Three-dimensional Distribution of Muscle and Adipose Tissue of the Thigh at CT: Association with Acute Hip Fracture

Mühlberg, Alexander; Museyko, Oleg; Bousson, V.; Pottecher, Pierre; Laredo, Jean‐Denis; Engelke, Klaus

doi:10.1148/radiol.2018181112

Cited by 34 publications

(28 citation statements)

References 33 publications

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“…Muscle area did not discriminate HF, and muscle density became insignificant after adjustment for age height and weight. 19 But again, the sample size was small (40 HFs) and the location of the analysed muscles differed from the current study. A strength of our study was the rather large number of included subjects.…”

Section: Discussioncontrasting

confidence: 63%

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Muscle density discriminates hip fracture better than computed tomography X‐ray absorptiometry hip areal bone mineral density

Zhao

et al. 2020

J cachexia sarcopenia muscle

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Background Muscle weakness is a key factor in the increase risk of falls and might also play a significant role in the increase of risk of hip fracture. Computed tomography-measured muscle size and muscle density are well-established imaging biomarkers used in studies of physical function, frailty or cancer, but limited to hip fracture. In particular, it is warranted to have a better understanding of the performance of muscle size and density in the discrimination of acute hip fractures. We also aim to determine age-related differences of muscle size and density in healthy controls and hip fracture patients. Methods Four hundred thirty-eight low-energy acute hip fracture cases and 316 healthy controls from the China Action on Spine and Hip Status study were included in the study. Muscle cross-sectional area and density were measured for the gluteus maximus and gluteus medius and minimus. Areal bone mineral density (aBMD) of the femoral neck and total hip was measured. Using propensity score matching, we generated three samples with cases and controls matched for age, body mass index, and gender: femoral neck fracture (FNF), intertrochanteric fracture (ITF), and any hip fracture vs. controls, respectively. Results Handgrip strength, gluteus muscle area and density, and bone parameters of the matched hip fracture groups were lower than those of the correspondence control groups, respectively (P < 0.05). The univariate analysis showed that associations of aBMD with FNF and with ITF were significantly weaker than associations between fracture and muscle parameters. Gluteus medius and minimus muscle density showed the highest areas under the curve (AUC) with FNF (0.88, 95% confidence interval, 0.85-0.92) and trochanteric fracture (0.95, 95% confidence interval, 0.92-0.97). The model including all muscle and bone parameters provided the highest AUC (FNF: AUC 0.912; ITF: AUC 0.958), and AUC results of another selected model without muscle density showed that association with fracture significantly dropped (FNF: AUC 0.755; ITF: AUC 0.858). Separate results for the two age groups younger and older than 70 years showed no age-related significant differences in discriminate models. Conclusions Muscle density performs better than aBMD from hip computed tomography X-ray absorptiometry and muscle size in discrimination of hip fracture. Combination of aBMD and muscle density provided the best discrimination. The integration of muscle assessments may trigger a paradigm shift in hip fracture prediction. Gluteus muscle density should also be evaluated as treatment outcome.

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Section: Discussioncontrasting

confidence: 63%

“…[14][15][16] However, only a few studies targeted the relationship of hip muscle characteristics with HF. [17][18][19] In particular, it is warranted to have a better understanding of the performance of muscle size and density in the discrimination of acute HFs.…”

Section: Introductionmentioning

confidence: 99%

Muscle density discriminates hip fracture better than computed tomography X‐ray absorptiometry hip areal bone mineral density

Zhao

et al. 2020

J cachexia sarcopenia muscle

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“…In a more recent retrospective analysis of the European Femur Fracture Study (EFFECT), a cross-sectional study of 40 female patients with acute hip fractures and 55 controls, we performed a sophisticated texture analysis of the distribution of EMCL and muscle tissue [202] using a CT density-based histogram analysis was performed [203]. After adjustment for BMD and cortical thickness, the hip fracture group was characterized by the lower relative adipose tissue volume of the upper thigh and some of the texture parameters discriminated the osteoporotic hip fracture [204]. The results could be interpreted as representing bone strength, protection against hip fracture by a larger cushion, and muscle degeneration.…”

Section: Voismentioning

confidence: 99%

Interactions between Muscle and Bone—Where Physics Meets Biology

et al. 2020

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Muscle and bone interact via physical forces and secreted osteokines and myokines. Physical forces are generated through gravity, locomotion, exercise, and external devices. Cells sense mechanical strain via adhesion molecules and translate it into biochemical responses, modulating the basic mechanisms of cellular biology such as lineage commitment, tissue formation, and maturation. This may result in the initiation of bone formation, muscle hypertrophy, and the enhanced production of extracellular matrix constituents, adhesion molecules, and cytoskeletal elements. Bone and muscle mass, resistance to strain, and the stiffness of matrix, cells, and tissues are enhanced, influencing fracture resistance and muscle power. This propagates a dynamic and continuous reciprocity of physicochemical interaction. Secreted growth and differentiation factors are important effectors of mutual interaction. The acute effects of exercise induce the secretion of exosomes with cargo molecules that are capable of mediating the endocrine effects between muscle, bone, and the organism. Long-term changes induce adaptations of the respective tissue secretome that maintain adequate homeostatic conditions. Lessons from unloading, microgravity, and disuse teach us that gratuitous tissue is removed or reorganized while immobility and inflammation trigger muscle and bone marrow fatty infiltration and propagate degenerative diseases such as sarcopenia and osteoporosis. Ongoing research will certainly find new therapeutic targets for prevention and treatment.

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“…Finally, of course, more data and clinical prediction tasks, e.g. for COPD 21 , liver 40 , or muscle diseases 41 , are needed for further validation of the method. As a further proof of concept, the predictive performance of established imaging biomarkers should be reproduced in studies with larger technical variation.…”

Section: 6%)mentioning

confidence: 99%

The Technome - A Predictive Internal Calibration Approach for Quantitative Imaging Biomarker Research

Mühlberg

Katzmann

Kärgel

et al. 2020

Sci Rep

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the goal of radiomics is to convert medical images into a minable data space by extraction of quantitative imaging features for clinically relevant analyses, e.g. survival time prediction of a patient. one problem of radiomics from computed tomography is the impact of technical variation such as reconstruction kernel variation within a study. Additionally, what is often neglected is the impact of inter-patient technical variation, resulting from patient characteristics, even when scan and reconstruction parameters are constant. In our approach, measurements within 3D regions-of-interests (Roi) are calibrated by further Rois such as air, adipose tissue, liver, etc. that are used as control regions (cR). our goal is to derive general rules for an automated internal calibration that enhance prediction, based on the analysed features and a set of CRs. We define qualification criteria motivated by statusquo radiomics stability analysis techniques to only collect information from the cRs which is relevant given a respective task. these criteria are used in an optimisation to automatically derive a suitable internal calibration for prediction tasks based on the cRs. our calibration enhanced the performance for centrilobular emphysema prediction in a copD study and prediction of patients' one-year-survival in an oncological study.

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Three-dimensional Distribution of Muscle and Adipose Tissue of the Thigh at CT: Association with Acute Hip Fracture

Cited by 34 publications

References 33 publications

Muscle density discriminates hip fracture better than computed tomography X‐ray absorptiometry hip areal bone mineral density

Muscle density discriminates hip fracture better than computed tomography X‐ray absorptiometry hip areal bone mineral density

Interactions between Muscle and Bone—Where Physics Meets Biology

The Technome - A Predictive Internal Calibration Approach for Quantitative Imaging Biomarker Research

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