Computed tomography-derived assessments of regional muscle volume: Validating their use as predictors of whole body muscle volume in cancer patients
Computed tomography-derived assessments of regional muscle volume: Validating their use as predictors of whole body muscle volume in cancer patients
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DOI：
10.1259/bjr.20180451
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发表时间：
2018-01-01
影响因子：
2.6
通讯作者：
Plodkowski, Andrew J.
中科院分区：
文献类型：
--
作者：
Halpenny, Darragh F.;Goncalves, Marcus;Plodkowski, Andrew J.
目的：评估CT衍生的区域骨骼肌体积（SMV）测量的准确性，以预测全身SMV在patients with melanoma.Methods：148例晚期黑色素瘤患者接受全身正电子发射断层扫描/CT进行了研究。在CT上测量全身SMV并用作参考标准。在胸部、腹部、骨盆和下肢获得SMV的CT衍生区域测量值。在发现队列（n-98）上开发模型，使用线性回归将全身SMV建模为每个区域测量值和临床因素的函数。通过估计每个模型的解释变异（R-2），在验证队列（n = 50）中评估衍生模型的预测性能。结果：在发现队列中，所有区域SMV测量值与全身SMV显著相关[β 1范围：0.673-1.153，所有p < 0.001]。骨盆区域测量的相关性最大{p = 1.153，[95%置信区间（0.989，1.317）]}。开发了结合临床变量和区域SMV的预测算法，以根据区域评估估计全身SMV。使用验证队列预测全身SMV，骨盆、腹部和胸部区域测量的R-2值分别为0.89，0.86，0.78。结论：SMV的区域测量是晚期黑色素瘤患者全身SMV的强预测因子。第一项利用全身成像作为参考标准的研究，验证了局部SMV在癌症患者中的使用，包括验证在传统评估区域之外使用区域SMV。
Objective: Evaluate the accuracy of CT-derived regional skeletal muscle volume (SMV) measurements to predict whole body SMV in patients with melanoma.Methods: 148 patients with advanced melanoma who underwent whole body positron emission tomography/CT were studied. Whole body SMV was measured on CT and used as the reference standard. CT-derived regional measures of SMV were obtained in the thorax, abdomen, pelvis, and lower limbs. Models were developed on a discovery cohort (n-98), using linear regression to model whole body SMV as a function of each regional measure, and clinical factors. Predictive performance of the derived models was evaluated in a validation cohort (n = 50) by estimating the explained variation (R-2) of each model.Results: In the discovery cohort, all regional SMV measurements were significantly associated with whole body SMV [beta 1 range: 0.673-1.153, all p < 0.001]. The magnitude of association was greatest for pelvic regional measurements {p = 1.153, [95% confidence interval (0.989,1.317)]}. Prediction algorithms incorporating clinical variables and regional SMVs were developed to estimate whole body SMV from regional assessments. Using the validation cohort to predict whole body SMV, the R-2 values for the pelvic, abdominal and thoracic regional measurements were 0.89, 0.86, 0.78.Conclusion: Regional measures of SMV are strong predictors of whole body SMV in patients with advanced melanoma.Advances in knowledge: The first study utilizing whole body imaging as a reference standard validating the use of regional SMVs in cancer patients, including validating the use of regional SMVs outside of traditionally assessed areas.