Association between thoracic and third lumbar CT-derived muscle mass and density in Caucasian patients without chronic disease: a proof-of-concept study

Abstract

Background Computed tomography (CT) is increasingly used in the clinical workup, and existing scan contains unused body composition data, potentially useful in a clinical setting. However, there is no healthy reference for contrast-enhanced thoracic CT-derived muscle measures. Therefore, we aimed at investigating whether there is a correlation between each of the thoracic and third lumbar vertebra level (L3) skeletal muscle area (SMA), skeletal muscle index (SMI), and skeletal muscle density (SMD) at contrast-enhanced CT in patients without chronic disease. Methods A proof-of-concept retrospective observational study was based on Caucasian patients without chronic disease, who received CT for trauma between 2012 and 2014. Muscle measures were assessed using a semiautomated threshold-based software by two raters independently. Pearson’s correlation between each thoracic level and third lumbar and intraclass correlation between two raters and test–retest with SMA as proxy parameters were used. Results Twenty-one patients (11 males, 10 females; median age 29 years) were included. The second thoracic vertebra (T2) had the highest median of cumulated SMA (males 314.7 cm2, females 118.5 cm2) and SMI (97.8 cm2/m2 and 70.4 cm2/m2, respectively). The strongest SMA correlation was observed between T5 and L3 (r = 0.970), the SMI between T11 and L3 (r = 0.938), and the SMD between the T10 and L3 (r = 0.890). Conclusions This study suggests that any of the thoracic levels can be valid to assess skeletal muscle mass. However, the T5 may be most favourable for measuring SMA, the T11 for SMI, and T10 for SMD when using contrast-enhanced thoracic CT. Relevance statement In COPD patients, a CT-derived thoracic muscle mass assessment may help identify who would benefit from focused pulmonary rehabilitation: thoracic contrast-enhanced CT conducted as part of the standard clinical workup can be used for this evaluation. Key points • Any thoracic level can be used to assess thoracic muscle mass. • Thoracic level 5 is strongly associated with the 3rd lumbar muscle area. • A strong correlation between the thoracic level 11 and the 3rd lumbar muscle index. • Thoracic level 10 is strongly associated with the 3rd lumbar muscle density. Graphical Abstract

Ethnic differences in CT derived abdominal body composition measures: a comparative retrospect pilot study between European and Inuit study population

“…For fat tissue, a study has shown that a thinner slice increased SFA by 0.2%, VFA by 3%, and IMFA by 17.3% [ 57 ]. One could speculate whether slice thickness has a clinically relevant impact on body composition measurements as differences are minor and fall within the expected uncertainties of manual or semi-automated segmentation with intra-analyst variation described in other studies [ 35 , 40 ]. An improvement could be to resample with the same slice thickness using fully automated solutions to save precious staff resources and avoid inter and intra-rater variations and intra-patient variability in measurements [ 58 ].…”

“…The data collection period was limited to these specific time periods because of comparable standardised trauma CT protocols. The European study population from the Northern Region Denmark was previously described in detail by Brath et al [ 40 ].…”