speed (r=0.245, p=0.031) and body surface area (r=0.276, p=0.014), but negatively correlated with age (r=-0.306, p=0.007). Regression analysis showed that the quadriceps femoris contraction index, muscle thickness, pennation angle, and cross-sectional area were factors that related the CTM. After adjusting for potential confounding factors, the association between Muscle Bundle Length and CTM became significant (OR=1.99, 95% CI: 1.22, 3.35, p=0.007). Muscular echo in patients was observed to varying degrees of enhancement. Conclusion Musculoskeletal ultrasonography in the quantitative analysis of muscle parameters and muscle echo of the quadriceps femoris can provide essential imaging evidence for predicting CTM.
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Affiliation(s)
- Roumei Wang
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Shien Fu
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Rui Huang
- College of Public Hygiene of Guangxi Medical University, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Chengcheng Qiu
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Yunxia Tang
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Yaoli Liu
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
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Ko HS, Attenberger U. Medical imaging in cancer cachexia. RADIOLOGIE (HEIDELBERG, GERMANY) 2024:10.1007/s00117-024-01346-5. [PMID: 38995346 DOI: 10.1007/s00117-024-01346-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/13/2024]
Abstract
Cancer cachexia, often referred to as "wasting syndrome," is characterized by fatigue, weakness, and involuntary weight loss. This syndrome is concomitant with progressive skeletal muscle atrophy with or without adipose tissue loss and is frequently accompanied by systemic inflammation. Understanding the complexities of cancer cachexia is crucial for early detection and intervention, and it is also paramount for enhancing patient outcomes. Medical imaging, comprising diverse imaging modalities, plays a pivotal role in this context, facilitating the diagnosis and surveillance assessment of both the disease extent and the body composition changes that offer valuable information and insights into disease progression. This article provides a comprehensive discourse of the pathophysiological mechanisms and clinical manifestations of cancer cachexia as well as the role of medical imaging in this setting. Particular emphasis is placed on contemporary multidisciplinary and translational research efforts for the development of diagnostic and treatment tools, aiming to mitigate the devastating consequences of cancer cachexia.
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Affiliation(s)
- Hyun Soo Ko
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany.
| | - Ulrike Attenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
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Martín-Martín J, Pajares-Hachero B, Alba-Conejo E, Ribelles N, Cuesta-Vargas AI, Roldán-Jiménez C. Validation of the Upper Limb Functional Index on Breast Cancer Survivor. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4997. [PMID: 36981904 PMCID: PMC10049349 DOI: 10.3390/ijerph20064997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED Breast cancer survivors (BCS) may face functional alterations after surgical intervention. Upper Limb Disorders (ULDs) are highly prevalent even years after a diagnosis. Clinicians may assess the upper limbs after breast cancer. The Upper Limb Functional Index (ULFI) has been validated across different populations and languages. This study aimed to assess the psychometric properties of the Upper Limb Functional Index Spanish version (ULFI-Sp) in the BCS. METHODS A psychometric validation study of the ULFI-Sp was conducted on 216 voluntary breast cancer survivors. The psychometric properties were as follows: analysis of the factor structure by maximum likelihood extraction (MLE), internal consistency, and construct validity by confirmatory factor analysis (CFA). RESULTS The factor structure was one-dimensional. ULFI-Sp showed a high internal consistency for the total score (α = 0.916) and the regression score obtained from MLE (α = 0.996). CFA revealed a poor fit, and a new 14-item model (short version) was further tested. The developed short version of the ULFI-SP is preferable to assess upper limb function in Spanish BCS. CONCLUSIONS Given the high prevalence of ULD in this population and the broader versions of ULFI across different languages, this study's results may be transferred to clinical practice and integrated as part of upper limb assessment after breast cancer.
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Affiliation(s)
- Jaime Martín-Martín
- Legal and Forensic Medicine Area, Department of Human Anatomy, Legal Medicine and History of Science, Faculty of Medicine, University of Malaga, 29010 Málaga, Spain
- Grupo Clinimetría en Fisioterapia (F-14), Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain
| | - Bella Pajares-Hachero
- UGCI Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain
| | - Emilio Alba-Conejo
- UGCI Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain
| | - Nuria Ribelles
- UGCI Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain
| | - Antonio I. Cuesta-Vargas
- Grupo Clinimetría en Fisioterapia (F-14), Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain
- Department Physiotherapy, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
- School of Clinical Science, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Cristina Roldán-Jiménez
- Grupo Clinimetría en Fisioterapia (F-14), Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain
- Department Physiotherapy, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
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Bulbrook BD, Chopp-Hurley JN, Wiebenga EG, Pritchard JM, Gatti AA, Keir PJ, Maly MR. Muscle Architecture and Subcutaneous Fat Measurements of Rectus Femoris and Vastus Lateralis at Optimal Length Aided by a Novel Ultrasound Transducer Attachment. Physiother Can 2023; 75:74-82. [PMID: 37250739 PMCID: PMC10211386 DOI: 10.3138/ptc-2021-0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/13/2021] [Accepted: 07/22/2021] [Indexed: 01/11/2024]
Abstract
Purpose: This cross-sectional study determines the sensitivity of muscle architecture and fat measurements of the rectus femoris (RF) and vastus lateralis (VL) muscles from ultrasound images acquired with varying transducer tilt, using a novel transducer attachment, in healthy adults. Secondary objectives were to estimate intrarater and interrater reliability of image measurement and acquisition, respectively. Methods: Thirty healthy adults participated (15 women and 15 men; 25 [SD 2.5] y). Ultrasound image acquisition was conducted by two raters at different transducer tilts relative to the skin: estimated perpendicular, and five measured angles (80°, 85°, 90°, 95°, 100°) using the transducer attachment. Muscle thickness (MT), subcutaneous fat thickness (FT), pennation angle (PA), and fascicle length (FL) were measured. Sensitivity and reliability were assessed using intra-class correlation coefficients (ICCs) and standard error of measurements (SEMs). Results: MT and FT for RF and VL were not sensitive to transducer tilt. However, PA and FL were sensitive to transducer tilt. MT and FT for both muscles showed high ICCs and low SEMs for intrarater and interrater reliability. For PA of both muscles, standardizing transducer tilt improved interrater ICCs and lowered SEMs. Conclusion: MT and FT measurements of RF and VL acquired at 60° knee flexion are robust to varying transducer tilt angles. PA measurements benefit from standardizing transducer tilt.
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Affiliation(s)
| | - Jaclyn N. Chopp-Hurley
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Emily G. Wiebenga
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Janet M. Pritchard
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
- School of Interdisciplinary Science, McMaster University, Hamilton, Ontario, Canada
| | - Anthony A. Gatti
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Peter J. Keir
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Monica R. Maly
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- School of Interdisciplinary Science, McMaster University, Hamilton, Ontario, Canada
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Casey P, Alasmar M, McLaughlin J, Ang Y, McPhee J, Heire P, Sultan J. The current use of ultrasound to measure skeletal muscle and its ability to predict clinical outcomes: a systematic review. J Cachexia Sarcopenia Muscle 2022; 13:2298-2309. [PMID: 35851996 PMCID: PMC9530572 DOI: 10.1002/jcsm.13041] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/21/2022] [Accepted: 06/25/2022] [Indexed: 11/06/2022] Open
Abstract
Quantification and monitoring of lean body mass is an important component of nutrition assessment to determine nutrition status and muscle loss. The negative impact of reduced muscle mass and muscle function is increasingly evident across acute and chronic disease states but is particularly pronounced in patients with cancer. Ultrasound is emerging as a promising tool to directly measure skeletal muscle mass and quality. Unlike other ionizing imaging techniques, ultrasound can be used repeatedly at the bedside and may compliment nutritional risk assessment. This review aims to describe the current use of skeletal muscle ultrasound (SMUS) to measure muscle mass and quality in patients with acute and chronic clinical conditions and its ability to predict functional capacity, severity of malnutrition, hospital admission, and survival. Databases were searched from their inception to August 2021 for full-text articles in English. Relevant articles were included if SMUS was investigated in acute or chronic clinical contexts and correlated with a defined clinical outcome measure. Data were synthesized for narrative review due to heterogeneity between studies. This review analysed 37 studies (3100 patients), which met the inclusion criteria. Most studies (n = 22) were conducted in critical care. The clinical outcomes investigated included functional status at discharge (intensive care unit-acquired weakness), nutritional status, and length of stay. SMUS was also utilized in chronic conditions such as chronic obstructive pulmonary disease, chronic heart failure, and chronic renal failure to predict hospital readmission and disease severity. Only two studies investigated the use of SMUS in patients with cancer. Of the 37 studies, 28 (76%) found that SMUS (cross-sectional area, muscle thickness, and echointensity) showed significant associations with functional capacity, length of stay, readmission, and survival. There was significant heterogeneity in terms of ultrasound technique and outcome measurement across the included studies. This review highlights that SMUS continues to gain momentum as a potential tool for skeletal muscle assessment and predicting clinically important outcomes. Further work is required to standardize the technique in nutritionally vulnerable patients, such as those with cancer, before SMUS can be widely adopted as a bedside prognostic tool.
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Affiliation(s)
- Patrick Casey
- Department of Oesophagogastric SurgerySalford Royal NHS Foundation TrustSalfordUK
- Division of Diabetes, Endocrinology and Gastroenterology, Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Mohamed Alasmar
- Department of Oesophagogastric SurgerySalford Royal NHS Foundation TrustSalfordUK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - John McLaughlin
- Division of Diabetes, Endocrinology and Gastroenterology, Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Department of GastroenterologySalford Royal NHS Foundation TrustSalfordUK
| | - Yeng Ang
- Division of Diabetes, Endocrinology and Gastroenterology, Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Department of GastroenterologySalford Royal NHS Foundation TrustSalfordUK
| | - Jamie McPhee
- Manchester Metropolitan University Institute of SportManchesterUK
- Department of Musculoskeletal RadiologySalford Royal NHS Foundation TrustSalfordUK
| | - Priam Heire
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Faculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
| | - Javed Sultan
- Department of Oesophagogastric SurgerySalford Royal NHS Foundation TrustSalfordUK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
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Escriche-Escuder A, Trinidad-Fernández M, Pajares B, Iglesias-Campos M, Alba E, García-Almeida JM, Roldán-Jiménez C, Cuesta-Vargas AI. Responsiveness of the new index muscular echotexture in women with metastatic breast cancer: an exercise intervention study. Sci Rep 2022; 12:15148. [PMID: 36071122 PMCID: PMC9452568 DOI: 10.1038/s41598-022-19532-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 08/30/2022] [Indexed: 12/05/2022] Open
Abstract
Ultrasound imaging texture analyses may provide information on tissue homogeneity changes in metastatic breast cancer (MBC) through second-order analyzes based on the gray-level co-occurrence matrix. This study aimed to analyze the responsiveness and correlations of biomarkers of muscular and fat echotexture after an exercise intervention in women with MBC. A 12-week exercise intervention was conducted in 2019, including aerobic and strength training. Echotexture variables were obtained at baseline and after intervention from the quadriceps (Q) and biceps brachii and brachialis. Mean differences were calculated using the T-Student parametric test for dependent samples of the differences in the means (P = 0.05; 95% CI). Data obtained from 13 MBC women showed significant differences in some echotexture variables after the intervention. QLQ-BR23 questionnaire correlated with several echotexture variables from muscle and subcutaneous fat. PFS-R scale correlated positively with the Q Subcutaneous Fat Non-Contraction Homogeneity (R = 0.43, P < 0.05). Q Muscle Non-Contraction Energy and Q Muscle Non-Contraction Textural Correlation explained 90% of the variance of QLQ-BR23. Some muscle and subcutaneous fat echotexture biomarkers showed good responsiveness after the exercise intervention. Additionally, some muscle and subcutaneous fat variables correlated with QLQ-BR23 and cancer-related fatigue measured by PFS-R scale in MBC patients. Trial registration: NCT03879096
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Affiliation(s)
- Adrian Escriche-Escuder
- Department of Physiotherapy, University of Malaga, C/ Arquitecto Peñalosa, 3, 29071, Málaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Manuel Trinidad-Fernández
- Department of Physiotherapy, University of Malaga, C/ Arquitecto Peñalosa, 3, 29071, Málaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Bella Pajares
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,UGCI Oncología Médica Hospitales Universitarios Regional y Virgen de la Victoria, Málaga, Spain
| | - Marcos Iglesias-Campos
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,UGCI Oncología Médica Hospitales Universitarios Regional y Virgen de la Victoria, Málaga, Spain
| | - Emilio Alba
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,UGCI Oncología Médica Hospitales Universitarios Regional y Virgen de la Victoria, Málaga, Spain
| | - José Manuel García-Almeida
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,UGCI Endocrinología y Nutrición, Hospital Regional Universitario y Virgen de la Victoria, Málaga, Spain
| | - Cristina Roldán-Jiménez
- Department of Physiotherapy, University of Malaga, C/ Arquitecto Peñalosa, 3, 29071, Málaga, Spain. .,Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
| | - Antonio I Cuesta-Vargas
- Department of Physiotherapy, University of Malaga, C/ Arquitecto Peñalosa, 3, 29071, Málaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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