Opportunistic Measurement of Skeletal Muscle Size and Muscle Attenuation on Computed Tomography Predicts 1-Year Mortality in Medicare Patients

Lenchik, Leon; Lenoir, Kristin M.; Tan, Josh; Boutin, Robert D.; Callahan, Kathryn E.; Kritchevsky, Stephen B.; Wells, Brian J.

doi:10.1093/gerona/gly183

Cited by 55 publications

(33 citation statements)

References 33 publications

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“…CT-derived measures of muscle mass and myosteatosis have been associated with adverse outcomes in many populations, including older adults (1,(30)(31)(32)(33)(40)(41)(42)(43)(44)(45). Increasing use of CT for deriving these muscle metrics was highlighted at two recent conferences of the National Institutes of Health (NIH): The National Cancer This systematic review reveals important trends in the literature on CT assessment of muscle mass and myosteatosis, including the muscles analyzed, analysis techniques, and use of diagnostic cut points.…”

Section: Discussionmentioning

confidence: 99%

“…In general, the aging literature reserves the term sarcopenia for low muscle mass (usually measured with dual X-ray absorptiometry or bioelectrical impedance analysis) and low physical function (usually measured with grip strength or gait speed) and considers myosteatosis a related, but distinct, entity (2)(3)(4)(6)(7)(8). In contrast, many cancer journals (and other nonaging journals) use the term sarcopenia for low muscle mass (usually measured with computed tomography [CT]) without any measurement of physical function and occasionally consider myosteatosis as a component of sarcopenia, rather than a distinct entity (1,(30)(31)(32)(33)(34).…”

mentioning

confidence: 99%

“…Despite the inconsistent terminology, the use of CT for research on muscle in older adults is becoming more common, due to its ability to measure muscle quality (eg, myosteatosis) and muscle mass (32). CT assessment of muscle mass usually involves measuring muscle cross-sectional area on a single CT image (5).…”

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confidence: 99%

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Approaches to Assessment of Muscle Mass and Myosteatosis on Computed Tomography: A Systematic Review

Amini

Boyle

Boutin

et al. 2019

The Journals of Gerontology: Series A

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230

201

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Background/Objective: There is increasing use of computed tomography (CT) in sarcopenia research using a wide variety of techniques. We performed a systematic review of the CT literature to identify the differences between approaches used. Methods: A comprehensive search of PubMed from 1983 to 2017 was performed to identify studies that used CT muscle measurements to assess muscle mass and myosteatosis. The CT protocols were evaluated based on anatomic landmark(s), thresholding, muscle(s) segmented, key measurement (ie, muscle attenuation, cross-sectional area, volume), derived variables, and analysis software. From the described search, 657 articles were identified and 388 studies met inclusion criteria for this systematic review. Results: Muscle mass was more commonly assessed than myosteatosis (330 vs. 125). The most commonly assessed muscle or muscle groups were total abdominal wall musculature (142/330 and 49/125 for muscle mass and myosteatosis, respectively) and total thigh musculature (90/330 and 48/125). The most commonly used landmark in the abdomen was the L3 vertebra (123/142 and 45/49 for muscle mass and myosteatosis, respectively). Skeletal muscle index and intermuscular adipose tissue were the most commonly used measures of abdominal wall muscle mass (114/142) and myosteatosis (27/49), respectively. Cut points varied across studies. A significant majority of studies failed to report important CT technical parameters, such as use of intravenous contrast and slice thickness (94% and 63%, respectively). Conclusions: There is considerable variation in the CT approaches used for the assessment of muscle mass and myosteatosis. There is a need to develop consensus for CT-based evaluation of sarcopenia and myosteatosis.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Approaches to Assessment of Muscle Mass and Myosteatosis on Computed Tomography: A Systematic Review

Amini

Boyle

Boutin

et al. 2019

The Journals of Gerontology: Series A

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230

201

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“…Age-related reductions of skeletal muscle mass, strength and function (termed 'sarcopenia') and cardiorespiratory fitness may prematurely force individuals into a state of physical dependence and are independent predictors of all-cause mortality [2][3][4] . Skeletal muscle mass is indispensable for locomotion, basal metabolism, energy storage and nutrient deposition 5 .…”

Section: Introductionmentioning

confidence: 99%

Superior Aerobic Capacity and Indices of Skeletal Muscle Morphology in Chronically Trained Master Endurance Athletes Compared With Untrained Older Adults

McKendry¹,

Joanisse

Baig

et al. 2019

The Journals of Gerontology: Series A

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The study aim was to comprehensively assess physiological function and muscle morphology in chronically trained older individuals against untrained young and older individuals. In a cross-sectional design, 15 young untrained controls (YC) (20 ± 2.7 years, 78.9 ± 13.3 kg), 12 untrained older controls (OC) (69.8 ± 4.1 years, 77.5 ± 14.2 kg), and 14 endurance-trained master athletes (MA) (67.1 ± 4.1 years, 68.7 ± 6.5 kg) underwent assessments of body composition, aerobic capacity, strength, muscle architecture, and fiber-type morphology. Skeletal muscle index was lower and body fat greater in OC versus MA. Estimated VO2max (mL·kg−1·minute−1) was similar between MA and YC, but lower in OC. Isometric leg strength normalized to fat-free mass was similar between groups, whereas normalized isometric arm strength was greater in YC than MA. Myosin heavy chain (MHC) I fiber area was greater in MA than OC, while MHC II fiber area was greater in YC than OC. MHC II fiber myonuclear domain size was greater in YC than OC and MA, whereas MA had greater MHC I and MHC II fiber capillarization than OC and YC. Satellite cell content was similar between groups. Chronic endurance training enhances indices of muscle morphology and improves body composition and aerobic capacity in older age, with potentially important implications for healthspan extension.

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“…This would not only help diagnose sarcopenia, but also improve the prediction of fracture risk. Generally defined as decreased skeletal muscle mass and function, sarcopenia has been shown to be an independent predictor of hip fractures and has also been associated with decreased quality of life and increased mortality [88][89][90][91][92]. The term "osteosarcopenia" has been applied to patients who have both conditions, generally indicating a poorer prognosis than either sarcopenia or osteoporosis alone [93].…”

Section: Collateral Benefits Of Using Ct For Osteoporosis Screeningmentioning

confidence: 99%

Opportunistic Screening for Osteoporosis Using Computed Tomography: State of the Art and Argument for Paradigm Shift

et al. 2018

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Purpose of Review-Osteoporosis is disproportionately common in rheumatology patients. For the past three decades, the diagnosis of osteoporosis has benefited from well-established practice guidelines that emphasized the use of dual x-ray absorptiometry (DXA). Despite these guidelines and the wide availability of DXA, approximately two thirds of eligible patients do not undergo testing. One strategy to improve osteoporosis testing is to employ computed tomography (CT) examinations obtained as part ofroutine patient care to "opportunistically" screen for osteoporosis, without additional cost or radiation exposure to patients. This review examines the role of opportunistic CT in the evaluation of osteoporosis. Recent Findings-Recent evidence suggests that opportunistic measurement of bone attenuation (radiodensity) using CT has sensitivity comparable to DXA. More importantly, such an approach has been shown to predict osteoporotic fractures. Summary-The paradigm shift of using CTs obtained for other reasons to opportunistically screen for osteoporosis promises to substantially improve patient care.

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Opportunistic Measurement of Skeletal Muscle Size and Muscle Attenuation on Computed Tomography Predicts 1-Year Mortality in Medicare Patients

Abstract: In older adults, higher skeletal muscle index and muscle attenuation on abdominopelvic CT examinations were associated with better survival, after adjusting for multiple risk factors.

Cited by 55 publications

References 33 publications

Approaches to Assessment of Muscle Mass and Myosteatosis on Computed Tomography: A Systematic Review

Approaches to Assessment of Muscle Mass and Myosteatosis on Computed Tomography: A Systematic Review

Superior Aerobic Capacity and Indices of Skeletal Muscle Morphology in Chronically Trained Master Endurance Athletes Compared With Untrained Older Adults

Opportunistic Screening for Osteoporosis Using Computed Tomography: State of the Art and Argument for Paradigm Shift

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