Adipose tissue radiodensity: A new prognostic biomarker in people with multiple myeloma

Júnior, Ademar Dantas da Cunha; Silveira, Marina Nogueira; Takahashi, Maria Emília Seren; Souza, Elemir Macedo de; Mosci, Camila; Ramos, Celso Darío; Brambilla, Sandra Regina; Pericole, Fernando V; Prado, Carla M.; Mendes, Maria Carolina Santos; Carvalheira, José Barreto Campello

doi:10.1016/j.nut.2021.111141

Cited by 15 publications

(19 citation statements)

References 57 publications

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“…Interestingly, both high adipose tissue radiodensity and increased adipose tissue glucose uptake may be related to this phenomenon, and therefore, they may be early markers of cancer cachexia. In accordance, high SAT radiodensity has similar HU to that of brown adipose tissue [55,59,60]. This may also be a consequence of inflammation, which is also associated with high adipose tissue radiodensity.…”

Section: Fdg Uptake Of Adipose Tissue and Radiodensitysupporting

confidence: 59%

“…Cachexia is a complex process, and anthropomorphic measures such as body mass index (BMI) and skeletal muscle depletion may not be suitable as prognostic biomarkers for cancer survival [50][51][52]. Although "gold standard" techniques are still not available for precisely measuring cancer cachexia progression in patients with MM, emergent evidence indicates that abnormalities in adipose tissue depots are associated with survival outcomes in MM patients [53][54][55][56]. Specifically, increased visceral adipose tissue (VAT) was identified as a predictive factor of poor treatment response [53], while lower subcutaneous adipose tissue (SAT) was associated with reduced survival [54].…”

Section: Fdg Uptake Of Adipose Tissue and Radiodensitymentioning

confidence: 99%

“…Specifically, increased visceral adipose tissue (VAT) was identified as a predictive factor of poor treatment response [53], while lower subcutaneous adipose tissue (SAT) was associated with reduced survival [54]. SAT radiodensity and increased VAT glucose uptake are associated with unfavorable prognosis in MM patients [55,56]. FDG uptake in VAT is usually measured in a slice at the third lumbar vertebra (L3) level.…”

Section: Fdg Uptake Of Adipose Tissue and Radiodensitymentioning

confidence: 99%

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Metabolic Volume Measurements in Multiple Myeloma

et al. 2021

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Multiple myeloma (MM) accounts for 10–15% of all hematologic malignancies, as well as 20% of deaths related to hematologic malignant tumors, predominantly affecting bone and bone marrow. Positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (FDG-PET/CT) is an important method to assess the tumor burden of these patients. It is often challenging to classify the extent of disease involvement in the PET scans for many of these patients because both focal and diffuse bone lesions may coexist, with varying degrees of FDG uptake. Different metrics involving volumetric parameters and texture features have been proposed to objectively assess these images. Here, we review some metabolic parameters that can be extracted from FDG-PET/CT images of MM patients, including technical aspects and predicting MM outcome impact. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are volumetric parameters known to be independent predictors of MM outcome. However, they have not been adopted in clinical practice due to the lack of measuring standards. CT-based segmentation allows automated, and therefore reproducible, calculation of bone metabolic metrics in patients with MM, such as maximum, mean and standard deviation of the standardized uptake values (SUV) for the entire skeleton. Intensity of bone involvement (IBI) is a new parameter that also takes advantage of this approach with promising results. Other indirect parameters obtained from FDG-PET/CT images, such as visceral adipose tissue glucose uptake and subcutaneous adipose tissue radiodensity, may also be useful to evaluate the prognosis of MM patients. Furthermore, the use and quantification of new radiotracers can address different metabolic aspects of MM and may have important prognostic implications.

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Section: Fdg Uptake Of Adipose Tissue and Radiodensitysupporting

confidence: 59%

Section: Fdg Uptake Of Adipose Tissue and Radiodensitymentioning

confidence: 99%

Section: Fdg Uptake Of Adipose Tissue and Radiodensitymentioning

confidence: 99%

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Metabolic Volume Measurements in Multiple Myeloma

et al. 2021

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“…The concept of adipose tissue radiodensity is emerging in literature, and its relationship to prognosis has been explored within the oncology setting. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

“… 10 Having higher SAT radiodensity was associated with shorter survival in patients with multiple myeloma. 3 In addition, increased SAT radiodensity has also been linked to the risk of decompensation in patients with cirrhosis. 13 …”

Section: Introductionmentioning

confidence: 99%

Higher subcutaneous adipose tissue radiodensity is associated with increased mortality in patients with cirrhosis

et al. 2022

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Myosteatosis in multiple myeloma: a key determinant of survival beyond sarcopenia

Diallo,

Blessing,

Ihorst

et al. 2024

Skeletal Radiol

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Objective Fatty infiltration of skeletal muscle (Myosteatosis) is associated with increased frailty, decreased muscle and mobility function, which seems fairly prevalent in multiple myeloma (MM) patients. This study aimed to determine the prognostic value of myosteatosis assessed by CT for progression-free survival (PFS) and overall survival (OS). Materials and methods This IRB-approved cohort study included patients with newly diagnosed MM who were treated at a single university hospital and received CT at baseline. Geriatric assessment was performed via International Myeloma Working Group frailty score and Revised Myeloma Comorbidity Index. Myosteatosis was determined through measurement of paravertebral muscle radiodensity. Statistical analyses included uni- and multivariable Cox proportional hazard models and the Kaplan–Meier-method. Results A total of 226 newly diagnosed MM patients (median age: 65 years [range: 29–89], 63% males, mean BMI: 25 [14–42]) were analyzed. The prevalence of myosteatosis was 51%. Muscle radiodensity was significantly decreased in individuals with International Staging System stage III vs. I (p < 0.001), indicating higher fatty muscle infiltration in patients with advanced disease. Both PFS and OS were significantly decreased in patients with myosteatosis (PFS: median 32.0 months (95% CI 20.5.5–42.2) vs. 66.4 months without myosteatosis (95% CI 42.5-not reached), p < .001); OS: median 58.6 (95% CI 51.3—90.2) vs. not reached, p < .001). Myosteatosis remained an independent predictor of OS in multivariable analyses (HR: 1.98; 95%-CI: 1.20–3.27). Conclusion Myosteatosis seems fairly prevalent in patients with newly diagnosed MM and associated with impaired overall survival. Prospective clinical trials are required to better understand the role of myosteatosis in MM patients.

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Adipose tissue radiodensity: A new prognostic biomarker in people with multiple myeloma

Cited by 15 publications

References 57 publications

Metabolic Volume Measurements in Multiple Myeloma

Metabolic Volume Measurements in Multiple Myeloma

Higher subcutaneous adipose tissue radiodensity is associated with increased mortality in patients with cirrhosis

Myosteatosis in multiple myeloma: a key determinant of survival beyond sarcopenia

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