Reliable and robust method for abdominal muscle mass quantification using CT/MRI: An explorative study in healthy subjects

Abstract

BackgroundQuantification of abdominal muscle mass by cross-sectional imaging has been increasingly used to diagnose sarcopenia; however, the technical method for quantification has not been standardized yet. We aimed to determine an optimal method to measure the abdominal muscle area.MethodsAmong 50 consecutive subjects who underwent abdominal CT and MRI for possible liver donation, total abdominal muscle area (TAMA) and total psoas muscle area (TPA) at the L3 inferior endplate level were measured by two blinded readers. Inter-scan agreement between CT and MRI and inter-reader agreement between the two readers were evaluated using intraclass correlation coefficient (ICC) and within-subject coefficient of variation (WSCV). To evaluate the effect of measurement level, one reader measured TAMA and TPA at six levels from the L2 to L4 vertebral bodies.ResultsTAMA was a more reliable biomarker than TPA in terms of inter-scan agreement (ICC: 0.928 vs. 0.788 for reader 1 and 0.853 vs. 0.821 for reader 2, respectively; WSCV: 8.3% vs. 23.4% for reader 1 and 10.4% vs. 22.3% for reader 2, respectively) and inter-reader agreement (ICC: 0.986 vs. 0.886 for CT and 0.865 vs. 0.669 for MRI, respectively; WSCV: 8.2% vs. 16.0% for CT and 11.6% vs. 29.7% for MRI, respectively). In terms of the measurement level, TAMA did not differ from the L2inf to L4inf levels, whereas TPA increased with a decrease in measurement level.ConclusionsTAMA is a better biomarker than TPA in terms of inter-scan and inter-reader agreement and robustness to the measurement level. CT was a more reliable imaging modality than MRI. Our results support the use of TAMA measured by CT as a standard biomarker for abdominal muscle area measurement.

A fully automatic deep learning system for L3 slice selection and body composition assessment on abdominal computed tomography.

“…These results may be attributable that the distance difference between GT and DLM was less than the height of a vertebral body, as the maximum distance difference was 40 mm. According to a recent study, the muscle area measurements were similar between the L2 inferior endplate level and L4 inferior endplate level 15 .…”

“…Still, these techniques have required manual selection of L3 slice CT images, which might be the greatest hurdle to achieve fully automatic body composition measurements. In general, it takes several minutes (around three minutes) to nd L3 slice level on abdominal CT even by experts 15 .…”

Impact of Sarcopenia on Acute Kidney Injury after Infrarenal Abdominal Aortic Aneurysm Surgery: A Propensity Matching Analysis

“…The skeletal muscle area (SMA), (i.e., psoas, paraspinal, transversus abdominis, rectus abdominis, quadratus lumborum, and internal and external obliques) was identified by applying programmed thresholds (−29 to +150 Hounsfield units) [ 20 ]. The visceral and subcutaneous fat regions were defined by employing fat material thresholds (−190 to −30 Hounsfield units) [ 21 ].…”

Radiologic Definition of Sarcopenia in Chronic Liver Disease

“…The measurements of skeletal muscle mass on CT and MRI were also found to be interchangeable. Park et al showed very good agreement between CT and MRI measurements of skeletal muscle mass at the level of the L3 vertebra (the ICC of reader 1 was 0.928 and that of reader 2 was 0.853) [ 64 ]. This result is also consistent with studies carried out at the level of the superior mesenteric artery (mostly the first lumbar vertebra) and the level of the third cervical vertebra (C3) [ 57 , 63 ].…”