| 1. Kirk B, Cawthon PM, Arai H, et al. The Conceptual Definition of Sarcopenia: Delphi Consensus from the Global Leadership Initiative in Sarcopenia (GLIS). Age Ageing. 2024 Mar 01;53(3):afae052. |
Review/Other-Dx |
107 participants |
The Global Leadership Initiative in Sarcopenia (GLIS) aimed to address this by establishing the global conceptual definition of sarcopenia. |
107 participants (mean age: 54 ± 12 years [1 missing age], 64% men) from 29 countries across 7 continents/regions completed the Delphi survey. Twenty statements were found to have a strong agreement. These included; 6 statements on 'general aspects of sarcopenia' (strongest agreement: the prevalence of sarcopenia increases with age (98.3%)), 3 statements on 'components of sarcopenia' (muscle mass (89.4%), muscle strength (93.1%) and muscle-specific strength (80.8%) should all be a part of the conceptual definition of sarcopenia)) and 11 statements on 'outcomes of sarcopenia' (strongest agreement: sarcopenia increases the risk of impaired physical performance (97.9%)). A key finding of the Delphi survey was that muscle mass, muscle strength and muscle-specific strength were all accepted as 'components of sarcopenia', whereas impaired physical performance was accepted as an 'outcome' rather than a 'component' of sarcopenia. |
4 |
| 16. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 01;48(1):16-31. |
Review/Other-Dx |
N/A |
To increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. |
Sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. |
4 |
| 17. Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020 Mar;21(3):S1525-8610(19)30872-2. |
Review/Other-Dx |
N/A |
The Asian Working Group for Sarcopenia (AWGS) 2014 consensus defined sarcopenia as "age-related loss of muscle mass, plus low muscle strength, and/or low physical performance" and specified cutoffs for each diagnostic component; research in Asia consequently flourished, prompting this update. |
AWGS 2019 retains the previous definition of sarcopenia but revises the diagnostic algorithm, protocols, and some criteria: low muscle strength is defined as handgrip strength <28 kg for men and <18 kg for women; criteria for low physical performance are 6-m walk <1.0 m/s, Short Physical Performance Battery score =9, or 5-time chair stand test =12 seconds. AWGS 2019 retains the original cutoffs for height-adjusted muscle mass: dual-energy X-ray absorptiometry, <7.0 kg/m2 in men and <5.4 kg/m2 in women; and bioimpedance, <7.0 kg/m2 in men and <5.7 kg/m2 in women. In addition, the AWGS 2019 update proposes separate algorithms for community vs hospital settings, which both begin by screening either calf circumference (<34 cm in men, <33 cm in women), SARC-F (=4), or SARC-CalF (=11), to facilitate earlier identification of people at risk for sarcopenia. |
4 |
| 36. Sousa-Santos AR, Barros D, Montanha TL, Carvalho J, Amaral TF. Which is the best alternative to estimate muscle mass for sarcopenia diagnosis when DXA is unavailable?. Arch Gerontol Geriatr. 2021;97():S0167-4943(21)00180-1. |
Observational-Dx |
159 patients |
To elucidate if it is anthropometry or bioelectrical impedance analysis (BIA) the method more concordant with DXA in estimating muscle mass for sarcopenia diagnosis among older adults, and to investigate the impact of several cut-off points in sarcopenia frequency. |
Sarcopenia frequency varied from 5.0 to 42.1% depending on the method and cut-off point applied. All surrogate diagnostic criteria had a higher agreement with the DXA defined criterion ASM over ASM/height². A substantial agreement was also found with BIA SMM/height² (?= 0.67), and with BIA SMI (?= 0.65), and a moderate agreement with MAMC (?= 0.42), p<0.001. Using the DXA ASM and ASM/height² criteria as reference, CC showed a specificity of 100% and 94%, respectively. |
3 |
| 37. Westbury LD, Beaudart C, Bruyère O, et al. Recent sarcopenia definitions-prevalence, agreement and mortality associations among men: Findings from population-based cohorts. J Cachexia Sarcopenia Muscle. 2023 Feb;14(1):565-575. |
Review/Other-Dx |
9170 |
To define sarcopenia in terms of thresholds employed, concordance in individuals and prediction of important health-related outcomes such as death |
Mean (SD) age of participants (n = 9170) was 74.3 (4.9) years; 5929 participants died during a mean (SD) follow-up of 12.1 (5.5) years. The proportion with sarcopenia according to each definition was EWGSOP2 (1.1%), SDOC (1.7%) and Modified SDOC (5.3%). Agreement was weak between EWGSOP2 and SDOC (? = 0.17). Pooled hazard ratios (95% CI) for mortality for presence versus absence of each definition were EWGSOP2 [1.76 (1.42, 2.18), I2 : 0.0%]; SDOC [2.75 (2.28, 3.31), I2 : 0.0%]; and Modified SDOC [1.93 (1.54, 2.41), I2 : 58.3%]. |
4 |
| 38. Stuck AK, Tsai LT, Freystaetter G, et al. Comparing Prevalence of Sarcopenia Using Twelve Sarcopenia Definitions in a Large Multinational European Population of Community-Dwelling Older Adults. J Nutr Health Aging. 2023;27(3):205-212. |
Review/Other-Dx |
1495 |
The aim of the study was to assess prevalence of sarcopenia in the DO-HEALTH European trial based on twelve current sarcopenia definitions. |
Mean age was 74.9 years (SD 4.4); 63.3% were women. Sarcopenia prevalence ranged between 0.7% using the EWGSOP2 or AWGS2 definition, up to 16.8% using the Delmonico definition. Overall, most sarcopenia definitions, including Delmonico (16.8%), Baumgartner (12.8%), FNIH1(10.5%), IWGS (3.6%), EWGSOP1 (3.4%), SDOC (2.0%), Morley (1.3%), and AWGS1 (1.1%) tended to be higher than the prevalence based on EWGSOP2 (0.7%). In contrast, the definitions AWGS2 (0.7%), EWGSOP2-LE (1.1%), FNIH2 (1.0%) - all based on muscle mass and muscle strength - showed similar lower prevalence as EWGSOP2 (0.7%). Moreover, most sarcopenia definitions did not overlap on identifying sarcopenia on an individual participant-level. |
4 |
| 39. Bhasin S, Travison TG, Manini TM, et al. Sarcopenia Definition: The Position Statements of the Sarcopenia Definition and Outcomes Consortium. J Am Geriatr Soc. 2020 Jul;68(7):1410-1418. |
Review/Other-Dx |
NA |
To develop an evidence-based definition of sarcopenia that can facilitate identification of older adults at risk for clinically relevant outcomes (eg, self-reported mobility limitation, falls, fractures, and mortality), the Sarcopenia Definition and Outcomes Consortium (SDOC) crafted a set of position statements informed by a literature review and SDOC's analyses of eight epidemiologic studies, six randomized clinical trials, four cohort studies of special populations, and two nationally representative population-based studies. |
The SDOC analyses identified grip strength, either absolute or scaled to measures of body size, as an important discriminator of slowness. Both low grip strength and low usual gait speed independently predicted falls, self-reported mobility limitation, hip fractures, and mortality in community-dwelling older adults. Lean mass measured by DXA was not associated with incident adverse health-related outcomes in community-dwelling older adults with or without adjustment for body size. |
4 |
| 40. Cawthon PM, Manini T, Patel SM, et al. Putative Cut-Points in Sarcopenia Components and Incident Adverse Health Outcomes: An SDOC Analysis. J Am Geriatr Soc. 2020 Jul;68(7):1429-1437. |
Meta-analysis |
8 studies |
We describe the associations between the SDOC-identified metrics of low grip strength (absolute or standardized to body size/composition); low dual-energy x-ray absorptiometry (DXA) lean mass as previously defined in the literature (appendicular lean mass [ALM]/ht2 ); and slowness (walking speed <.8 m/s) with subsequent adverse outcomes (falls, hip fractures, mobility limitation, and mortality). |
Low grip strength (absolute or standardized to body size/composition) was associated with incident outcomes, usually independently of slowness, in both men and women. ORs and HRs generally ranged from 1.2 to 3.0 for those below vs above the cut-point. DXA lean mass was not consistently associated with these outcomes. When considered together, those who had both muscle weakness by absolute grip strength (<35.5 kg in men and <20 kg in women) and slowness were consistently more likely to have a fall, hip fracture, mobility limitation, or die than those without either slowness or muscle weakness. |
Inadequate |
| 41. Kremer WM, Labenz C, Kuchen R, et al. Sonographic assessment of low muscle quantity identifies mortality risk during COVID-19: a prospective single-centre study. J Cachexia Sarcopenia Muscle. 2022 Feb;13(1):169-179. |
Experimental-Dx |
136 patients |
To explore sonographic muscle indices as predictors of COVID-19 outcome and to test the feasibility of sonographic muscle measurement in an isolation context. |
Compared with other muscle indices, the psoas muscle area index (PMAI) showed the most favourable characteristics to predict outcome of COVID-19 disease. Sonographic morphometry of patients without COVID-19 (n = 136) revealed a gender-specific median for PMAI (male: 291.1 mm2 /m2 , female 260.6 mm2 /m2 ) as threshold value of low muscle quantity. Subsequently, COVID-19 patients (Cohort I: n = 58; Cohort II: n = 55) were prospectively assessed by bedside sonography. The studied COVID-19 patients developed a critical course of disease in 22.4% (Cohort I: n = 13/58) and 34.5% (Cohort II: n = 20/55). Mortality rate reached 12.1% (Cohort I: n = 7/58) and 20.0% (Cohort I: n = 11/55) within 30 days of follow up. COVID-19 patients with a PMAI below the gender-specific median showed a higher 30 day mortality in both COVID-19 cohorts (log rank, P < 0.05). The optimal PMAI cutoff value (206 mm2 /m2 ) predicted 30 day mortality of hospitalized COVID-19 patients with a sensitivity of 72% and specificity of 78.5% (receiver operating characteristic-area under the curve: 0.793, 95% confidence interval 0.671-0.914, P = 0.008). Multivariable log-regression analysis of PMAI, age, gender, BMI and comorbidities confirmed an independent association of low PMAI with 30 day mortality of COVID-19 patients (P = 0.018). |
3 |
| 42. Kremer WM, Schwarz A, Schepers M, et al. Evaluation of Sonographic Muscle Measurement Using Established Muscle Markers. J Ultrasound Med. 2024 Dec;43(12):2385-2397. |
Observational-Dx |
723 |
To prospectively evaluate sonographic measurement and to compare it with established measurements of muscle quantity and function. |
In 156 patients, sonographic indices were compared with corresponding CT indices. Of the 723 patients included, sonographic indices were compared with hand strength in 429 patients. Interobserver and intraobserver variability showed better results for the femur indices than for the psoas indices (correlation coefficient: 0.8697/0.9118 vs 0.7502/0.7319). Psoas muscle indices correlated best with the reference standard of the SMI. The optimal cut-off for each muscle index for determining muscle loss according to the SMI and hand grip strength was calculated. |
2 |
| 43. Nagae M, Umegaki H, Yoshiko A, et al. Muscle changes on muscle ultrasound and adverse outcomes in acute hospitalized older adults. Nutrition. 2022 Oct;102():S0899-9007(22)00111-3. |
Observational-Dx |
145 patients |
To determine whether muscle changes on muscle ultrasound can predict poor outcomes in acute hospitalized older adults. |
Changes in BATT, EI, and corrected EI at 7 d after admission were found in 0.2%, 0.0%, and 0.2% of cases, respectively. The respective rates for mortality, hospital-associated complications, and ADL decline were 8.7%, 52.8%, and 43%, respectively. Multivariable logistic regression analysis showed that the BATT value at admission tended to be associated with mortality. Changes in BATT, EI, and collected EI were not associated with adverse outcomes. |
4 |
| 44. Shafaat O, Liu Y, Jackson KR, et al. Association between Abdominal CT Measurements of Body Composition before Deceased Donor Liver Transplant with Posttransplant Outcomes. Radiology. 2023 Mar;306(3):e212403. |
Observational-Dx |
454 adult first-time deceased-donor LT recipients |
To quantify the association between abdominal CT-based body composition measurements and post-pre-liver transplant (LT) mortality in a large North American cohort. |
A total of 454 recipients (median age, 57 years [IQR, 50-62 years]; 294 men) were evaluated. In the adjusted model, pre-LT sarcopenia was associated with a higher hazard ratio (HR) of post-LT mortality (HR, 1.6 [95% CI: 1.1, 2.4]; C-statistic, 0.64; P = .02). SMI was significantly negatively associated with survival after adjustment for covariates. There was no evidence that myosteatosis was associated with mortality (HR, 1.3 [95% CI: 0.86, 2.1]; C-statistic, 0.64; P = .21). There was no evidence that BMI (HR, 1.2 [95% CI: 0.95, 1.4]), VAT (HR, 1.0 [95% CI: 0.98, 1.1]), SAT (HR, 1.0 [95% CI: 0.97, 1.0]), and VAT/SAT ratio (HR, 1.1 [95% CI: 0.90, 1.4]) were associated with mortality (P = .15-.77). |
3 |
| 45. Fumagalli IA, Le ST, Peng PD, et al. Automated CT Analysis of Body Composition as a Frailty Biomarker in Abdominal Surgery. JAMA Surg. 2024 Jul 01;159(7):766-774. |
Review/Other-Dx |
48,444 adults |
To evaluate the associations of body composition scores derived from multiple skeletal muscle and adipose tissue measurements from automated segmentation of computed tomography (CT) with the Hospital Frailty Risk Score (HFRS) and adverse outcomes after abdominal surgery. |
The study included 48 444 adults; mean [SD] age at surgery was 61 (17) years, and 51% were female. Using principal component analysis, 3 body composition scores were derived: body size, muscle quantity and quality, and distribution of adiposity. Higher muscle quantity and quality scores were inversely correlated (r = -0.42; 95% CI, -0.43 to -0.41) with the HFRS and associated with a reduced risk of 30-day readmission or mortality (quartile 4 vs quartile 1: relative risk, 0.61; 95% CI, 0.56-0.67) and 30-day postoperative morbidity (quartile 4 vs quartile 1: relative risk, 0.59; 95% CI, 0.52-0.67), independent of sex, age, comorbidities, body mass index, procedure characteristics, and the HFRS. In contrast to the muscle score, scores for body size and greater subcutaneous and intermuscular vs visceral adiposity had inconsistent associations with postsurgical outcomes and were attenuated and only associated with 30-day postoperative morbidity after adjustment for the HFRS. |
4 |
| 46. Bedrikovetski S, Seow W, Kroon HM, Traeger L, Moore JW, Sammour T. Artificial intelligence for body composition and sarcopenia evaluation on computed tomography: A systematic review and meta-analysis. Eur J Radiol. 2022 Apr;149():S0720-048X(22)00068-7. |
Meta-analysis |
15 studies |
Tracing muscle groups manually on CT to calculate body composition parameters and diagnose sarcopenia is costly and time consuming. Artificial Intelligence (AI) provides an opportunity to automate this process. In this systematic review, we aimed to assess the performance of CT-based AI segmentation models used for body composition analysis. |
284 studies were identified, of which 24 could be included in the systematic review. Among them, 15 were included in the meta-analysis, all of which used deep learning. Deep learning models for skeletal muscle (SM) segmentation performed with a pooled DSC of 0.941 (95 %CI 0.923-0.959) and a pooled JSC of 0.967 (95 %CI 0.949-0.986). Additionally, a pooled DSC of 0.967 (95 %CI 0.958-0.978), 0.963 (95 %CI 0.957-0.969) and 0.970 (95 %CI 0.944-0.996) was observed for segmentation of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and bone, respectively. SM studies suffered from significant publication bias, and heterogeneity among the included studies was considerable. |
Good |
| 47. Lortie J, Gage G, Rush B, Heymsfield SB, Szczykutowicz TP, Kuchnia AJ. The effect of computed tomography parameters on sarcopenia and myosteatosis assessment: a scoping review. J Cachexia Sarcopenia Muscle. 2022 Dec;13(6):2807-2819. |
Review/Other-Dx |
7 articles |
Computed tomography (CT) is a valuable assessment method for muscle pathologies such as sarcopenia, cachexia, and myosteatosis. However, several key underappreciated scan imaging parameters need consideration for both research and clinical use, specifically CT kilovoltage and the use of contrast material. We conducted a scoping review to assess these effects on CT muscle measures. |
Ten studies evaluated the effect of contrast on muscle density of which nine found that contrast significantly increases CT muscle density (arterial phase 6–23% increase, venous phase 19–57% increase, and delayed phase 23–43% increase). Seven out of 10 studies evaluating the effect of contrast on muscle area found significant increases in area due to contrast (=2.58%). Six studies evaluating kilovoltage on muscle density found that lower kilovoltage resulted in a higher muscle density (14–40% increase). One study reported a significant decrease in muscle area when reducing kilovoltage (2.9%). The use of contrast and kilovoltage variations can have dramatic effects on skeletal muscle analysis and should be considered and reported in CT muscle analysis research. These significant factors in CT skeletal muscle analysis can alter clinical and research outcomes and are therefore a barrier to clinical application unless better appreciated. |
4 |
| 48. Boutin RD, Kaptuch JM, Bateni CP, Chalfant JS, Yao L. Influence of IV Contrast Administration on CT Measures of Muscle and Bone Attenuation: Implications for Sarcopenia and Osteoporosis Evaluation. AJR Am J Roentgenol. 2016 Nov;207(5):1046-1054. |
Observational-Dx |
201 patients (97 men, 104 women; mean age, 57.7 ± 12.5 [SD] years) |
The objective of our study was to characterize enhancement of muscle and bone that occurs on standardized four-phase contrast-enhanced CT. |
The study included 201 patients (97 men, 104 women; mean age, 57.7 ± 12.5 [SD] years). Subject age was inversely correlated with unenhanced attenuation in the psoas muscles, posterior paraspinal muscles, and L4 (p < 0.001). The psoas muscles, posterior paraspinal muscles, and L4 enhanced significantly (p < 0.001) at all three contrast-enhanced phases. The greatest muscle enhancement was observed on delayed phase scans, whereas the greatest enhancement in L4 was seen on portal phase imaging. The unenhanced attenuation of the psoas muscles was significantly and negatively correlated with enhancement of the psoas muscles at the portal and delayed phases (p < 0.05 and p < 0.01, respectively), but these correlations were not seen for the posterior paraspinal muscles. Age was positively correlated with posterior paraspinal muscle enhancement at the portal and delayed phases in men (p < 0.05 and p < 0.01, respectively) but not in women. |
3 |
| 49. Brath MSG, Kristensen SV, Sahakyan M, et al. Influence of weight-adjusted contrast enhancement on computed tomography-derived skeletal muscle measures: a retrospective proof-of-concept comparative study between Danish females and males. Am J Clin Nutr. 2024 Sep;120(3):S0002-9165(24)00578-1. |
Observational-Dx |
72 patients (51 males and 21 females) with a mean age of 59 (55 and 62) y |
This study investigates whether weight-adjusted IVC influences SMA, SMI, and SMD differently in females and males compared with noncontrast abdominal CT. In addition, the study explores associations between contrast and noncontrast-assessed SMA, SMI, SMD, and demographic factors. |
The study included 72 patients (51 males and 21 females) with a mean age of 59 (55 and 62) y. Weight-adjusted IVC increased SMA by =3.28 cm2 (95% confidence interval [CI]: 2.58, 3.98) corresponding to 2.4% (1.8, 2.9) in the late venous phase compared with noncontrast CT. Analysis between sexes showed no difference in the effects of IVC on SMA and SMI between females and males. However, females exhibited a higher increase in SMD during the venous by a mean of 1.7 HU (0.9; 2.5) and late venous phases with a mean HU of 1.80 (1.0; 2.6) compared with males. Multivariate regression analysis indicated an association between the differences in SMD and sex during venous (–1.38, 95% CI: –2.48, –0.48) and late venous phases (–1.23, 95% CI: –2.27, –0.19). |
3 |
| 50. Moeller AR, Garrett JW, Summers RM, Pickhardt PJ. Adjusting for the effect of IV contrast on automated CT body composition measures during the portal venous phase. Abdom Radiol (NY). 2024 Jul;49(7):2543-2551. |
Review/Other-Dx |
1,612 older adults |
To determine and adjust the effect of intravenous (IV) contrast on these automated body composition measures at routine portal venous phase post-contrast imaging. |
We found that simple, linear relationships can be derived to determine non-contrast equivalent values from the post-contrast CT biomeasures. Excellent positive linear correlation (r2 = 0.91-0.99) between pre- and post-contrast values was observed for all automated soft tissue measures, whereas moderate positive linear correlation was observed for bone attenuation (r2 = 0.58-0.76). In general, the area- and volume-based measurement require less adjustment than attenuation-based measures, as expected. |
4 |
| 51. Lortie J, Ufearo D, Hetzel S, Pickhardt PJ, Szczykutowicz TP, Kuchnia AJ. Validating a Practical Correction for Intravenous Contrast on Computed Tomography-Based Muscle Density. J Comput Assist Tomogr. ;49(3):480-485. |
Review/Other-Dx |
109 patients |
To obtain external validation using different patient cohorts, muscle regions, and CT series. |
In the sample of 109 patients (mean age: 63 years [SD: 14.3]; 41.3% female), densities in smaller regions of interest within the paraspinal muscles and the entire paraspinal muscle density (PS) in venous and delayed phase contrast scans were higher than in noncontrast. Equivalence testing showed that average corrected contrast and noncontrast muscle densities were within 3 HU for both muscle measures for the total patient sample, and for a majority of male and female subsamples. The correction is suitable for regions of interests of venous contrast (90% CI: -1.90, -0.69 HU) and delayed contrast scans (90% CI: 0.075, 1.29 HU) and within the PS measures of venous contrast (90% CI: -2.04, -0.94 HU) and delayed contrast scans (90% CI: -0.11, 0.89 HU). |
4 |
| 52. Lenchik L, Lenoir KM, Tan J, et al. Opportunistic Measurement of Skeletal Muscle Size and Muscle Attenuation on Computed Tomography Predicts 1-Year Mortality in Medicare Patients. J Gerontol A Biol Sci Med Sci. 2019 Jun 18;74(7):1063-1069. |
Review/Other-Dx |
436 participants |
To determine relationships between CT-measured skeletal muscle size and attenuation with 1-year risk of mortality in older adults enrolled in a Medicare Shared Savings Program (MSSP). |
Within 1 year of follow-up, 20.6% (90/436) participants died. In the fully-adjusted model, higher muscle index and muscle attenuation were associated with lower risk of mortality. A one-unit standard deviation (SD) increase was associated with a HR = 0.69 (95% CI = 0.49, 0.96; p = .03) for total muscle index, HR = 0.67 (95% CI = 0.49, 0.90; p < .01) for psoas muscle index, HR = 0.54 (95% CI = 0.40, 0.74; p < .01) for total muscle attenuation, and HR = 0.79 (95% CI = 0.66, 0.95; p = .01) for psoas muscle attenuation. |
4 |
| 53. Lee MH, Zea R, Garrett JW, Graffy PM, Summers RM, Pickhardt PJ. Abdominal CT Body Composition Thresholds Using Automated AI Tools for Predicting 10-year Adverse Outcomes. Radiology. 2023 Feb;306(2):e220574. |
Observational-Dx |
9223 |
To determine population and sex-specific thresholds for muscle, abdominal fat, and abdominal aortic calcium measures at abdominal CT for predicting risk of death, adverse cardiovascular events, and fragility fractures. |
Longitudinal follow-up documented subsequent death, adverse cardiovascular events (myocardial infarction, cerebrovascular event, and heart failure), and fragility fractures. Receiver operating characteristic (ROC) curve analysis was performed to derive thresholds for body composition measures to achieve optimal ROC curve performance and high specificity (90%) for 10-year risks. Results A total of 9223 asymptomatic adults (mean age, 57 years ± 7 [SD]; 5152 women and 4071 men) were evaluated (median follow-up, 9 years). Muscle attenuation and aortic calcium had the highest diagnostic performance for predicting death, with areas under the ROC curve of 0.76 for men (95% CI: 0.72, 0.79) and 0.72 for women (95% CI: 0.69, 0.76) for muscle attenuation. Sex-specific thresholds were higher in men than women (P < .001 for muscle attenuation for all outcomes). The highest-performing markers for risk of death were muscle attenuation in men (31 HU; 71% sensitivity [164 of 232 patients]; 72% specificity [1114 of 1543 patients]) and aortic calcium in women (Agatston score, 167; 70% sensitivity [152 of 218 patients]; 70% specificity [1427 of 2034 patients]). Ninety-percent specificity thresholds for muscle attenuation for both risk of death and fragility fractures were 23 HU (men) and 13 HU (women). For aortic calcium and risk of death and adverse cardiovascular events, 90% specificity Agatston score thresholds were 1475 (men) and 735 (women). |
3 |
| 54. Nachit M, Horsmans Y, Summers RM, Leclercq IA, Pickhardt PJ. AI-based CT Body Composition Identifies Myosteatosis as Key Mortality Predictor in Asymptomatic Adults. Radiology. 2023 Jun;307(5):e222008. |
Observational-Dx |
8982 |
To use artificial intelligence-based body composition metrics from routine abdominal CT scans in asymptomatic adults to clarify the association between obesity, liver steatosis, myopenia, and myosteatosis and the risk of mortality. |
Overall, 8982 consecutive outpatients (mean age, 57 years ± 8 [SD]; 5008 female, 3974 male) were included. Abnormal body composition was found in 86% (434 of 507) of patients who died during follow-up. Myosteatosis was found in 278 of 507 patients (55%) who died (15.5% absolute risk at 10 years). Myosteatosis, obesity, liver steatosis, and myopenia were associated with increased mortality risk (hazard ratio [HR]: 4.33 [95% CI: 3.63, 5.16], 1.27 [95% CI: 1.06, 1.53], 1.86 [95% CI: 1.56, 2.21], and 1.75 [95% CI: 1.43, 2.14], respectively). In 8303 patients (excluding 679 patients without complete data), after multivariable adjustment, myosteatosis remained associated with increased mortality risk (HR, 1.89 [95% CI: 1.52, 2.35]; P < .001). |
3 |
| 55. Wen Z, Wang T, Luo S, Liu Y. CT scan-derived pectoralis muscle parameters are closely associated with COVID-19 outcomes: A systematic review and meta-analysis. PLoS One. 2025;20(1):e0316893. |
Meta-analysis |
9 studies with 4109 COVID-19 patients |
To assess the correlation between pectoral muscle parameters derived from chest CT and the prognosis of patients with COVID-19. |
A total of 9 studies with 4109 COVID-19 patients were included. The meta-analysis findings revealed a correlation between pectoralis muscle parameters and COVID-19 prognosis. Specifically, patients with higher pectoralis muscle density (PMD) exhibited a lower mortality risk, with an odds ratio (OR) of 0.95 (95% CI: 0.92-0.99). The rate of intubation was lower in COVID-19 patients with a high pectoralis muscle index (PMI) (OR = 0.96, 95% CI: 0.92-1.00). |
Good |
| 56. Persits I, Mirzai S, Sarnaik KS, et al. Low Muscle Mass by Preprocedural Computed Tomography Is Associated With Worse Short-Term Outcomes in Transcatheter Aortic Valve Replacement Recipients. Am J Cardiol. 2024 Apr 15;217():S0002-9149(24)00150-4. |
Review/Other-Dx |
158 patients without LMM and 80 patients with LMM |
To evaluate the impact of LMM as a surrogate for sarcopenia on both short and long-term outcomes after TAVR. To assess the feasibility of incorporating direct skeletal muscle measurement, using readily available CT chest imaging, as a preoperative risk stratification tool before TAVR. |
In our cohort, 238 patients met inclusion criteria, and 80 (33.6%) were identified to have LMM. Patients with LMM were older with lower body mass index, decreased grip strength, lower hemoglobin A1c, and higher N-terminal pro-brain natriuretic peptide. They had greater rates of the composite outcome and 2-year all-cause mortality, which remained significant on multivariable adjustment (hazard ratio 1.71, 95% confidence interval 1.05 to 2.78, p = 0.030 and hazard ratio 2.31, 95% confidence interval 1.02 to 5.24, p = 0.045, respectively) compared with patients without LMM; there was no significant difference in 5-year all-cause mortality. |
4 |
| 57. Soh S, Suh YJ, Lee S, Roh YH, Kwak YL, Kim YJ. Prognostic value of CT body composition analysis for 1-year mortality after transcatheter aortic valve replacement. Eur Radiol. 2025 Jan;35(1):244-254. |
Review/Other-Dx |
408 patients |
To investigate the value of body composition indices derived from pre-procedural computed tomography (CT) in predicting 1-year mortality among patients who underwent transcatheter aortic valve replacement (TAVR). |
Finally, 408 patients were included (185 men and 223 women; mean age, 81.7 ± 5.1 years; range, 62-98 years). Post-procedural death occurred in 13.2% of patients. The muscle-height index and fat-height index at the L3 level were more strongly correlated with those at the T12 level (r = 0.765, p < 0.001 and r = 0.932, p < 0.001, respectively) than with those at the T4 level (r = 0.535, p < 0.001 and r = 0.895, p < 0.001, respectively). The cumulative 1-year mortality rate was highest for patients with both sarcopenia and adipopenia (26%), followed by those with adipopenia only (17%), those with sarcopenia only (12%), and those with neither sarcopenia nor adipopenia (8%, p = 0.002). Multivariable analysis revealed that body composition at the T12 level was an independent risk factor for 1-year mortality (hazard ratio: 4.09, 95% confidence interval: 2.01-8.35) in patients with both sarcopenia and adipopenia (p < 0.001). |
4 |
| 58. Moon SW, Kim SY, Choi JS, et al. Thoracic skeletal muscle quantification using computed tomography and prognosis of elderly ICU patients. Sci Rep. 2021 Dec 06;11(1):23461. |
Review/Other-Dx |
190 elderly (age > 70 years) patients admitted to the ICU |
To evaluate whether pectoralis muscle mass loss could be a predictor of prognosis in elderly ICU patients. |
PMCSA below median was significantly related with prolonged ventilation (odds ratio 2.92) and a higher SOFA scores during the ICU stay (estimated mean = 0.94). PMCSA below median was a significant risk for hospital mortality (hazards ratio 2.06). In elderly ICU patients, a low ICU admission PMCSA was associated with prolonged ventilation, higher SOFA score during the ICU stay, and higher mortality. |
4 |
| 59. Lortie J, Rush B, Gage G, et al. Correcting Posterior Paraspinal Muscle Computed Tomography Density for Intravenous Contrast Material Independent of Sex and Vascular Phase. J Thorac Imaging. 2023 Nov 01;38(6):367-373. |
Observational-Dx |
140 patients (calibration sample), 100 patients (validation sample) |
To characterize the effects of contrast enhancement at different phases and to determine if a clinically feasible correction factor can adjust contrast-enhanced muscle density to non-enhanced muscle density. |
We evaluated 140 patients (mean age 52.0 y [SD: 18.3]; 60% female) in the calibration sample and 100 patients (mean age 54.8 y [SD: 18.9]; 60% female) in the validation sample. Contrast-enhanced muscle density was higher than NC by 8.6 HU (SD: 6.2) for the arterial phase (female, 10.4 HU [SD: 5.7]; male, 6.0 HU [SD:6.0]) and by 6.4 HU [SD:8.1] for the venous phase (female, 8.0 HU [SD: 8.6]; male, 4.0 HU [SD: 6.6]). Corrected contrast-enhanced and NC muscle density was equivalent within 3 HU for all correctionns. The -7.5 HU correction, independent of sex and phase, performed well for arterial (95% CI: -0.18, 1.80 HU) and venous-phase data (95% CI: -0.88, 1.41 HU). |
3 |
| 60. Shen Y, Luo L, Fu H, et al. Chest computed tomography-derived muscle mass and quality indicators, in-hospital outcomes, and costs in older inpatients. J Cachexia Sarcopenia Muscle. 2022 Apr;13(2):966-975. |
Observational-Dx |
1,135 patients |
Tp hypothesize that muscle mass and muscle quality indicators derived from opportunistic chest computed tomography (CT) images at the 12th thorax vertebra level (T12) can predict in-hospital death, length of hospital stay (hospital LOS), and hospital costs among older patients in acute care wards. |
We included 1135 older patients with a median age of 80 years (interquartile range, 73 to 85 years), 498 (44%) were women, 148 (13%) patients died during hospitalization. The SMI and SMD were negatively correlated to age (? = -0.11, P < 0.001, ? = -0.30, P < 0.001, respectively), whereas the IMAT was positively correlated to age (? = 0.27, P < 0.001). Compared with survivors, dead patients had significantly lower SMI in men (P < 0.001) but not in women (P = 0.760). After adjusting for sex and other potential confounders, the SMI [increased per 1 cm2/m2, odds ratio (OR) 0.96, 95% confidence interval (CI) 0.93 to 0.99] and SMD (increased per 1 Hounsfield unit, OR 0.93, 95% CI 0.90 to 0.96) were negatively and independently associated with in-hospital death, whereas the IMAT (increased per 1 cm2, OR 1.09, 95% CI 1.05 to 1.14) was independently and positively associated with in-hospital death. None of the SMI, SMD, or IMAT was significantly related to long hospital LOS or increased hospital costs. |
3 |
| 61. Lenchik L, Barnard R, Boutin RD, et al. Automated Muscle Measurement on Chest CT Predicts All-Cause Mortality in Older Adults From the National Lung Screening Trial. J Gerontol A Biol Sci Med Sci. 2021 Jan 18;76(2):277-285. |
Observational-Dx |
6,803 male and 4,558 female |
To determine the relationship between muscle measurements on computed tomography (CT) with survival in a large multicenter trial of older adults. |
After a mean 6.44 ± 1.06 years of follow-up, 635 (9.33%) men and 265 (5.81%) women died. In men, higher SMA and SMD were associated with a lower risk of all-cause mortality, in fully adjusted models. A one-unit standard deviation increase was associated with a hazard ratio (HR) = 0.85 (95% confidence interval [CI] = 0.79, 0.91; p < .001) for SMA and HR = 0.91 (95% CI = 0.84, 0.98; p = .012) for SMD. In women, the associations did not reach significance. |
3 |
| 62. Wang M, Tang H, Chen X, et al. Opportunistic Muscle Evaluation During Chest CT Is Associated With Vertebral Compression Fractures in Old Adults: A Longitudinal Study. J Gerontol A Biol Sci Med Sci. 2024 Feb 01;79(2):glad162. |
Observational-Dx |
7,906 patients |
To evaluate the association between computed tomography (CT)-based erector spinae muscle area and attenuation and vertebral compression fracture (VCF) in elderly individuals in a longitudinal study. |
Of the 7,906 included participants, 72 developed new VCF over a median follow-up of 2 years. Large area of the erector spinae (adjusted hazard ratio [HR] = 0.2, 95% confidence interval [CI]: 0.1–0.7) and high bone attenuation (adjusted HR = 0.2, 95% CI: 0.1–0.5) were independently associated with VCF. High muscle attenuation was associated with severe VCF (adjusted HR = 0.46, 95% CI: 0.24–0.86). The addition of muscle area improved the area under the curve of bone attenuation from 0.79 (95% CI: 0.74–0.86) to 0.86 (95% CI: 0.82–0.91; p = .001). |
3 |
| 63. Ryu J, Eom S, Kim HC, et al. Chest X-ray-based opportunistic screening of sarcopenia using deep learning. J Cachexia Sarcopenia Muscle. 2023 Feb;14(1):418-428. |
Observational-Dx |
926 patients (derivation cohort), 149 patients (external test set) |
To develop a chest X-ray-based deep learning model to predict presence of sarcopenia. |
Mean age of the derivation cohort (n = 926; women n = 700, 76%; sarcopenia n = 141, 15%) and the external test (n = 149; women n = 95, 64%; sarcopenia n = 18, 12%) cohort was 61.4 and 71.6 years, respectively. In the internal test set (a hold-out set, n = 189, from the derivation cohort) and the external test set (n = 149), the concordance correlation coefficient for ALM prediction was 0.80 and 0.76, with an average difference of 0.18 ± 2.71 and 0.21 ± 2.28, respectively. Gradient-weight class activation mapping for deep neural network models to predict ALM and HGS commonly showed highly weight pixel values at bilateral lung fields and part of the cardiac contour. SARC-CXR score showed good discriminatory performance for sarcopenia in both internal test set [area under the receiver-operating characteristics curve (AUROC) 0.813, area under the precision-recall curve (AUPRC) 0.380, sensitivity 0.844, specificity 0.739, F1-score 0.540] and external test set (AUROC 0.780, AUPRC 0.440, sensitivity 0.611, specificity 0.855, F1-score 0.458). Among SARC-CXR model features, predicted low ALM from chest X-ray was the most important predictor of sarcopenia based on SHapley Additive exPlanations values. Higher estimation uncertainty of HGS contributed to elevate the predicted risk of sarcopenia. In internal test set, SARC-CXR score showed better discriminatory performance than SARC-F score (AUROC 0.813 vs. 0.691, P = 0.029). |
3 |
| 64. Grova M, Crispino F, Maida M, et al. Sarcopenia is a negative predictive factor for endoscopic remission in patients with Crohn's disease treated with biologics. Dig Liver Dis. 2023 Jul;55(7):S1590-8658(23)00482-6. |
Observational-Dx |
358 patients |
To investigate the role of sarcopenia in predicting clinical and endoscopic outcomes in patients with Crohn’s disease (CD). |
Sarcopenia was found in 18.2% of patients, and it was associated with a lower rate of ER (14.8% vs 47.7%; p = 0.002) after 12 months of therapy, while it was not associated with SFCR (65.1% vs 70.1%; p = 0.435), hospitalisation (9.2% vs 7.8%; p = 0.801) and surgery (3.1% vs 6.1%; p = 0.549). Sarcopenia was identified as a predictor of lack of ER (odds ratio [OR]=5.2; p = 0.006), as well as smoking (OR=2.5; p = 0.028) and perianal disease (OR=2.6; p = 0.020). |
3 |
| 65. Blagec P, Sara S, Tripalo Batoš A, et al. Magnetic Resonance Imaging Can Be Used to Assess Sarcopenia in Children with Newly Diagnosed Crohn's Disease. Nutrients. 2023 Sep 02;15(17):3838. |
Observational-Dx |
30 children |
To determine the proportion of patients with sarcopenia diagnosed by MRI and compare these results to bioelectrical impedance analysis (BIA). |
30 newly diagnosed children with CD were included (mean age 14.2 years, 53% male). Sarcopenia was found in 13 (43%) children; mean TPMA was 15.2 (1.1 SD) cm2 and TPVM 30.95 (1.7 SD) cm2. A highly positive correlation was shown for lean mass assessed by BIA and TPMA (0.706, p < 0.001) and TPVM (0.75, p < 0.001). Sarcopenia was more prevalent in boys (77% vs. 24%, p = 0.004), patients with the perianal disease (69% vs. 29%, p = 0.03), and children with sarcopenia were likely to receive anti-TNF (77% vs. 41%, p = 0.05). During the follow-up period, 16 (53%) children experienced a relapse. TPMA (HR 0.99, p = 0.018) and TPVM (HR 0.99, p = 0.031) values were statistically significant risk factors for relapse. |
3 |
| 66. Beer L, Bastati N, Ba-Ssalamah A, et al. MRI-defined sarcopenia predicts mortality in patients with chronic liver disease. Liver Int. 2020 Nov;40(11):2797-2807. |
Observational-Dx |
265 patients |
To explore whether sarcopenia, diagnosed by an abbreviated magnetic resonance imaging (MRI) protocol is a risk factor for hepatic decompensation and mortality in patients with chronic liver disease (CLD). |
The inter-observer agreement for the TPMT measurements (? = 0.98; 95% confidence interval [95% CI]:0.96-0.98), as well as the intra-observer agreement between the three image sequences (? = 0.99; 95% CI: 0.99-1.00) were excellent. Sarcopenia was not predictive of first or further hepatic decompensation. In patients with cACLD and dACLD, sarcopenia was a risk factor for mortality (cACLD: hazard ratio (HR):3.13, 95% CI: 1.33-7.41, P = .009; dACLD:HR:2.45, 95% CI: 1.32-4.57, P = .005) on univariate analysis. After adjusting for the model of end-stage liver disease (MELD) score, albumin and evidence of clinical significant portal hypertension, sarcopenia (adjusted HR: 2.76, 95% CI: 1.02-7.42, P = .045) remained an independent risk factor for mortality in patients with cACLD. |
2 |
| 67. Nakamura A, Yoshimura T, Sato T, Ichikawa T. Diagnosis and Pathogenesis of Sarcopenia in Chronic Liver Disease Using Liver Magnetic Resonance Imaging. Cureus. 2022 May;14(5):e24676. |
Observational-Dx |
512 patients |
To develop new diagnostic criteria for magnetic resonance imaigng (MRI) in Asians and investigate the relationship between adipopenia and sarcopenia using MRI proton density fat fraction (PDFF), which is correlated with body fat mass. |
Among patients with CLD, the prevalence rates of sarcopenia and adipopenia were 25% and 17%, respectively. We found that sarcopenia increased from stage 3 fibrosis and was inversely correlated with steatosis grade. Multivariate analysis found that MRI-PDFF was associated with sarcopenia. The Kaplan-Meier method in cirrhosis (n = 122) showed that the non-sarcopenia, sarcopenia, and sarcopenia/adipopenia groups had three-year survival rates of 97%, 55% (p < 0.01), and 23%, respectively. The Cox proportional hazards model identified the Child-Pugh score and sarcopenia/adipopenia as independent prognostic factors. |
3 |
| 68. Faron A, Sprinkart AM, Kuetting DLR, et al. Body composition analysis using CT and MRI: intra-individual intermodal comparison of muscle mass and myosteatosis. Sci Rep. 2020 Jul 16;10(1):11765. |
Observational-Dx |
50 consecutive participants of a cancer screening program that underwent same day low-dose chest CT and MRI |
To (a) assess CSA and MFI measurements as surrogates of skeletal muscle mass and quality in CT and MRI in subjects who received both imaging modalities at the same day and (b) to compare measurements intra-individually to assess agreement between modalities for determination of skeletal muscle mass and quality. |
CSA and MFI were highly correlated between CT and MRI (CSA: r = 0.93, P < 0.001; MFI: r = - 0.90, P < 0.001). Mean CSA was higher in CT compared to MRI (46.6cm2 versus 43.0cm2; P = 0.05) without significance. Based on MRIPDFF, a linear regression model was established to directly estimate skeletal muscle fat content from CT. Bland-Altman plots showed a difference between measurements of - 0.5 cm2 to 7.6 cm2 and - 4.2% to 2.4% regarding measurements of CSA and MFI, respectively. |
2 |
| 69. Drucker Iarovich M, Matos JF, Lowes WH, et al. Cardiac MRI Pectoralis Muscle Thickness as a Measure of Sarcopenia: Prognostic Significance, Interreader Agreement, and Physiologic Correlation. Radiol Cardiothorac Imaging. 2024 Dec;6(6):e240147. |
Observational-Dx |
1,045 patients |
To evaluate pectoralis muscle thickness at routine cardiac magnetic resonance imaging (MRI) as a marker of sarcopenia, including prognostic significance for major adverse cardiac events (MACE), interobserver agreement, and correlation with physiologic parameters. |
The study included 1045 patients (mean age, 50 years ± 17 [SD]; 642 male, 403 female). After median follow-up of 3.3 years (IQR: 2.3–3.9 years), MACE occurred in 66 patients. In multivariable models adjusted for patient age, left ventricular ejection fraction, late gadolinium enhancement, and cardiomyopathy cause, pectoralis major muscle thickness was predictive of MACE in both male (hazard ratio [HR], 0.89 [95% CI: 0.85, 0.94]; P < .001) and female patients (HR, 0.85 [95% CI: 0.76, 0.96]; P = .008), with improved model fit in nested models. Pectoralis muscle thickness measurements had excellent intra- and interobserver agreement (intraclass correlation coefficient, 0.99 and 0.95, respectively) and correlated with absolute peak oxygen uptake (r = 0.65, P < .0001) and oxygen uptake efficiency slope (r = 0.61, P < .001) in the subset who underwent CPET within 1 year of MRI (n = 258). |
3 |
| 70. Mirzai S, Aleixo GFP, Mazumder S, et al. Sarcopenia evaluation on cardiac magnetic resonance imaging in older adults for outcomes prediction following surgical aortic valve replacement. Int J Cardiol. 2023 Nov 15;391():S0167-5273(23)01059-8. |
Observational-Dx |
133 patients |
To assess the prognostic utility of opportunistic muscle measurements on preoperative cardiac magnetic resonance imaging (CMR) in older adults undergoing surgical aortic valve replacement (SAVR). |
The average age was 64 ± 9 years, with most Caucasian (93.2%). Compared to non-sarcopenic patients, sarcopenic patients were older with lower body mass index. During a median follow-up of 27.3 (7.6–60.4) months, 10 (22.2%) deaths occurred in the sarcopenic groupand 8 (9.1%) in the non-sarcopenic group (p = 0.039 by log-rank test). On subgroup analysis (66 patients), higher-risk sarcopenic patients had 10 (37.0%) deaths compared to 8 (20.5%) in higher-risk non-sarcopenic patients (p = 0.011 by log-rank test). |
3 |
| 71. Miller RJH, Yi J, Shanbhag A, et al. Deep learning-quantified body composition from positron emission tomography/computed tomography and cardiovascular outcomes: a multicentre study. Eur Heart J. 2025 Jun 23;46(24):2336-2347. |
Observational-Dx |
10,085 |
In this study, we evaluated an automated pipeline designed to segment subcutaneous adipose tissue (SAT), EAT, VAT, intermuscular adipose tissue (IMAT), bone, and SM to provide quantitative measures of sarcopenia and cardiometabolic health. We then evaluated their independent prognostic utility after adjusting for existing markers of risk from PET/CT MPI including CAC, relative perfusion, and myocardial flow reserve (MFR). |
This study included 10 085 patients, with median age 68 (interquartile range 59–76) and 5767 (57%) male. Body tissue segmentations were completed in 102 ± 4 s. Higher VAT density was associated with an increased risk of death or MI in both unadjusted [hazard ratio (HR) 1.40, 95% confidence interval (CI) 1.37–1.43] and adjusted (HR 1.24, 95% CI 1.19–1.28) analyses, with similar findings for IMAT, SAT, and EAT. Patients with elevated VAT density and reduced myocardial flow reserve had a significantly increased risk of death or MI (adjusted HR 2.49, 95% CI 2.23–2.77). |
3 |
| 72. Simonsen C, Kristensen TS, Sundberg A, et al. Assessment of sarcopenia in patients with upper gastrointestinal tumors: Prevalence and agreement between computed tomography and dual-energy x-ray absorptiometry. Clin Nutr. 2021 May;40(5):S0261-5614(21)00161-8. |
Observational-Dx |
131 patients |
To investigate the prevalence of sarcopenia assessed by dual-energy xray absorptiometry (DXA) and computed tomography (CT) as well as the agreement between the methods for identification of sarcopenia. |
With DXA the prevalence of sarcopenia was 11.5% and 19.1%. Using CT, the prevalence of sarcopenia was 3.8% and 26.7% using cut-off values from healthy young adults and 64.1% using the widely applied cut-off value. The agreement between DXA and CT in identifyingsarcopenia was poor, with Cohen's kappa values ranging from 0.05 to 0.39. The mean difference for estimated total lean soft tissue was 1.4 kg, with 95% limits of agreement from -8.6 to 11.5 kg. For appendicular lean soft tissue, the ratio between DXA and CT was 1.15, with 95% limits of agreement from 0.92 to 1.44. |
3 |
| 73. Casey P, Alasmar M, McLaughlin J, et al. The current use of ultrasound to measure skeletal muscle and its ability to predict clinical outcomes: a systematic review. J Cachexia Sarcopenia Muscle. 2022 Oct;13(5):2298-2309. |
Review/Other-Dx |
3100 patients |
To describe the current use of skeletal muscle ultrasound (SMUS) to measure muscle mass and quality in patients with acute and chronic clinical conditions and its ability to predict functional capacity, severity of malnutrition, hospital admission, and survival. |
The clinical outcomes investigated included functional status at discharge (intensive care unit-acquired weakness), nutritional status, and length of stay. SMUS was also utilized in chronic conditions such as chronic obstructive pulmonary disease, chronic heart failure, and chronic renal failure to predict hospital readmission and disease severity. Only two studies investigated the use of SMUS in patients with cancer. Of the 37 studies, 28 (76%) found that SMUS (cross-sectional area, muscle thickness, and echointensity) showed significant associations with functional capacity, length of stay, readmission, and survival. There was significant heterogeneity in terms of ultrasound technique and outcome measurement across the included studies. This review highlights that SMUS continues to gain momentum as a potential tool for skeletal muscle assessment and predicting clinically important outcomes. Further work is required to standardize the technique in nutritionally vulnerable patients, such as those with cancer, before SMUS can be widely adopted as a bedside prognostic tool. |
4 |
| 74. de Luis Roman D, García Almeida JM, Bellido Guerrero D, et al. Ultrasound Cut-Off Values for Rectus Femoris for Detecting Sarcopenia in Patients with Nutritional Risk. Nutrients. 2024 May 21;16(11):1552. |
Observational-Dx |
1000 |
To assess the usefulness of ultrasound of the rectus femoris for detecting sarcopenia in hospitalized patients at risk of malnutrition and to define cut-off values of ultrasound measures. |
A total of 1000 subjects were included and 991 of them (58.9% men, mean age 58.5 years) were evaluated. Risk of sarcopenia was detected in 9.6% patients, probable sarcopenia in 14%, confirmed sarcopenia in 9.7%, and severe sarcopenia in 3.9%, with significant differences in the distribution of groups between men and women (p < 0.0001). The cross-sectional area (CSA) of the rectus femoris showed a significantly positive correlation with body cell mass of BIA and handgrip strength, and a significant negative correlation with TUG. Cut-off values were similar within each category of sarcopenia, ranging between 2.40 cm2 and 3.66 cm2 for CSA, 32.57 mm and 40.21 mm for the X-axis, and 7.85 mm and 10.4 mm for the Y-axis. In general, these cut-off values showed high sensitivities, particularly for the categories of confirmed and severe sarcopenia, with male patients also showing better sensitivities than women. |
2 |
| 75. Güner G, Özçakar L, Baytar Y, et al. Sonographic Measurements of Rectus Femoris Muscle Thickness Strongly Predict Neutropenia in Cancer Patients Receiving Chemotherapy. Cancers (Basel). 2024 Mar 05;16(5):1061. |
Observational-Dx |
65 patients |
To explore the possible association between low skeletal muscle mass (SMM)-assessed by computed tomography (CT) and ultrasound (US)-and hematologic toxicity in cancer patients. |
A total of 65 patients (14 males, 51 females) were included. ROC (receiver operating characteristic) analysis identified threshold values of 18.0 mm [AUC (area under the curve) = 0.765] for females and 20.0 mm (AUC = 0.813) for males, predicting severe neutropenia. Using these cut-offs, females with low rectus femoris (RF) thickness (<18.0 mm) had a significantly higher incidence of grade =3 neutropenia (50.0% vs. 10.8%, p = 0.005), and males with low RF values (<20.0 mm) had a higher incidence (80.0% vs. 22.2%, p = 0.063). A regression analysis, irrespective of age, gender, and body mass index, revealed that only low RF muscle thickness increased the risk of grade 3-4 neutropenia by 9.210 times (95% CI = 2.401-35.326, p = 0.001). |
4 |
| 76. Abdulsalam AJ, Merza AH, Kara M. Evaluating sarcopenia in cancer patients: focus on the rectus femoris muscle. Support Care Cancer. 2024 May 15;32(6):350. |
Review/Other-Dx |
N/A |
No abstract available |
No abstract available |
4 |
| 77. Sousa IM, Pereira JPDC, Rüegg RAB, et al. Comparing A-mode ultrasound and computed tomography for assessing cancer-related sarcopenia: A cross-sectional study. Nutr Clin Pract. 2025 Jun;40(3):699-708. |
Review/Other-Dx |
120 patients |
To evaluate the feasibility of using A-mode US to assess muscle thickness, compare it with computed tomography (CT)-derived results, and assess its ability to diagnose sarcopenia. |
We included 120 patients (53.3% women, 45% older adults, and 85.8% with disease stages III-IV). TMT alone and the combined approach (BMT + TMT) were weak and positively correlated and significantly associated with muscle CSA, explaining 35% of CSA variability (R2 = 0.35). TMT individual and combined with BMT exhibited the highest accuracy for men (area under the curve >0.70). Sarcopenia diagnosed by BMT + TMT exhibited the highest frequency (34%) and moderate agreement with CT-derived sarcopenia (? = 0.48). |
4 |
| 78. Albano D, Dondi F, Ravanelli M, et al. Prognostic Role of "Radiological" Sarcopenia in Lymphoma: A Systematic Review. Clin Lymphoma Myeloma Leuk. 2022 May;22(5):S2152-2650(21)02438-1. |
Review/Other-Dx |
25 articles (4454 patients) |
To perform a systematic review on the prognostic role of "radiological" sarcopenia in lymphoma. |
Diffuse large B-cell lymphoma was the most common lymphoma variant studied, followed by Hodgkin lymphoma. Skeletal muscle area (SMA) was defined as the parameter to distinguish between sarcopenic and nonsarcopenic lymphoma on CT scans and was usually measured at the level of the third lumbar vertebra. In the literature, different thresholds are used to define sarcopenia, related to the features of patients included in the studies. Despite this heterogeneity, in most cases, sarcopenia was demonstrated to be significantly correlated with OS and PFS. Sarcopenia measurement with CT (high dose or low dose) is a safe, accurate and precise method. |
4 |
| 79. Lee MH, Pickhardt SG, Garrett JW, et al. Utility of Fully Automated Body Composition Measures on Pretreatment Abdominal CT for Predicting Survival in Patients With Colorectal Cancer. AJR Am J Roentgenol. 2023 Mar;220(3):371-380. |
Review/Other-Dx |
1766 patients |
To assess the utility of fully automated body composition measures derived from pretreatment CT examinations in predicting survival in patients with CRC. |
Patients who died, compared with patients who survived, had lower median muscle attenuation (19.2 vs 26.2 HU, p < .001), SAT area (168.4 cm2 vs 197.6 cm2, p < .001), and aortic calcium (620 vs 182, p < .001). Measures with highest 5-year AUCs for predicting survival in patients without (n = 1303) and with (n = 463) metastatic disease were muscle attenuation (0.666 and 0.701, respectively) and aortic calcium (0.677 and 0.689, respectively). A combination of muscle attenuation, SAT area, and aortic calcium yielded 5-year AUCs of 0.758 and 0.732 in patients without and with metastases, respectively. Risk of death was increased (p < .05) in patients in the lowest quartile for muscle attenuation (hazard ratio [HR] = 1.55) and SAT area (HR = 1.81) and in the highest quartile for aortic calcium (HR = 1.37) and decreased (p < .05) in patients in the highest quartile for VAT area (HR = 0.79) and SAT area (HR = 0.76). In 423 patients with available BMI, BMI did not significantly predict death (p = .75). |
4 |
| 80. Anabtawi NM, Pasala MS, Grimshaw AA, et al. Low skeletal muscle mass and treatment outcomes among adults with haematologic malignancies: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2024 Jun;15(3):1084-1093. |
Meta-analysis |
20 studies involving 3468 patients |
To summarize the evidence to date on the prevalence and impact of LSMM on adverse outcomes among adults with haematologic malignancies. |
Of 3791 studies screened, we identified 20 studies involving 3468 patients with a mean age of 60 years; 44% were female and the most common malignancy was diffuse large B-cell lymphoma (42%). Most studies measured muscle mass using single slice computed tomography imaging at the L3 level. The presence of LSMM was associated with worse OS (pooled HR = 1.81, 95% CI = 1.48-2.22, P < 0.001) with moderate heterogeneity (Cochran's Q, I2 = 60.4%), PFS (pooled HR = 1.61, 95% CI = 1.28-2.02, P < 0.001) with moderate heterogeneity (Cochran's Q, I2 = 66.0%). Similarly, LSMM was associated with worse NRM (HR = 1.72, 95% CI = 1.34-2.22, P < 0.001) with little evidence of heterogeneity (Cochran's Q, I2 = 0.0%). |
Good |
| 81. Meerkerk CDA, Bruijnen CP, van den Bos F, Emmelot-Vonk MH, de Bree R. The geriatric assessment and sarcopenia to assess frailty in older patients with cancer. J Geriatr Oncol. 2024 Jul;15(6):S1879-4068(24)00074-2. |
Review/Other-Dx |
143 patients |
To determine whether the addition of sarcopenia to the G8 could enhance the detection of frailty based on GA in older patients with cancer. |
No abstract available. |
4 |
| 82. Láinez Ramos-Bossini AJ, Gámez Martínez A, Luengo Gómez D, et al. Computed Tomography-Based Sarcopenia and Pancreatic Cancer Survival-A Comprehensive Meta-Analysis Exploring the Influence of Definition Criteria, Prevalence, and Treatment Intention. Cancers (Basel). 2025 Feb 11;17(4):607. |
Meta-analysis |
48 studies |
To evaluate the impact of computed tomography (CT)-based sarcopenia on overall survival (OS) and progression-free survival (PFS) in patients with PC, considering potential confounders such as the CT-based method and thresholds used to define sarcopenia, as well as treatment intention. |
Sarcopenia was significantly associated with worse OS (pooled cHR = 1.58, 95% CI: 1.38-1.82; pooled aHR = 1.39, 95% CI: 1.16-1.66) and worse PFS (pooled cHR = 1.55, 95% CI: 1.29-1.86; pooled aHR = 1.31, 95% CI: 1.11-1.55). Subgroup analyses revealed significantly different, stronger associations in studies using stricter sarcopenia cutoffs (<50 cm2/m2 for males) and in patients undergoing curative treatments. Heterogeneity was substantial across analyses (I2 > 67%), but with generally low t2 values (0.01-0.25). Egger's test indicated potential publication bias for OS (p < 0.001), but no significant bias was observed for PFS (p = 0.576). |
Good |
| 83. Troschel FM, Jin Q, Eichhorn F, et al. Sarcopenia on preoperative chest computed tomography predicts cancer-specific and all-cause mortality following pneumonectomy for lung cancer: A multicenter analysis. Cancer Medicine. 10(19):6677-6686, 2021 10. |
Observational-Dx |
367 patients |
To confirm whether preoperative sarcopenia on chest computed tomography (CT) predicts mortality following pneumonectomy in patients with lung cancer, we developed this bi-institutional transatlantic cohort study in January 2019 with the a priori hypothesis that sarcopenia on preoperative chest CT is an independent risk factor for cancer-specific and overall survival following pneumonectomy for non-small cell lung cancer (NSCLC). |
Three hundred and sixty-seven patients (67.4% male, median age 62 years, 16.9% early-stage) underwent predominantly standard pneumonectomy (89.6%) for stage IIIA NSCLC (45.5%) and squamous cell histology (58%). Sarcopenia was present in 104 of 367 patients (28.3%). Ninety-day all-cause mortality was 7.1% (26/367). After a median follow-up of 20.5 months (IQR, 9.2-46.9), 183 of 367 patients (49.9%) had died. One hundred and thirty-three (72.7%) of these deaths were due to lung cancer. Sarcopenia was associated with shorter CSS (HR 1.7, p = 0.008) and OS (HR 1.7, p = 0.003). |
2 |
| 84. Kaltenhauser S, Niessen C, Zeman F, et al. Diagnosis of sarcopenia on thoracic computed tomography and its association with postoperative survival after anatomic lung cancer resection. Sci Rep. 2023 Oct 27;13(1):18450. |
Observational-Dx |
Non-sarcopenic group (n=185) and Sarcopenic group (n=95) |
To provide an assessment of sarcopenia solely by thoracic CT that meets the European consensus defnition and diagnostic criteria and analyze its relevance for preoperative risk stratification for long-term survival of lung cancer patients after anatomic resection. |
We showed that skeletal muscle index and radiation attenuation at level T10 correlate well with those at level L3 (Pearson's R = 0.82 and 0.66, p < 0.001). During a median follow-up period of 55.7 months, sarcopenia was independently associated with worse overall (hazard ratio (HR) = 2.11, 95%-confidence interval (95%-CI) = 1.38-3.23, p < 0.001) and cancer-specific survival (HR = 2.00, 95%-CI = 1.19-3.36, p = 0.009) of lung cancer patients following anatomic resection. |
2 |
| 85. Sun C, Hirata Y, Kawahara T, et al. Diagnosis of Respiratory Sarcopenia for Stratifying Postoperative Risk in Non-Small Cell Lung Cancer. JAMA Surg. 2025 Jan 01;160(1):e244800. |
Observational-Dx |
806 patients |
To investigate the clinical utility of respiratory sarcopenia for optimizing postoperative risk stratification in patients with non–small cell lung cancer (NSCLC). |
Of a total of 1016 patients, 806 (497 men [61.7%]; median [IQR] age, 69 [64-76] years) were eligible for electronic computed tomography image analysis. The median (IQR) duration of follow-up for survival was 5.2 (3.6-6.4) years. Respiratory strength was more closely correlated with PMI than pectoralis muscle radiodensity (Pearson r2, 0.58 vs 0.29). Respiratory strength and PMI declined with aging simultaneously (both P?for trend <?.001). Pre–respiratory sarcopenia was present in 177 patients (22.0%), and respiratory sarcopenia was present in 130 patients (16.1%). The risk of postoperative complications escalated from 82 patients (16.4%) with normal status to 39 patients (22.0%) with pre–respiratory sarcopenia to 39 patients (30.0%) with respiratory sarcopenia (P?for trend <?.001), as did the risk of delayed recovery after surgery (P?for trend <?.001). Compared with patients with normal status or pre–respiratory sarcopenia, patients with respiratory sarcopenia exhibited worse 5-year overall survival (438 patients [87.2%] vs 133 patients [72.9%] vs 85 patients [62.5%]; P?for trend <?.001). Multivariable analysis identified respiratory sarcopenia as a factor independently associated with increased risk of mortality (hazard ratio,?1.83; 95% CI,?1.15-2.89; P?=?.01) after adjustment for sex, age, smoking status, performance status, chronic heart disease, forced expiratory volume in 1 second, diffusing capacity for carbon monoxide, C-reactive protein, albumin, carcinoembryonic antigen, histology, and pathologic stage. |
3 |
| 86. Mantz L, Mercaldo ND, Simon J, et al. Preoperative Chest CT Myosteatosis Indicates Worse Postoperative Survival in Stage 0-IIB Non-Small Cell Lung Cancer. Radiology. 2025 Feb;314(2):e240282. |
Observational-Dx |
838 patients |
To assess whether increased myosteatosis markers at chest CT before lung resection of early-stage NSCLC are associated with and predictive of worse overall survival (OS). |
Among 838 patients (median age, 68 years [IQR, 61–74 years]; 475 [56.7%] female patients), 219 died after a median follow-up of 5.3 years (IQR, 3.0–6.4 years). Increased myosteatosis, represented by decreased SMD and an increased IMAT index, was associated with worse OS (adjusted hazard ratio, 0.87 [95% CI: 0.80, 0.93]; P < .001 and adjusted hazard ratio, 1.24 [95% CI: 1.12, 1.37]; P < .001, respectively). There was no evidence of an association between OS and skeletal muscle index, SAT index, and SAT density. The predictive performance (concordance) increased from 0.723 (95% CI: 0.686, 0.753) to 0.731 (95% CI: 0.692, 0.762) after including myosteatosis markers. |
3 |
| 87. Huang Y, Cun H, Mou Z, et al. Multiparameter body composition analysis on chest CT predicts clinical outcomes in resectable non-small cell lung cancer. Insights Imaging. 2025 Feb 06;16(1):32. |
Observational-Dx |
2712 patients |
This study investigates the association between baseline CT body composition parameters and clinical outcomes in patients with resectable non-small cell lung cancer (NSCLC). |
A total of 2712 patients (mean age, 61.53 years; 1146 females) were evaluated. A total of 635 patients (23.41%) died. 465 patients (19.51%) experienced recurrence and/or distant metastasis. After multivariable adjustment, skeletal muscle index (SMI, HR?=?0.86), intermuscular adipose index (IMAI, HR?=?1.49), and subcutaneous adipose index (SAI, HR?=?0.96) were associated with OS. Similar results were found after stratification by gender, TNM stage, and center. There was no significant association between all body composition metrics and DFS (all p?>?0.05). The body composition metrics significantly enhance the model including clinicopathological factors, resulting in an improved AUC for predicting 1-year and 3-year OS, with AUC values of 0.707 and 0.733, respectively. |
3 |
| 88. Guichet PL, Taslakian B, Zhan C, et al. MRI-Derived Sarcopenia Associated with Increased Mortality Following Yttrium-90 Radioembolization of Hepatocellular Carcinoma. Cardiovasc Intervent Radiol. 2021 Oct;44(10):1561-1569. |
Observational-Tx |
82 consecutive patients with HCC treated with 90Y radioembolization |
To evaluate the influence of sarcopenia on survival in patients with hepatocellular carcinoma (HCC) treated with 90Y radioembolization. |
Sarcopenia was identified in 30% (25/82) of patients. Death was reported for 49% (32/65) of males and 71% (8/17) of females (mean follow-up 19.6 months, range 21 days-58 months). Patients with sarcopenia were found to have increased mortality at 180 days (31.8% vs. 8.9%) and 1 year (68.2% vs. 21.2%). Sarcopenia was an independent predictor of mortality adjusted for BCLC stage and sub-analysis demonstrated that sarcopenia independently predicted increased mortality for patients with BCLC stage B disease. |
2 |
| 89. Rao C, Chen J, Xu K, et al. Association of magnetic resonance imaging-derived sarcopenia with outcomes of patients with hepatocellular carcinoma after hepatectomy. Abdom Radiol (NY). 2024 Jul;49(7):2272-2284. |
Review/Other-Dx |
193 patients |
To evaluate whether sarcopenia, diagnosed by magnetic resonance imaging (MRI) protocol, constitutes a prognosis-associated risk factor in patients with hepatocellular carcinoma (HCC) after hepatectomy. |
The areas of SM and PM, and SMI and PMI were significantly higher in the men than in the women (all p < 0.05). Notably, SMI-defined sarcopenia displayed a significant sex difference (p = 0.003), while PMI-defined sarcopenia did not (p = 0.370). Through univariate and multivariate analyses, PMI-defined sarcopenia remained an independent predictor for OS and RFS (HR = 3.486, 95% CI: 1.700-7.145, p = 0.001 and HR = 1.993, 95% CI: 1.246-3.186, p = 0.004), even after adjusting for other clinical variables. Moreover, Kaplan-Meier analysis demonstrated significantly poorer OS and RFS for patients with sarcopenia defined by using PMI, but not SMI, compared to those without sarcopenia (p < 0.001 and p = 0.006, respectively). |
4 |
| 90. Cespiati A, Smith D, Lombardi R, Fracanzani AL. The Negative Impact of Sarcopenia on Hepatocellular Carcinoma Treatment Outcomes. Cancers (Basel). 2024 Jun 24;16(13):2315. |
Review/Other-Tx |
N/A |
To analyze the impact of sarcopenia on HCC treatment outcomes, shedding light on an underexplored subject in the pursuit of more personalized management. |
Sarcopenia was found to be prevalent among HCC patients, exhibiting different occurrence, possibly attributable to diverse diagnostic criteria. Notably, despite variations in studies utilizing skeletal muscle indices, sarcopenia independently correlated with lower overall survival (OS), recurrence-free survival (RFS), and progression-free survival (PFS) across surgical (both transplantation and resection), locoregional, and systemic therapies, including tyrosine-kinase inhibitors (TKIs) and immune-checkpoint inhibitors (ICIs). Moreover, a link between sarcopenia and increased rate and severity of adverse events, particularly in surgery and TKIs recipients, and larger tumor size at diagnosis was observed. While baseline sarcopenia negatively influenced treatment outcomes, alterations in muscle mass post-treatment emerged as primary determinants of reduced OS. |
4 |
| 91. Wang Z, Zhu L, Wang Y, Han X, Xu Q, Dai M. Looking at or beyond the tumor - a systematic review and meta-analysis of quantitative imaging biomarkers predicting pancreatic cancer prognosis. Abdom Radiol (NY). 2025 Apr 08;(). |
Meta-analysis |
43 studies |
To evaluate the prognostic value of quantitative imaging biomarkers derived from computed tomography (CT) and magnetic resonance imaging (MRI) for pancreatic cancer (PC), with a particular focus on body composition parameters beyond the traditional intrinsic features of the tumor. |
We performed a meta-analysis of ten imaging biomarkers investigated in 43 included studies. Larger tumor size, lower skeletal muscle radiodensity, lower skeletal muscle index (SMI), presence of sarcopenic obesity, lower psoas muscle index (PMI), higher visceral to subcutaneous adipose tissue area ratio, and lower visceral adipose tissue index were associated with significantly worse OS. In particular, lower SMI and lower PMI had relatively high HRs (1.65 for SMI, 95% CI 1.39-1.96, and 2.20 for PMI, 95% CI 1.74-2.78). Patients with lower SMI exhibited poorer RFS (HR 1.78, 95% CI 1.46-2.18). Subgroup analyses identified the origin region of the study and intervention type as potential factors of heterogeneity for SMI in predicting OS. |
Good |
| 92. Rossi F, Valdora F, Barabino E, Calabrese M, Tagliafico AS. Muscle mass estimation on breast magnetic resonance imaging in breast cancer patients: comparison between psoas muscle area on computer tomography and pectoralis muscle area on MRI. Eur Radiol. 2019 Feb;29(2):494-500. |
Review/Other-Dx |
26 patients |
To evaluate the correlation between psoas muscle area (TPA) on CT images and pectoralis muscle area (PMA) on MRI in breast cancer patients. |
The Pearson r correlation coefficient was 0.70 (95% CI 0.41-0.81) and the coefficient of determination was 0.49. The inter-reader agreement was k = 0.85 and k = 0.79 for axial 1.25-mm and 5-mm CT images, respectively. The intra-reader agreement of reader 1 was k = 0.98 and k = 0.94 for 1.25-mm and 5-mm CT images, respectively. The intra-reader agreement of reader 2 was k = 0.95 and k = 0.94 for 1.25-mm and 5-mm CT images, respectively. On axial T1-weighted images, the inter-reader agreement for radiologists evaluating the PMA was k = 0.61. Intra-observer agreement of reader 1 and reader 2 for PMA estimation was good (0.62 and 0.64), respectively. |
4 |
| 93. Zhou C, Foster B, Hagge R, et al. Opportunistic body composition evaluation in patients with esophageal adenocarcinoma: association of survival with 18F-FDG PET/CT muscle metrics. Ann Nucl Med. 2020 Mar;34(3):174-181. |
Observational-Dx |
59 patients |
18F-FDG PET is widely used to accurately stage numerous types of cancers. Although 18F-FDG PET/CT features of tumors aid in predicting patient prognosis, there is increasing interest in mining additional quantitative body composition data that could improve the prognostic power of 18F-FDG PET/CT, without additional examination costs or radiation exposure. The aim of this study was to determine the association between overall survival and body composition metrics derived from routine clinical 18F-FDG PET/CT examinations. |
Among the 59 patients studied, psoas MA and SUVmax were found to be significant predictors of survival (HR 0.94, 95% CI 0.88-0.99, p = 0.04, and HR 0.37, 95% CI 0.14-0.97, p = 0.04, respectively) and remained independent predictors. Psoas CSA and SUVmean did not significantly influence survival outcomes. |
3 |
| 94. Zhou Y, Zhou J, Cai X, et al. Integrating 18F-FDG PET/CT radiomics and body composition for enhanced prognostic assessment in patients with esophageal cancer. BMC Cancer. 2024 Nov 14;24(1):1402. |
Observational-Dx |
91 patients |
This study aimed to develop a predictive model utilizing radiomics and body composition features derived from 18F-FDG PET/CT scans to forecast progression-free survival (PFS) and overall survival (OS) outcomes in patients with esophageal squamous cell carcinoma (ESCC). |
Multivariate analysis identified Rad-scorePFS (P?=?0.003), sarcopenia (P?<?0.001), and visceral adipose tissue index (VATI) (P?<?0.001) as independent predictors of PFS. For OS, Rad-scoreOS (P?=?0.001), sarcopenia (P?=?0.002), VATI (P?=?0.037), stage (P?=?0.042), and body mass index (BMI) (P?=?0.008) were confirmed as independent prognostic factors. Integration of the Rad-score with clinical variables and body composition parameters enhanced predictive accuracy, yielding C-indices of 0.810 (95% CI: 0.737–0.884) for PFS and 0.806 (95% CI: 0.720–0.891) for OS. |
3 |
| 95. Umit EG, Korkmaz U, Baysal M, et al. Evaluation of Sarcopenia with F-18 FDG PET/CT and relation with disease outcomes in patients with multiple myeloma. Eur J Cancer Care (Engl). 2020 Nov;29(6):e13318. |
Review/Other-Dx |
105 patients |
To evaluate the development of muscle loss in MM patients and also with a new method of sarcopenia evaluation, F-18 FDG PET/CT. |
Both female and male patients were observed to be effected after MM treatment in terms of lumbar and femoral muscle evaluations with CT. Metabolic evaluations confirmed a loss of quality in muscles in terms of metabolic volume and total lesion glycolysis. |
4 |
| 96. Abdallah NH, Nagayama H, Takahashi N, et al. Muscle and fat composition in patients with newly diagnosed multiple myeloma. Blood Cancer J. 2023 Dec 12;13(1):185. |
Review/Other-Dx |
341 patients |
To evaluate the association between muscle and fat areas and radiodensity, and overall survival (OS) in patients with newly diagnosed MM. |
We included 341 patients diagnosed with MM from 2010-2019 who had an 18F-fluorodeoxyglucose positron emission tomography/computed tomography at diagnosis. A cross-sectional image at the third lumbar vertebrae was segmented into muscle and fat components. Median follow up was 5.7 years. There was no association between sarcopenia and baseline disease characteristics or OS. Low muscle radiodensity was associated with higher disease stage, anemia, and renal failure. OS was 5.6 vs. 9.0 years in patients with muscle radiodensity in the lower vs. middle/upper tertiles, respectively (P = 0.02). High subcutaneous adipose tissue (SAT) radiodensity was associated with higher stage, anemia, thrombocytopenia, hypercalcemia, renal failure, and high LDH. OS was 5.4 years vs. not reached in patients with SAT radiodensity in the upper vs. middle/lower tertiles, respectively (P = 0.001). |
4 |
| 97. Zwart AT, Cavalheiro VJ, Lamers MJ, et al. The validation of low-dose CT scans from the [18F]-FDG PET-CT scan to assess skeletal muscle mass in comparison with diagnostic neck CT scans. Eur J Nucl Med Mol Imaging. 2023 May;50(6):1735-1742. |
Review/Other-Dx |
233 |
To study whether (low) SMI based on LD CT scan from [18F]-FDG PET-CT is comparable to those derived from diagnostic neck CT scans. |
The cohort (n = 233) mean age was 66.2 ± 12.8 years, and 74.2% of patients were male. Inter-rater reliability was excellent (ICC > 0.990, 95% confidence interval 0.975-0.996, p < 0.001). The agreement of SMI between both modalities was high according to the Bland-Altman plot (mean ?SMI = - 0.19 cm2/m2), and there was no substantial bias. Cohen's Kappa analysis showed an almost perfect agreement of low SMI between the two modalities (? = 0.911, p < 0.001). The position of arms didn't affect the high agreement of (low) SMI. |
4 |
| 98. Yuan H, Tan X, Sun X, He L, Li D, Jiang L. Role of 18F-FDG PET/CT and sarcopenia in untreated non-small cell lung cancer with advanced stage. Jpn J Radiol. 2023 May;41(5):521-530. |
Observational-Dx |
202 patients |
To establish a simple approach to predict sarcopenia using 18F-FDG PET/CT parameters and clinical characteristics and determine their roles in prognostication in advanced stage non-small cell lung cancer (NSCLC). |
Among the enrolled 202 patients, 82 (40.6%) were diagnosed with sarcopenia. Higher age, male, lower BMI, and lower SUVmax_Muscle were correlated with a higher incidence of sarcopenia (P?<?0.05), while age, sex, BMI, and SUVmax_Muscle were independently predictive of sarcopenia, and thus were utilized to construct a nomogram model. Multivariate Cox regression analysis revealed that sarcopenia score derived from the nomogram model, sarcopenia, stage, and TLG_WB were independently predictive of both PFS and OS. |
2 |
| 100. Lai JC, Tandon P, Bernal W, et al. Malnutrition, Frailty, and Sarcopenia in Patients With Cirrhosis: 2021 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021 Sep;74(3):1611-1644. |
Review/Other-Dx |
N/A |
Tto offer clinicians pragmatic recommendations that could be implemented immediately in clinical practice to target malnutrition, frailty, and sarcopenia in this population. |
No abstract available. |
4 |
| 101. Khristenko E, Sinitsyn V, Rieden T, et al. CT-based screening of sarcopenia and its role in cachexia syndrome in pancreatic cancer. PLoS One. 2024;19(1):e0291185. |
Observational-Dx |
177 patients |
To evaluate the value of CT for sarcopenia screening in patients with PDAC, intending to expand the diagnostic value of tomographic studies. |
Two groups were formed: Group 1 consisted of 117 patients with PDAC in various locations and stages and Group 2, or the control group, consisted of 60 "nominally healthy" patients with other somatic non-oncological diseases. The body mass index (BMI) was defined as a ratio of patient's weight to the square of their height (kg/m2). CT-based body composition analysis was performed using commercially available software with evaluation of sarcopenia using skeletal muscle index (SMI, cm2/m2). Based on the SMI values, sarcopenia was found in 67.5% of patients (79 out of 117) in the first patient group. It was found more frequently in males (42 out of 56; 75%) than in females (37 out of 61; 60.6%). Additionally, we observed a decrease in muscle mass (hidden sarcopenia) in 79.7% in patients with a normal BMI. Even in overweight patients, sarcopenia was found in 50% (sarcopenic obesity). In patients with reduced BMI sarcopenia was found in all cases (100%). Statistically significant difference of SMI between two groups was revealed for both sexes (p = 0,0001), with no significant difference between groups in BMI. BMI is an inaccurate value for the assessment of body composition as it does not reflect in the details the human body structure. As SMI may correlate with the prognosis, decreased muscle mass- especially "hidden" sarcopenia or sarcopenic obesity- should be reported. |
3 |
| 111. Benz E, Pinel A, Guillet C, et al. Sarcopenia and Sarcopenic Obesity and Mortality Among Older People. JAMA Network Open. 7(3):e243604, 2024 03 04.JAMA netw. open. 7(3):e243604, 2024 03 04. |
Observational-Dx |
5,888 participants |
To investigate the prevalence of sarcopenia and SO and their association with all-cause mortality. |
In the total population of 5888 participants (mean [SD] age, 69.5 [9.1] years; mean [SD] BMI, 27.5 [4.3]; 3343 [56.8%] female), 653 (11.1%; 95% CI, 10.3%-11.9%) had probable sarcopenia and 127 (2.2%; 95% CI, 1.8%-2.6%) had confirmed sarcopenia. Sarcopenic obesity with 1 altered component of BC was present in 295 participants (5.0%; 95% CI, 4.4%-5.6%) and with 2 altered components in 44 participants (0.8%; 95% CI, 0.6%-1.0%). An increased risk of all-cause mortality was observed in participants with probable sarcopenia (hazard ratio [HR], 1.29; 95% CI, 1.14-1.47) and confirmed sarcopenia (HR, 1.93; 95% CI, 1.53-2.43). Participants with SO plus 1 altered component of BC (HR, 1.94; 95% CI, 1.60-2.33]) or 2 altered components of BC (HR, 2.84; 95% CI, 1.97-4.11) had a higher risk of mortality than those without SO. Similar results for SO were obtained for participants with a BMI of 27 or greater. |
4 |
| 112. Kinoshita K, Matsui Y, Hirano Y, et al. Association between the presence or absence of muscle mass assessment in sarcopenia diagnosis and poor health outcomes: A follow-up study of older outpatients at a frailty clinic. Geriatr Gerontol Int. 25(4):553-559, 2025 Apr. |
Review/Other-Dx |
730 patients |
To examine the longitudinal association between the presence or absence of muscle mass assessment in sarcopenia diagnosis and the incidence of poor health outcomes. |
The multiple logistic regression analysis, adjusted for sex, age, body mass index, cognitive impairment, depressive symptoms, polypharmacy, multimorbidity, pre-orthopedic surgery, undergoing cancer treatment and stroke history, determined the odds ratios (95% confidence intervals) for outcomes with robust used as the reference group were: low muscle mass only 0.84 (0.52-1.35); low grip strength or physical function only 1.04 (0.71-1.53); and sarcopenia 2.00 (1.39-2.87). |
4 |
| 113. Canales C, Mazor E, Coy H, et al. Preoperative Point-of-Care Ultrasound to Identify Frailty and Predict Postoperative Outcomes: A Diagnostic Accuracy Study. Anesthesiology. 2022 Feb 01;136(2):268-278. |
Experimental-Dx |
32 patients and 20 health volunteers |
To identify whether point-of-care ultrasound measurements of the quadriceps and rectus femoris muscles can be used to discriminate between frail and not-frail patients and predict postoperative outcomes. |
A total of 32 patients and 20 healthy volunteers were included. Frailty was identified in 18 of the 32 patients. Receiver operating characteristic curve analysis showed that quadriceps depth and psoas muscle area are able to identify frailty (area under the curve-receiver operating characteristic, 0.80 [95% CI, 0.64 to 0.97] and 0.88 [95% CI, 0.76 to 1.00], respectively), whereas the cross-sectional area of the rectus femoris is less promising (area under the curve-receiver operating characteristic, 0.70 [95% CI, 0.49 to 0.91]). Quadriceps depth was also associated with unplanned postoperative skilled nursing facility discharge disposition (area under the curve 0.81 [95% CI, 0.61 to 1.00]) and delirium (area under the curve 0.89 [95% CI, 0.77 to 1.00]). |
3 |
| 114. Anderson BM, Wilson DV, Qasim M, et al. Ultrasound quadriceps muscle thickness is variably associated with frailty in haemodialysis recipients. BMC Nephrol. 24(1):16, 2023 01 18. |
Review/Other-Dx |
223 patients |
To explore the relationship between ultrasound-derived bilateral anterior thigh thickness (BATT), sarcopenia, and frailty by common frailty tools (Frailty Phenotype [FP], Frailty Index [FI], Edmonton Frailty [EFS], and Clinical Frailty Scale [CFS]). |
In total 223 study participants had ultrasound measurements. Frailty ranged from 34% for FP to 58% for FI. BATT was associated with increasing frailty on simple linear regression by all frailty tools, but lost significance on addition of covariables. Upon dichotomising frailty tools into Frail/Not Frail, BATT was associated with frailty by all tools on univariable analyses, but only retained association for EFS on the fully adjusted model (OR 0.97, 95% C.I. 0.94-1.00, P = 0.05). |
4 |
| 115. Prell T, Grimm A, Axer H. Uncovering sarcopenia and frailty in older adults by using muscle ultrasound-A narrative review. Front Med (Lausanne). 2024;11():1333205. |
Review/Other-Dx |
N/A |
To describe the benefits and challenges when using ultrasound for the evaluation of frailty and sarcopenia. |
No results in abstract. |
4 |
| 116. Yang F, Zhu L, Cao B, et al. Accuracy of Ultrasound Measurements of Muscle Thickness in Identifying Older Patients With Sarcopenia and Its Impact on Frailty: A Systematic Review and Meta-Analysis. [Review]. Journal of the American Medical Directors Association. 26(2):105419, 2025 Feb.J AM MED DIR ASSOC. 26(2):105419, 2025 Feb. |
Meta-analysis |
8 studies |
Systematic review was to assess the diagnostic test accuracy of muscle ultrasound for identifying older patients with sarcopenia and to investigate its association with frailty. |
Pooled sensitivity was 0.85 (95% CI, 0.78-0.93), specificity was 0.74 (95% CI, 0.65-0.81), DOR was 16.65 (95% CI, 4.90-96.67), and SROC-area under the curve was 0.87, indicating moderate to high diagnostic accuracy. Association with frailty yielded an odds ratio of 7.91 (95% CI, 6.15-10.17). Most studies received an "unclear" rating in several QUADAS-2 domains, especially in patient selection and reference standards, indicating limitations in study design that may impact the generalizability of results. |
Good |
| 117. Shear BM, Chiu AK, Stombler A, et al. Comparison of Sarcopenia With Frailty and Area Deprivation Index for Predicting Postoperative Mortality and Complications in Thoracolumbar Trauma. Clin Spine Surg. 2025 Apr 07;(). |
Observational-Dx |
276 patients |
To compare sarcopenia to frailty and socioeconomic deprivation as preoperative predictors of mortality and complications in thoracolumbar spine trauma. |
A total of 276 patients were included. A total of 22 mortalities occurred (7.7%), with 18 (6.3%) occurring within 90-days postoperatively. On univariate analysis, only the mFI-5 scale was associated with 1-month (OR=2.42, P<0.001), 3-month (OR=2.61, P<0.001), and overall mortality (OR=2.29, P<0.001). On multivariate analysis, none of the sarcopenia, ADI, or mFI-5 were independently associated with mortality, the occurrence of postoperative complications, or revision. |
3 |
| 118. Park B, Vandal A, Welsh F, et al. Sarcopenia, myosteatosis, and frailty parameters to predict adverse outcomes in patients undergoing emergency laparotomy: prospective observational multicentre cohort study. BJS Open. 2025 Mar 04;9(2):zraf016. |
Observational-Dx |
101 patients |
The aim of this study was to examine functional compromise in emergency laparotomy using sarcopenia, myosteatosis, and frailty parameters and evaluate impacts on functional and patient-centred outcomes. |
A total of 101 patients undergoing emergency laparotomy during the study interval were analysed; 21.6% of participants had sarcopenia, 34.7% had myosteatosis, and 24.8% were living with frailty. Muscle strength parameters (low grip strength and a positive SARC-F questionnaire) had significant relationships with primary outcomes. Low grip strength (less than 27 kg for male patients and less than 16 kg for female patients) was most significant for risk of admission for rehabilitation (adjusted risk ratio 5.48 (95% c.i. 2.03 to 14.82)). A positive SARC-F questionnaire (an overall score of greater than or equal to 4 out of 10) was most significant for not returning home (adjusted risk ratio 8.26 (95% c.i. 1.81 to 37.76)). Isolated low muscle quantity (less than 52.4 cm2/m2 for male patients and less than 38.5 cm2/m2 for female patients) demonstrated no relationship. Being frail was most significant for a reduced number of days alive and out of hospital at 90 days (-13.4% compared with non-frail participants (95% c.i. -24.3% to -0.8%)). Sarcopenia and low grip strength were the only parameters to demonstrate a relationship with 3- and 6-month mortality. |
1 |
| 119. Bradley NA, Walter A, Roxburgh CSD, McMillan DC, Guthrie GJK. The Relationship between Clinical Frailty Score, CT-Derived Body Composition, Systemic Inflammation, and Survival in Patients with Chronic Limb-Threatening Ischemia. Ann Vasc Surg. 2024 Jul;104():S0890-5096(23)00339-4. |
Observational-Dx |
190 patients |
Chronic limb-threatening ischemia (CLTI) carries significant morbidity and mortality and is associated with poor quality of life. The present study aims to examine these relationships and their prognostic value in patients with CLTI. |
There were 190 patients included with a median (interquartile range) follow-up of 22 (6) months (range 15-32 months) and 79 deaths during the follow-up period. One hundred patients (53%) had a CFS >4. CFS >4 (hazard ratio [HR] 2.14, 95% confidence interval [CI] 1.25-3.66, P < 0.01), CT-SS (HR 1.47, 95% CI 1.03-2.09, P < 0.05), and mGPS (HR 1.54, 95% CI 1.11-2.13, P < 0.01) were independently associated with increased mortality. CT-SS (odds ratio 1.88, 95% CI 1.09-3.24, P < 0.01) was independently associated with CFS >4. Patients withCT-SS 0 and CFS =4 had 90% (standard error [SE] 5%) 1-year survival, compared with 35% (SE 9%) in patients with CT-SS 2 and CFS >4 (P < 0.001). Patients with mGPS 0 and CFS =4 had 94% (SE 4%) 1-year survival compared with 44% (SE 6%) in the mGPS 2 and CFS>4 subgroup (P < 0.001). |
4 |
| 120. Liu D, Ji D, Garrett JW, et al. Automated abdominal CT imaging biomarkers and clinical frailty measures associated with postoperative deceased-donor liver transplant outcomes. Eur Radiol. 2025 Mar 23. |
Observational-Dx |
598 liver transplant recipients |
To quantify the potential of fully automated CT-based body composition metrics and clinical frailty data in predicting liver transplant recipient postoperative outcomes. |
598 liver transplant recipients (median age, 56 years [IQR, 49-61]; 383 men/215 women) were included from 2005 to 2021. Mean clinical follow-up interval after transplant was 8.6 ± 4.5 years, with 224 deaths (mean interval, 5.3 ± 3.9 years post-transplant) and 246 graft failures (mean interval, 4.7 ± 4.0 years post-transplant) observed. Univariate HRs for post-transplant survival included 1.53 (95% CI, 1.14-2.06) for muscle attenuation, 1.66 (95% Cl, 1.24-2.22) for aortic Agatston score, 1.35 (1.02-1.80) for SAT area, and 1.82 (1.35-2.46) for liver volume. For those meeting the frailty criteria, HR was 2.14 (1.08-4.22). Multivariate 10-year AUC for predicting mortality was 0.675 using liver volume, aortic Agatston score, and muscle attenuation. 10-year univariate AUC for clinical frailty assessment was 0.601 but increased to 0.878 when combined with CT measures. |
2 |
| 121. Weerink LBM, van Leeuwen BL, Kwee TC, Lamoth CJC, van Munster BC, de Bock GH. Co-occurrence of CT-based radiological sarcopenia and frailty are related to impaired survival in surgical oncology. Br J Radiol. 2025 Apr 01;98(1168):607-613. |
Review/Other-Dx |
372 patients |
The objective of this study was to investigate the association of radiological sarcopenia and frailty with postoperative outcomes in adult patients undergoing oncological surgery. |
Median age was 69 (28-86) years, 77 patients (23.5%) were frail and radiological sarcopenia was present in 134 patients (41.0%). Combined radiological sarcopenia and frailty was present in 35 patients (10.7%). One-year (65.6% versus 87.0%) and three-year survival (31.4% versus 66.8%) were significantly worse in patients with combined radiological sarcopenia and frailty. The combined presence of radiological sarcopenia and frailty was associated with significantly decreased overall survival (HRadjusted: 2.06, 95% CI: 1.39-3.05, P < .001). |
4 |
| 122. Tolonen A, Kerminen H, Lehtomäki K, et al. Association between Computed Tomography-Determined Loss of Muscle Mass and Impaired Three-Month Survival in Frail Older Adults with Cancer. Cancers (Basel). 2023 Jun 28;15(13):3398. |
Observational-Dx |
80 patients |
The primary aim of this study was to examine the association between CT-determined low muscle mass with published and optimized cut-offs and 3-month OS rates. The secondary aim was to investigate whether low muscle mass offers additional predictive value for treatment decisions in combination with oncological and geriatric evaluations in frail older adults with cancer. |
Frailty was assessed with G8-screening and comprehensive geriatric assessment in older adults at risk of frailty. The L3-level skeletal (SMI) and psoas (PMI) muscle indexes were determined from routine CT scans. Established and optimized SMI and PMI cut-offs were used. In the non-curative treatment group (n = 58), 3-month OS rates for normal and low SMI were 95% and 64% (HR 9.28; 95% CI 1.2-71) and for PMI 88%, and 60%, respectively (HR 4.10; 1.3-13). A Cox multivariable 3-month OS model showed an HR of 10.7 (1.0-110) for low SMI, 2.34 (0.6-9.8) for ECOG performance status 3-4, 2.11 (0.5-8.6) for clinical frailty scale 5-9, and 0.57 (0.1-2.8) for males. The 24-month OS rates in the curative intent group (n = 21) were 91% and 38% for the normal and low SMI groups, respectively. |
3 |
| 123. Jung J, Lee J, Lim JH, et al. The effects of muscle mass and quality on mortality of patients with acute kidney injury requiring continuous renal replacement therapy. Sci Rep. 2023 May 05;13(1):7311. |
Review/Other-Dx |
2200 patients |
This study examined the effects of muscle mass on mortality in patients with acute kidney injury requiring continuous renal replacement therapy. |
We established that muscle mass had protective effects on the mortality of patients with acute kidney injury requiring continuous renal replacement therapy. This study showed that muscle mass is a significant determinant of mortality, even if the density is low. |
4 |
| 124. Romanowski KS, Fuanga P, Siddiqui S, Lenchik L, Palmieri TL, Boutin RD. Computed Tomography Measurements of Sarcopenia Predict Length of Stay in Older Burn Patients. J Burn Care Res. 2021 Feb 03;42(1):3-8. |
Observational-Dx |
83 patients |
This study aims to investigate the relationship between frailty and computed tomography (CT)-derived sarcopenia with length of stay and mortality in older burn patients. |
Eighty-three patients (59 men; mean age 70.2 ± 8.5 years) had chest (n = 50) or abdomen (n = 60) CT scans. Mean TBSA = 14.3 ± 14.0%, LOS = 25.8 ± 21.3 days, CFS = 4.36 ± 0.99. Sixteen patients (19.3%) died while in the hospital. CT-derived measurement of SMI at T12 was significantly associated with LOS (P < .05), but not with mortality (P = .561). CT-derived metrics at L3 were not significantly associated with outcomes. CFS was not associated with LOS (P = .836) or mortality (P = .554). |
2 |
| 125. Persits I, Mirzai S, Sarnaik KS, et al. Sarcopenia and frailty in patients undergoing transcatheter aortic valve replacement. Am Heart J. 2024 Oct;276():S0002-8703(24)00173-X. |
Review/Other-Dx |
184 eligible patients |
To compare traditional and novel markers of sarcopenia and frailty in terms of their ability to predict adverse outcomes post-TAVR. |
In this study we included 184 eligible patients from January to December of 2018, (96.7%) of which were balloon expandable valves. The three risk models identified 22.8% patients as sarcopenic, 63.6% as frail by the Adapted Green score, and 53.8% as frail by the Green-SMI score. There were higher rates of the composite outcome in patients with sarcopenia (54.8%) and frailty (41.9% with the Adapted Green and 50.5% with the Green-SMI score) compared to their nonsarcopenic (30.3%) and nonfrail counterparts (25.4% with the Adapted Green and 18.8% with the Green-SMI score). Sarcopenia and frailty by Green-SMI, but not by the Adapted Green, were associated with higher risks of the composite outcome on multivariable adjustment (HR 2.2 [95% CI: 1.25-4.02], P = .007 and HR 3.4 [95% CI: 1.75-6.65], P < .001, respectively). |
4 |
| 126. Wang X, Wang Z, Cheng Y, Chen X. Effects of sarcopenia on postoperative recovery in elderly patients after cardiac surgery with cardiopulmonary bypass. BMC Geriatr. 2025 Apr 30;25(1):295. |
Observational-Tx |
268 patients older than 65 years who underwent cardiac surgery with CPB |
To explore the relationship between sarcopenia evaluated via ESM and poor outcomes following cardiac surgery with cardiopulmonary bypass (CPB) in elderly patients. |
The ESMCSA/BSA detected sarcopenia in 51.1% of patients. Patients with sarcopenia had significantly extended durations of stay in both the intensive care unit and the hospital compared to those without sarcopenia. Furthermore, the incidence of major adverse events was significantly higher in the sarcopenia group compared to the non-sarcopenia group (15.3% vs. 32.1%, P < 0.001). Furthermore, multivariate logistic regression analysis demonstrated that sarcopenia (OR 2.457, 95% CI 1.178-5.126, P = 0.017) independently predicted the risk of postoperative complications after adjusting for gender, preoperative nutritional status, serum albumin, estimated glomerular filtration rate, creatinine, white blood cell count, lymphocytes, type of surgery, surgical time, and aortic cross-clamp time. Kaplan-Meier survival analysis revealed a statistically significant difference in overall mortality between groups (log-rank P = 0.011). The Cox proportional hazards model identified preoperative sarcopenia as an independent risk factor for long-term mortality (HR, 2.132; 95% CI 1.144-3.972, P = 0.017). |
2 |
| 127. Boutin RD, Bamrungchart S, Bateni CP, et al. CT of Patients With Hip Fracture: Muscle Size and Attenuation Help Predict Mortality. AJR Am J Roentgenol. 2017 Jun;208(6):W208-W215. |
Observational-Dx |
274 patients |
Tto determine the association between muscle cross-sectional area and attenuation, as measured on routine CT scans, and mortality in older patients with hip fracture. |
The overall mortality rate increased from 28.3% at 1 year to 79.5% at 5 years. Mortality was associated with decreased thoracic muscle size (odds ratio [OR], 0.66; 95% CI, 0.49-0.87). This association persisted after adjusting for demographic variables (OR, 0.69; 95% CI, 0.50-0.95), the ASA classification (OR, 0.70; CI, 0.51-0.97), and the CCI (OR, 0.72; 95% CI, 0.52-1.00). Similarly, decreased survival was associated with decreased thoracic muscle attenuation after adjusting for all of these combinations of covariates (OR, 0.67-0.72; 95% CI, 0.49-0.99). Decreased lumbar muscle size and attenuation trended with decreased survival but did not reach statistical significance. |
3 |
| 128. Li EL, Hu JS, Chen ZH, et al. Based on CT scans at the 12th thoracic spine level, assessing the impact of skeletal muscle and adipose tissue index on one-year postoperative mortality in elderly hip fracture patients: a propensity score-matched multicenter retrospective study. BMC Musculoskelet Disord. 2025 Jan 06;26(1):21. |
Observational-Dx |
334 participants |
This study aimed to prove whether skeletal muscle and adipose tissue index measured by computed tomography (CT) images based on a single layer are associated with one-year postoperative mortality in elderly hip fracture patients. |
Institution 1's results identified that a lower SMI significantly heightened the risk of one-year postoperative mortality (OR = 0.799,95%CI 0.677-0.943, P = 0.008), making SMI an independent predictor. Institution 2's results identified that age (OR = 1.081, 95%CI 1.005-1.163, P = 0.036), SMI (OR = 0.881, 95%CI 0.784-0.991, P = 0.035) as independent predictors of one-year postoperative mortality in elderly hip fracture. Receiver operator characteristics analysis revealed area under the curve (AUC) values for institution 1: SMI (0.738 (95%CI 0.626-0.851), significant), VFI (0.605 (95%CI 0.476-0.734)), VSR (0.583 (95%CI 0.451-0.715)); and for institution 2: SMI (0.742 (95%CI 0.612-0.872), significant) and Age (0.775 (95%CI 0.677-0.874), significant). Collectively, these results underscore that SMI serves as an independent predictor of one-year postoperative mortality in elderly hip fracture patients. |
3 |
| 129. Çinkooglu A, Bayraktaroglu S, Ufuk F, et al. Reduced CT-derived erector spinae muscle area: a poor prognostic factor for short- and long-term outcomes in idiopathic pulmonary fibrosis patients. Clin Radiol. 2023 Dec;78(12):S0009-9260(23)00372-0. |
Observational-Dx |
195 patients |
To assess the relationship between idiopathic pulmonary fibrosis (IPF) prognosis, baseline skeletal muscle mass, and attenuation on computed tomography (CT) and clinical parameters.The aims of the present study were to investigate the relationship between erector spinae muscle area (ESMA) and indexes and IPF prognosis, and to evaluate the relationship between CT-derived muscle parameters and clinical parameters. |
There was a moderate correlation between ESMA and PMA and pectoralis muscle index (PMI; r=0.536, p<0001 and r=0.403, p<0.001 respectively). ESMA correlated significantly with forced expiratory volume in 1 second (FEV1; hazard ratio [HR] = 0.488 p<0.001)and forced vital capacity (FVC; HR=0.501, p<0.001). Compared with PMA, ESMA was more strongly associated with 1- and 2-year mortality in patients with IPF (HR=0.957, p=0.022). The survival rate in male patients with sarcopenia was significantly worse (p=0.040). |
3 |
| 130. Liu J, Ye Z, Xiang J, et al. Association of muscle mass and radiodensity assessed by chest CT with all-cause and cardiovascular mortality in hemodialysis patients. Int Urol Nephrol. 2024 Nov;56(11):3627-3638. |
Observational-Dx |
603 patients |
This study investigates the prognostic value of skeletal muscle index (SMI) and skeletal muscle radiodensity (SMD) measured by chest CT in relation to all-cause and cardiovascular disease (CVD) mortality among hemodialysis (HD) patients. |
The study included 603 patients with a median age of 58 years. Of these, 187 (31.0%) patients with SMI < 30.00 cm2/m2 (male) or < 25.04 cm2/m2 (female) and 192 (31.8%) patients with SMD < 32.25 HU (male) or < 30.64 HU (female) were categorized as lower SMI and SMD, respectively. Over a median follow-up of 3.8 years, 144 deaths occurred. Multivariate Cox regression analysis showed that lower SMI and SMD were independently associated with all-cause mortality (SMI: HR = 1.47, 95% CI 1.03-2.10; SMD: HR = 1.75, 95% CI 1.20-2.54) and CVD mortality (SMI: HR = 1.74, 95% CI 1.03-2.94; SMD: HR = 1.72, 95% CI 1.02-2.95). Adding SMI and SMD to the established risk model improved the C-index from 0.82 to 0.87 (P < 0.001). Decision curve analysis showed that the prognostic model incorporating both SMI and SMD offered the highest net benefit for predicting all-cause mortality. |
3 |
| 133. Basty N, Thanaj M, Whitcher B, Bell JD, Thomas EL. Comparing DXA and MRI body composition measurements in cross-sectional and longitudinal cohorts. medRxiv. 2024:2024-12. |
Review/Other-Dx |
32,961 participants |
To assess the accuracy of dual X-ray absorptiometry (DXA) compared to magnetic resonance imaging (MRI) for evaluating body composition. |
Results showed that DXA reliably captured fat measurements but overestimated lean mass compared to MRI, particularly in android regions for men (4.10 vs. 1.74 kg) and women (2.92 vs. 1.10 kg). Longitudinal MRI data revealed a 4-5% muscle and lean mass decrease, undetected by DXA, which showed lean mass increases in women at the follow-up visit. |
4 |
| 134. Tavoian D, Ampomah K, Amano S, Law TD, Clark BC. Changes in DXA-derived lean mass and MRI-derived cross-sectional area of the thigh are modestly associated. Sci Rep. 2019 Jul 11;9(1):10028. |
Review/Other-Dx |
36 patients |
To determine the accuracy of DXA at detecting changes in lean mass, using MRI-derived MV as a reference standard. 10 male and 16 female subjects (29.2 ± 9.5 years) underwent DXA and MRI scans before and after a 10-week resistance training intervention. |
10 male and 16 female subjects (29.2 ± 9.5 years) underwent DXA and MRI scans before and after a 10-week resistance training intervention. DXA thigh lean mass was compared to MRI mid-thigh MV, and percent change in size was compared between MRI and DXA. There was a strong correlation between measures cross-sectionally (r = 0.89) in agreement with previous investigations. However, there was a modest correlation of percentage change over time between methods (r = 0.49). Bland-Altman plots revealed that the amount of random error increased as the magnitude of the change from baseline increased. DXA measures of change in lean mass were modestly associated with MRI measures of change in MV. |
4 |
| 135. Otsuka Y, Yamada Y, Maeda A, et al. Effects of resistance training intensity on muscle quantity/quality in middle-aged and older people: a randomized controlled trial. J Cachexia Sarcopenia Muscle. 2022 Apr;13(2):894-908. |
Observational-Dx |
50 |
To investigate whether and how low-intensity and moderate-intensity resistance training improved both muscle quantity and quality measured by MRI, DXA, and segmental bioelectrical impedance spectroscopy (S-BIS) in middle-aged and older people. |
Fifty participants (no-Ex 17, age 63.5 ± 8.5 years, women 47.1%; low-Ex 16, age 63.6 ± 8.1 years, women 50.0%; moderate-Ex 17, age 63.5 ± 8.3 years, women 52.9%) completed the 24 week exercise intervention. For the primary outcome, significant intervention effects were found in thigh muscle CSA on MRI between the moderate-Ex and no-Ex groups (+6.8 cm2 , P < 0.01). Low-Ex for 24 weeks only increased quadriceps CSA (+2.3 cm2 , P < 0.05). The per cent change of thigh muscle CSA (+7.0%, P < 0.01) after 24 week moderate-Ex was higher than that of leg lean mass on DXA (+2.3%, P = 0.088). Moderate-Ex for 24 weeks also improved S-BIS electrical properties related to muscle quantity and quality, including the intracellular resistance index (+0.1 cm2 /O, P < 0.05), membrane capacitance (+0.7 nF, P < 0.05), and phase angle (+0.3 deg, P < 0.05); their changes were positively correlated with that of thigh muscle CSA (P < 0.01). |
2 |
| 136. Zemski AJ, Hind K, Keating SE, Broad EM, Marsh DJ, Slater GJ. Same-Day Vs Consecutive-Day Precision Error of Dual-Energy X-Ray Absorptiometry for Interpreting Body Composition Change in Resistance-Trained Athletes. J Clin Densitom. 2019;22(1):S1094-6950(18)30171-9. |
Review/Other-Dx |
21 |
To investigate the impact short-term biological variation has on LSC measures, and establish if there is a difference in precision based on gender in a resistance-trained population. |
Twenty-one resistance-trained athletes (age: 30.6 ± 8.2 yr; stature: 174.2 ± 7.2 cm; mass: 74.3 ± 11.6 kg) with at least 12 mo consistent resistance training experience, underwent 2 consecutive DXA scans on 1 d of testing, and a third scan the day before or after. ISCD-recommended techniques were used to calculate same-day and consecutive-day precision error and LSC values. There was high association between whole body (R2 = 0.98-1.00) and regional measures (R2 = 0.95-0.99) for same-day (R2 = 0.98-1.00), and consecutive-day (R2 = 0.95-0.98) measurements. The consecutive-day precision error, in comparison to same-day precision error, was significantly different (p < 0.05), and almost twice as large for fat mass (1261 g vs 660 g), and over 3 times as large for lean mass (2083 g vs 617 g), yet still remained within the ISCD minimum acceptable limits for DXA precision error. No whole body differences in precision error were observed based on gender. |
4 |
| 137. Powers C, Fan B, Borrud LG, Looker AC, Shepherd JA. Long-term precision of dual-energy X-ray absorptiometry body composition measurements and association with their covariates. J Clin Densitom. 2015;18(1):S1094-6950(13)00172-8. |
Review/Other-Dx |
609 |
To investigate the long-term repeatability of both total and subregional body composition measurements and their associations with covariates in a large sample. |
Participants with scan-quality issues were excluded. Participants varied in race and ethnicity, sex, age (mean 38.8±17.5; range 16-69 yr), and BMI (mean, 26.9±5.2; range 14.1-43.5 kg/m2). The length of time between scans ranged from 3 to 51 days (mean, 18.7±8.4). Precision error estimates for total body measures (bone mineral density, bone mineral content, lean mass, total mass, fat mass, and percent body fat) were calculated as root mean square percent coefficients of variation and standard deviations. The average root mean square percent coefficients of variation and root mean square standard deviations of the precision error for total body variables were 1.12 and 0.01 g/cm2 for bone mineral density, 1.14 and 27.3 g for bone mineral content, 1.97 and 505 g for fat mass, 1.46 and 760 g for lean mass, 1.10 and 858 g for total mass, and 1.80 and 0.59 for percent body fat. In general, only fat and lean masses were impacted by participant and scan qualities (obesity category, sex, the magnitude of the body composition variables, and time between scans). |
4 |
| 138. Westbury LD, Syddall HE, Fuggle NR, et al. Relationships Between Level and Change in Sarcopenia and Other Body Composition Components and Adverse Health Outcomes: Findings from the Health, Aging, and Body Composition Study. Calcif Tissue Int. 2021 Mar;108(3):302-313. |
Review/Other-Dx |
2689 participants |
To investigate how baseline values and rates of decline in components of sarcopenia and other body composition parameters relate to adverse clinical outcomes using the Health, Aging, and Body Composition Study.gated how baseline values and rates of decline in components of sarcopenia and other body composition parameters relate to adverse clinical outcomes using the Health, Aging, and Body Composition Study. |
Baseline values and 2-3 year conditional changes (independent of baseline) in each characteristic were examined as predictors of mortality, hospital admission, low trauma fracture, and recurrent falls in the subsequent 10-14 years using Cox regression (generalized estimating equations used for recurrent falls) with adjustment for sex, ethnicity, age, and potential confounders. Lower levels and greater declines in all parameters (excluding hip BMD level) were associated (p < 0.05) with increased rates of mortality; fully-adjusted hazard ratios per SD lower gait speed and grip strength were 1.27 (95% CI 1.19, 1.36) and 1.14 (1.07, 1.21), respectively. |
4 |
| 139. Goodpaster BH, Park SW, Harris TB, et al. The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci. 2006 Oct;61(10):1059-64. |
Review/Other-Dx |
1880 patients |
The loss of muscle mass is considered to be a major determinant of strength loss in aging. |
Both men and women lost strength, with men losing almost twice as much strength as women. Blacks lost about 28% more strength than did whites. Annualized rates of leg strength decline (3.4% in white men, 4.1% in black men, 2.6% in white women, and 3.0% in black women) were about three times greater than the rates of loss of leg lean mass ( approximately 1% per year). The loss of lean mass, as well as higher baseline strength, lower baseline leg lean mass, and older age, was independently associated with strength decline in both men and women. However, gain of lean mass was not accompanied by strength maintenance or gain (ss coefficients; men, -0.48 +/- 4.61, p =.92, women, -1.68 +/- 3.57, p =.64). |
4 |
| 140. Santanasto AJ, Miljkovic I, Cvejkus RK, Boudreau RM, Wheeler VW, Zmuda JM. Body Composition Across the Adult Lifespan in African Caribbean Men: The Tobago Longitudinal Study of Aging. J Frailty Aging. 2022;11(1):40-44. |
Review/Other-Dx |
1918 |
Body composition and muscle strength change vary by age and ethnicity, and have a major impact on health and physical function. |
Annualized rates of change were calculated with all 3 time-points using Generalized Estimating Equations. We found that whole body lean mass declined at constant rate until age 65 (-0.72%/year; 95% CI: -0.76, -0.67), which accelerated to -0.92 %/year (-1.02, -0.82) among those 65-69, and again to -1.16 %/year (-1.30, -1.03 ) among those aged 70+. Whole body fat mass increased by a near constant rate of 2.93 %/year (2.72, 3.15%) across the lifespan. Finally, grip strength decline accelerated at age 50, and about 2x faster than lean mass through the lifespan after the age of 50. |
4 |
| 141. Barazzoni R, Jensen GL, Correia MITD, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):S0261-5614(22)00044-9. |
Review/Other-Dx |
Not Listed |
To evaluate existing tools for direct or indirect skeletal muscle measurement, evaluate potential proposals and approaches for cutoff utilization, and identify the level of agreement on the use of skeletal muscle function parameters as a surrogate of skeletal muscle massin the diagnosis of malnutrition. |
No results in abstract |
4 |
| 142. Fuest KE, Lanz H, Schulz J, et al. Comparison of Different Ultrasound Methods to Assess Changes in Muscle Mass in Critically ill Patients. J Intensive Care Med. 2023 May;38(5):431-439. |
Review/Other-Dx |
62 |
To assess qualitative muscle changes during an ICU stay in patients at high risk for the development of neuromuscular acquired weakness (ICUAW). |
Ultrasound methods and measurement sites of the quadriceps muscles from all protocols were equally effective in detecting muscle changes. During the first week of an ICU stay, two groups were identified: patients with decreased muscle mass on ultrasound (n = 42) and a cohort with enlargement (n = 23). Hospital mortality was significantly increased in the cohort with muscle swelling (8 (19%) versus 12 (52%), p = .013). |
4 |
| 143. López Jiménez E, Neira Álvarez M, Menéndez Colino R, et al. Muscle mass loss measured with portable ultrasound in hospitalized older adults: The ECOSARC study. J Nutr Health Aging. 2024 Jan;28(1):S1279-7707(23)01270-8. |
Observational-Dx |
143 |
To analyze the evolution of muscle of the Quadriceps Rectus Femoris (QRF) between admission and discharge, in older adults hospitalized with an acute medical disease in Acute Geriatric Units (AGUs). |
From the complete sample (n = 143), in 45 (31.5%) participants, ultrasound images were classified as non-valid by an expert radiologist. Mean age was 87.8 (SD 5.4). Mean hospital stay 7.6 days (SD 4.3). From those with valid images, 36 (49.3%), 2 (2.7%), and 35 (47.9%) presented a decrease, equal values, or an increase in QRF area from baseline to discharge, respectively, and 37 (50.0%), 2 (2.7%), and 35 (47.3%) presented a decrease, equal values, or an increase in QRF thickness, respectively. 26 (35.6%) presented a decrease in more than 0.2 cm2 of QRF area, and 23 (31.1%) a decrease in more than 0.1 cm of QRF thickness. Only 4 (5.4%) patients presented new edema, while 13 (17.6%) worsened echogenicity. |
3 |
| 144. Akazawa N, Harada K, Okawa N, Kishi M, Tamura K, Moriyama H. Changes in Quadriceps Thickness and Echo Intensity in Chronic Stroke Survivors: A 3-Year Longitudinal Study. J Stroke Cerebrovasc Dis. 2021 Mar;30(3):S1052-3057(20)30961-7. |
Review/Other-Dx |
34 |
To examine longitudinal changes in quadriceps muscle mass and intramuscular adipose tissue in chronic stroke survivors. |
No significant differences in any characteristics were observed between the flow-up and lost follow-up groups. In the follow-up group, there was a significant decrease in quadriceps thickness on the paretic (10.3% decrease) and non-paretic (17.0% decrease) sides at follow-up after 3 years compared with baseline. There was a significant increase in quadriceps echo intensity on the paretic (20.0% increase) and non-paretic (24.9% increase) sides at follow-up after 3 years compared with baseline. There were significant positive relationships between changes in body weight and changes in quadriceps thickness on the paretic and non-paretic sides. Chronic stroke survivors with greater reductions in body weight showed a trend towards a greater decrease in quadriceps thickness on the paretic and non-paretic sides. |
4 |
| 145. Monjo H, Fukumoto Y, Asai T, et al. Changes in Muscle Thickness and Echo Intensity in Chronic Stroke Survivors: A 2-Year Longitudinal Study. J Clin Neurol. 2022 May;18(3):308-314. |
Review/Other-Dx |
15 |
To identify 2-year longitudinal changes in the muscle thickness (MT) and echo intensity (EI) of the abdominal, thigh, and lower limb muscles in chronic stroke survivors. |
After 2 years, the VL on the paretic side showed a significant decrease in MT (p=0.031) and increase in EI (p=0.002), whereas the RF on the nonparetic side showed a significant decrease in EI (p=0.046). Correlation coefficient analyses showed that changes in MT (r=0.668, p=0.012) and EI (r=0.597, p=0.018) of the VL on the paretic side were significantly associated with a change in the body mass index. |
4 |
| 146. Loosen SH, van den Bosch V, Gorgulho J, et al. Progressive Sarcopenia Correlates with Poor Response and Outcome to Immune Checkpoint Inhibitor Therapy. Clin. Med.. 10(7), 2021 Mar 25. |
Review/Other-Dx |
88 patients |
To evaluate skeletal muscle composition as a novel prognostic marker in patients undergoing ICI therapy for solid malignancies. |
While baseline L3SMI and MMA values were unsuitable for predicting the individual response and outcome to ICI therapy, longitudinal changes of the L3SMI and MMA (?L3SMI, ?MMA) during ICI therapy turned out to be a relevant marker of therapy response and overall survival. Patients who responded to ICI therapy at three months had a significantly higher ?L3SMI compared to non-responders (-3.20 mm2/cm vs. 1.73 mm2/cm, p = 0.002). Moreover, overall survival (OS) was significantly lower in patients who had a strongly decreasing ?L3SMI (<-6.18 mm2/cm) or a strongly decreasing ?MMA (<-0.4 mm2/cm) during the first three month of ICI therapy. Median OS was only 127 days in patients with a ?L3SMI of below -6.18 mm2/cm, compared to 547 days in patients with only mildly decreasing or even increasing ?L3SMI values (p < 0.001). |
4 |
| 147. Brown JC, Caan BJ, Meyerhardt JA, et al. The deterioration of muscle mass and radiodensity is prognostic of poor survival in stage I-III colorectal cancer: a population-based cohort study (C-SCANS). J Cachexia Sarcopenia Muscle. 9(4):664-672, 2018 08. |
Observational-Dx |
1924 patients |
To explore the relationship between muscle wasting and mortality in a large population-based study of patients with non-metastatic colorectal cancer (CRC). |
The hazard ratio for all-cause mortality among patients with the largest deterioration in muscle mass (=2 SD; =11.4% loss from baseline), as compared with those who remained stable (±1 SD; 0.0 ± 5.7%) was 2.15 [95% confidence interval (CI): 1.59-2.92; P < 0.001]. The hazard ratio for all-cause mortality among patients who experienced the largest deterioration in muscle radiodensity (=2 SD; =20.2% loss from baseline), as compared with those who remained stable (±1 SD; 0.0 ± 10.1%) was 1.61 (95% CI: 1.20-2.15; P = 0.002). |
3 |
| 148. Hopkins JJ, Reif R, Bigam D, Baracos VE, Eurich DT, Sawyer MM. Change in Skeletal Muscle Following Resection of Stage I-III Colorectal Cancer is Predictive of Poor Survival: A Cohort Study. World Journal of Surgery. 43(10):2518-2526, 2019 10.World J Surg. 43(10):2518-2526, 2019 10. |
Review/Other-Dx |
667 patients |
To quantify sarcopenia and skeletal muscle loss from time of diagnosis to end of surveillance and determine its effect on survival outcomes after completion of 2 years of surveillance. |
Of 667 patients included, median survival from surgery was 7.96 years, with 75 recurrences occurring after 2 years. On average patients lost muscle mass (-0.415%/year; CI -0.789, -0.042) and radiodensity (-5.76 HU/year; CI -6.74, -4.80), but gained total adipose tissue (7.06%/year; CI 4.34, 9.79). Patients with sarcopenia at diagnosis (HR 1.80; CI 1.13, 2.85) or muscle loss over time (HR 1.55; CI 1.01, 2.37) had worse overall survival, with significantly worse joint effect (HR 2.73; CI 1.32, 5.65). |
4 |
| 149. Kurk SA, Peeters PHM, Dorresteijn B, et al. Loss of skeletal muscle index and survival in patients with metastatic colorectal cancer: Secondary analysis of the phase 3 CAIRO3 trial. Cancer Med. 9(3):1033-1043, 2020 02. |
Review/Other-Dx |
557 patients |
Low skeletal muscle index (SMI) in metastatic colorectal cancer (mCRC) patients is associated with poor outcomes. |
This analysis included 450 of the 557 patients randomized in the CAIRO3 study. Mean SMI decreased during p1: mean -0.6 SMI units [95% CI -1.07;-0.26] and p3: -2.2 units [-2.7;-1.8], whereas during p2, SMI increased + 1.2 units [0.8-1.6]. BMI changes did not reflect changes in SMI. SMI loss during p2 and p3 was significantly associated with shorter survival (HR 1.19 [1.09-1.35]; 1.54 [1.31-1.79], respectively). Sarcopenia at PD1 was significantly associated with early PD2 (HR 1.40 [1.10-1.70]). BMI loss independent of SMI loss was only associated with shorter overall survival during p3 (HR 1.35 [1.14-1.63]). |
4 |
| 150. Lee J, Lin JB, Wu MH, et al. Muscle radiodensity loss during cancer therapy is predictive for poor survival in advanced endometrial cancer. J Cachexia Sarcopenia Muscle. 2019 Aug;10(4):814-826. |
Observational-Dx |
131 patients |
To investigate the association between body composition changes during staging surgery and adjuvant chemoradiotherapy and outcomes in patients with stage III endometrial cancer. |
The median follow-up was 50.6 (range 12.1-117.0) months. Overall, body mass index (BMI) changes during treatment were 0.4% per 210 days (95% confidence interval: -0.6 to 1.4; P = 0.41), and patients experienced an average SMD loss of 2.1% per 210 days (95% confidence interval: -4.0 to -0.2; P = 0.03). Weight loss and SMD loss =5% were observed in 23 (17.6%) and 54 (41.2%) patients, respectively. The changes in SMD did not correlate with those in BMI (Spearman's ? for SMD, -0.13; P = 0.13). SMD change (per 1 Hounsfield unit/210 days decrease) was independently associated with poorer overall survival (hazard ratio: 1.32, 95% confidence interval: 1.14-1.52; P < 0.001) and progression-free survival (hazard ratio: 1.28, 95% confidence interval: 1.12-1.43; P < 0.001). Our results did not show association between survival and pretreatment myosteatosis and sarcopenia or changes in SMI and total adipose tissue index during treatment. The pretreatment skeletal muscle gauge was associated with treatment modifications such as delays, dose reductions, and discontinuation of chemotherapy. |
3 |
| 151. Cox MC, Booth M, Ghita G, et al. The impact of sarcopenia and acute muscle mass loss on long-term outcomes in critically ill patients with intra-abdominal sepsis. J Cachexia Sarcopenia Muscle. 2021 Oct;12(5):1203-1213. |
Observational-Dx |
47 sepsis patients |
To examine whether patients with sarcopenia at baseline would be subject to high sepsis-associated inpatient mortality.To examine whether among sepsis survivors, those with persistent acute muscle wasting would have poor functional status at 1 year. |
Among 47 sepsis patients enrolled (mean age 53 ± 14 years), half (n = 23; 49%) were sarcopenic at baseline. Overall, sepsis patients exhibited acute and persistent muscle wasting with an average 8% decrease in SMI from baseline at 3 months (P = 0.0008). Sarcopenic (SAR) and non-sarcopenic (NSAR) groups were similar in regards to age and comorbidity burden. SAR patients had greater acute physiologic derangement (APACHE II, 18 vs. 12.5), higher incidence of multiple organ failure (57% vs. 17%), longer hospital (21 vs. 12 days) and intensive care unit length of stays (13 vs. 4 days), and higher inpatient mortality (17% vs. 0%; all P < 0.05). Pre-existing SAR was a strong independent predictor of early death or developing chronic critical illness (odds ratio 11.87, 95% confidence interval CI 1.88-74.9; P = 0.009, area under the curve 0.880) and was associated with significantly higher risk of 1-year mortality (34.9% vs. 4.2%, p = 0.007). Lower baseline SMI was also predictive of poor functional status at 12 months (OR 0.89, 95% confidence interval 0.80-0.99; p = 0.039, area under the curve 0.867). Additionally, SAR patients had AMW with persistent muscle mass loss at 3 months that was associated with decreased health-related quality of life and SF-36 physical function domains (P < 0.05). Persistent AMW at 3 months was not predictive of mortality or poor functional status, with return to near-baseline muscle mass among sepsis survivors by 6 months. |
3 |
| 152. Lee MW, Jeon SK, Paik WH, et al. Prognostic value of initial and longitudinal changes in body composition in metastatic pancreatic cancer. J Cachexia Sarcopenia Muscle. 2024 Apr;15(2):735-745. |
Observational-Tx |
456 patients with metastatic pancreatic cancer who received palliative chemotherapy |
To analyse the association between body composition changes after chemotherapy and survival in patients with metastatic pancreatic cancer. |
A total of 452 deaths occurred during follow-up in the entire cohort. The survival rate was 49.3% (95% confidence interval [CI], 44.9-54.2) at 1 year and 3.7% (95% CI, 2.0-6.8) at 5 years. In multivariable analysis, higher MA (=44.4 HU in males and =34.8 HU in females) at initial CT was significantly associated with better OS in both males and females (adjusted hazard ratio [HR], 0.706; 95% CI, 0.538-0.925; P = 0.012 for males, and HR, 0.656; 95% CI, 0.475-0.906; P = 0.010 for females), whereas higher SATI (=42.8 cm2/m2 in males and =65.8 cm2/m2 in females) was significantly associated with better OS in female patients only (adjusted HR, 0.568; 95% CI, 0.388-0.830; P = 0.003). In longitudinal analysis, SMI, VATI and SATI significantly decreased between initial and 2-month follow-up CT, whereas mean MA significantly decreased between 2- and 6-month follow-up CT. In multivariable Cox regression analysis of longitudinal changes, which was stratified by disease control state, SATI change was significantly associated with OS in male patients (adjusted HR, 0.513; 95% CI, 0.354-0.745; P < 0.001), while other body composition parameters were not. |
2 |
| 153. Deng CY, Lin YC, Wu JS, et al. Progressive Sarcopenia in Patients With Colorectal Cancer Predicts Survival. AJR Am J Roentgenol. 2018 Mar;210(3):526-532. |
Observational-Tx |
101 patients |
To evaluate the relationship between sarcopenia and overall and progression-free survival in patients with colorectal cancer. |
A total of 101 patients were included (mean age ± SD, 63.7 ± 13.7 years; 68 men, 33 women). The hazard ratios for overall survival were 2.27, 1.68, and 1.54 for changes in SMI of the psoas muscle, paraspinal muscle, and total muscle (all p < 0.05). The hazard ratios for overall survival were 1.14, 1.18, and 1.24 for changes in attenuation of the psoas muscle, paraspinal muscle, and total muscle, respectively (all p < 0.05). The hazard ratios for progression-free survival were 1.33, 1.41, and 1.23 for changes in SMI of the psoas muscle, paraspinal muscle, and total muscle (not statistically significant). The hazard ratios for progression-free survival were 1.10, 1.21, and 1.23 for changes in attenuation of the psoas muscle, paraspinal muscle, and total muscle, respectively (p < 0.05). Kaplan-Meier analysis showed significant differences in overall and progression-free survival based on sex-specific quartiles of muscle quantity and quality. |
2 |
| 154. Kuboi R, Tsubokawa N, Kamigaichi A, et al. Impact of pectoralis major muscle mass decrease after lobectomy on the prognosis of lung cancer. Jpn J Clin Oncol. 2025 Aug 03;55(8):941-946. |
Observational-Tx |
460 patients with pathological stage I-II non-small cell lung cancer who underwent lobectomy |
To investigate the impact of a postoperative decrease in pectoralis major muscle mass on long-term outcomes. |
The group showing a decrease in muscle mass (n = 126) exhibited a higher incidence of chronic obstructive pulmonary disease than the group showing no decrease in muscle mass (n = 334). The median rate of change in the muscle mass of the pectoralis major was 1.00. The median follow-up period was 42.8 months. Overall survival was significantly lower in the group showing a decrease in muscle mass than in the group showing no decrease in muscle mass (P < .001). Multivariable Cox regression analysis revealed that a decrease in pectoralis major muscle mass after surgery was an independent prognostic factor for overall survival (hazard ratio, 1.05; 95% confidence interval, 1.03-1.06; P < .001). |
2 |
| 155. Lee J, Kim EY, Kim E, et al. Longitudinal changes in skeletal muscle mass in patients with advanced squamous cell lung cancer. Thorac Cancer. 2021 Jun;12(11):1662-1667. |
Observational-Tx |
70 consecutive patients who underwent palliative chemotherapy for SQCLC |
To analyze the longitudinal changes in skeletal muscle area with follow-up computed tomography (CT) examinations from the time of diagnosis until the end of life in patients with advanced advanced squamous cell lung cancer (SQCLC). |
The median age was 69 years; 62 patients (89%) had metastatic disease at the time of initial diagnosis. Sarcopenia was present in 58 patients (82.9%) at baseline; all patients experienced net muscle loss over the disease trajectory. The median overall survival was 8.7 (95% confidence interval 5.9-11.5) months. The mean percentage loss of skeletal muscle between the first and last CT was 16.5 ± 11.0%. Skeletal muscle loss accelerated over time and was the highest in the last 3 months of life (p < 0.001). Patients losing skeletal muscle rapidly (upper tertile, >3.24 cm2 /month) had shorter overall survival than patients losing skeletal muscle slowly (median, 5.7 vs. 12.0 months, p < 0.001). |
3 |
| 156. Mason SE, Moreta-Martinez R, Labaki WW, et al. Longitudinal Association Between Muscle Loss and Mortality in Ever Smokers. Chest. 2022 Apr;161(4):S0012-3692(21)04290-2. |
Observational-Dx |
Participants with complete data for at least one visit in the
COPDGene study (n = 9,268) and the ECLIPSE study (n = 1,760) |
To investigate whether longitudinal loss of fat-free mass (FFM) is associated with increased mortality, including in those with initially normal or elevated body composition metrics. |
Both cohorts demonstrated a left-shifted distribution of baseline FFM, not reflected in BMI, and an increase in all-cause mortality risk associated with longitudinal loss of PMA. For each 1-cm2 PMA loss, mortality increased 3.1% (95% CI, 2.4%-3.7%; P < .001) in COPDGene, and 2.4% (95% CI, 0.9%-4.0%; P < .001) in ECLIPSE. Increased mortality risk was independent of enrollment values for BMI and disease severity [BODE (body mass, airflow obstruction, dyspnea, and exercise capacity) index quartiles] and was significant even in participants with initially greater than average PMA. |
3 |
| 157. Pishgar F, Shabani M, Quinaglia A C Silva T, et al. Quantitative Analysis of Adipose Depots by Using Chest CT and Associations with All-Cause Mortality in Chronic Obstructive Pulmonary Disease: Longitudinal Analysis from MESArthritis Ancillary Study. Radiology. 2021 Jun;299(3):703-711. |
Review/Other-Dx |
2994 participants |
To investigate associations between soft-tissue markers subcutaneous adipose tissue (SAT), intermuscular adipose tissue (IMAT), and pectoralis muscle (PM) index from chest CT with mortality in participants with COPD. |
Among 2994 participants who were included (mean age, 69 years ± 9 [standard deviation]; 1551 women), 265 had COPD (9%; mean age, 72 years ± 9; 162 men) and 49 participants with COPD (18%) died during follow-up. The SAT, IMAT, and PM areas had moderate-to-excellent reliabilities (intraclass correlation coefficient, 0.88-0.99). In the 2994 participants, the SAT (? = 0.80; 95% CI: 0.78, 0.81; P < .001) and IMAT indexes (? = 0.37; 95% CI: 0.34, 0.41; P < .001) were correlated with fat mass index. Those with COPD and higher SAT index had lower risks of mortality (hazard ratio, 0.2; 95% CI: 0.1, 0.4; P < .001, per doubling), whereas a higher IMAT index was associated with a higher risk of mortality (hazard ratio, 1.4; 95% CI: 1.0, 1.9; P = .04, per doubling). |
4 |
| 158. Nicholson JM, Orsso CE, Nourouzpour S, et al. Computed tomography-based body composition measures in COPD and their association with clinical outcomes: A systematic review. Chron Respir Dis. 2022;19():14799731221133387. |
Review/Other-Dx |
28 articles (15,431 COPD patients) |
To describe the CT-methodology used to assess body composition and identify the association of body composition measures and disease severity, health-related quality of life (HRQL), cardiometabolic risk factors, respiratory exacerbations, and survival in patients with COPD. |
Twenty eight articles were included with 15,431 COPD patients, across all GOLD stages with 77% males, age range (mean/median 59-78 years), and BMI range 19.8-29.3 kg/m2. There was heterogeneity in assessment of muscle mass and adiposity using thoracic (n = 22) and abdominal (n = 8) CT-scans, capturing different muscle groups, anatomic locations, and adiposity compartments (visceral, subcutaneous, and epicardial). Low muscle mass and increased adiposity were associated with increased COPD severity measures (lung function, exercise capacity, dyspnea) and lower HRQL, but were not consistent across studies. Increased visceral adiposity (n = 6) was associated with cardiovascular disease or risk factors (hypertension, hyperlipidemia, and diabetes). Low muscle CSA was prognostic of respiratory exacerbations or mortality in three of six studies, whereas the relationship with increased intermuscular adiposity and greater mortality was only observed in one of three studies. |
4 |
| 159. Jiang M, Hua X, Wu M, et al. Longitudinal changes in sarcopenia was associated with survival among cirrhotic patients. Front Nutr. 2024;11():1375994. |
Review/Other-Dx |
307 adult patients with clinically diagnosed liver cirrhosis who underwent at least 2 abdominal CT scans in the hospital |
To perform a longitudinal analysis to evaluate the impact of changes in sarcopenia for cirrhotic patients. |
A total of 307 patients were included for analysis. At the second assessment, 10.10% (31/307) patients were new-onset sarcopenia, 27.69% (85/307) with persistent sarcopenia status, while 13.03% (40/307) patients with sarcopenia developed non-sarcopenia and 49.19% (151/307) with persistent non-sarcopenia status. The overall survival rate was significantly lower in the persistent sarcopenia and new-onset sarcopenia than in the non-sarcopenia group and sarcopenia to non-sarcopenia group (p < 0.001). Persistent sarcopenia (HR 5.799, 95%CI 1.563-21.521, p = 0.009) and new onset sarcopenia (HR 5.205, 95%CI 1.482-18.282, p = 0.010) were identified as poor prognostic factors for cirrhotic patients. The etiology of cirrhosis and the initial skeletal muscle mass were independent risk factors for new-onset sarcopenia. |
4 |
| 160. Nishikawa H, Shiraki M, Hiramatsu A, Moriya K, Hino K, Nishiguchi S. Japan Society of Hepatology guidelines for sarcopenia in liver disease (1st edition): Recommendation from the working group for creation of sarcopenia assessment criteria. Hepatol Res. 2016 Sep;46(10):951-63. |
Review/Other-Dx |
N/A |
To summarize the current knowledge with regard to sarcopenia and present the assessment criteria for sarcopenia in liver disease proposed by the JSH (1st edition). |
No results in abstract. |
4 |
| 161. Albano D, Dondi F, Treglia G, et al. Longitudinal Body Composition Changes Detected by [18F]FDG PET/CT during and after Chemotherapy and Their Prognostic Role in Elderly Hodgkin Lymphoma. Cancers (Basel). 2022 Oct 20;14(20):5147. |
Review/Other-Dx |
58 patients |
To investigate the longitudinal body changes in terms of muscle and adipose areas and their prognostic role in elderly (>65 years) patients affected by Hodgkin lymphoma (HL). |
Fifty-eight (66%) patients had sarcopenia at baseline and sarcopenia rate increased at interim scan with 68 (77%) cases and at end-of-treatment scan with 73 (83%) cases. Muscular areas (SMA and SMI) declined significantly during the treatment (p < 0.001), decreasing from baseline by 5% and 7% at interim and end-of-treatment evaluation, respectively. Instead, VAT, SAT, IMAT, and TAT increased significantly over this time (p < 0.001). |
4 |
| 162. Kang H, Kim I, Park H, Ahn W, Kim SK, Lee S. Prognostic value of body composition measures in breast cancer patients treated with chemotherapy. Sci Rep. 2024 Oct 07;14(1):23309. |
Observational-Tx |
85 breast cancer patients who underwent surgery and chemotherapy |
To evaluate the predictive value of body composition measures for mortality, recurrence, and chemotherapy-induced neutropenia in patients with breast cancer following surgery and chemotherapy. |
Longitudinal analysis revealed a decrease in muscle mass (P < 0.001 for both SMA and SMI) and nonsignificant changes in fat mass (P = 0.449 for SAT and P = 0.798 for VAT). A lower SMI at diagnosis was significantly associated with increased mortality (P = 0.019) and a higher incidence of grade 4 neutropenia (P = 0.008). There was no significant association between SMI at diagnosis and recurrence (P = 0.691). No associations were found between body composition measurements during the follow-up period and the clinical outcomes. Lower skeletal muscle mass at diagnosis is strongly associated with higher mortality and chemotherapy-induced complications in patients with breast cancer, highlighting the potential of readily available imaging techniques as valuable predictors of clinical outcomes. |
2 |
