A comparison of CT based measures of skeletal muscle mass and density from the Th4 and L3 levels in patients with advanced non-small-cell lung cancer
A comparison of CT based measures of skeletal muscle mass and density from the Th4 and L3 levels in patients with advanced non-small-cell lung cancer
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DOI：
10.1038/s41430-018-0325-5
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发表时间：
2019-07-01
影响因子：
4.7
通讯作者：
Jordhoy, Marit
中科院分区：
文献类型：
--
作者：
Gronberg, Bjorn H.;Sjoblom, Bjorg;Jordhoy, Marit
背景：从L3水平的CT图像评估的肌肉质量和密度是癌症患者生存的预后和预测毒性。然而，L3并不总是包括在常规CT扫描中。我们的目的是调查是否在Th 4水平的图像可以使用instead.Methods：从三个化疗试验中晚期NSCLC患者有资格（n = 1305）。从基线CT扫描评估Th 4和L3水平的骨骼肌面积（cm（2））、骨骼肌指数（SMI，cm（2）/m2）和骨骼肌密度（SMD）。将Th 4和L3水平的SMI和SMD转换为z评分，通过Bland-Altman图研究评分之间的一致性，并通过类内相关分析进行估计。线性回归被用来测试，如果Th 4 SMI和SMD Z-分数预测L3 SMI和SMD Z-scores.Results：CT图像从401例患者在两个层面上进行分析。Th 4和L3 SMI z评分之间存在中度一致性，男性组内相关性为0.71（95% CI 0.64-0.77），女性组内相关性为0.53（95% CI 0.41-0.63）。根据Th 4 SMI z评分预测L3 SMI z评分的回归模型显示，男性和女性的系数分别为0.71（95% CI 0.62-0.80）和0.53（95% CI 0.40-0.66）。R方分别为0.51和0.28，表明中度一致。一个类似的，中度协议之间的Th 4和L3 SMD Z-scores observed.Conclusion：只有中度协议之间的肌肉措施，从Th 4和L3水平，这表明，从L3水平的缺失数据不能被替换的分析图像在Th 4水平。
Background: Muscle mass and density assessed from CT-images at the L3 level are prognostic for survival and predict toxicity in cancer patients. However, L3 is not always included on routine CT-scans. We aimed to investigate whether images at the Th4 level may be used instead.Methods: Patients from three chemotherapy trials in advanced NSCLC were eligible (n = 1305). Skeletal muscle area (cm(2)), skeletal muscle index (SMI, cm(2)/m(2)) and skeletal muscle density (SMD) at Th4 and L3 levels were assessed from baseline CT-scans. SMI and SMD at the Th4 and L3 level were transformed into z-scores and the agreement between scores was investigated by Bland-Altman plots and estimated by intra-class correlation analyses. Linear regression was used to test if Th4 SMI and SMD z-scores predicted L3 SMI and SMD z-scores.Results: CT-images from 401 patients were analysable at both levels. There was a moderate agreement between Th4 and L3 SMI z-scores with an intra-class correlation of 0.71 (95% CI 0.64-0.77) for men and 0.53 (95% CI 0.41-0.63) for women. Regression models predicting L3 SMI z-scores from Th4 SMI z-scores showed coefficients of 0.71 (95% CI 0.62-0.80) among men and 0.53 (95% CI 0.40-0.66) among women. R-squares were 0.51 and 0.28, respectively, indicating moderate agreement. A similar, moderate agreement between Th4 and L3 SMD z-scores was observed.Conclusion: There was only moderate agreement between muscle measures from Th4 and L3 levels, indicating that missing data from the L3 level cannot be replaced by analysing images at the Th4 level.