Feasibility of using head and neck CT imaging to assess skeletal muscle mass in head and neck cancer patients
Feasibility of using head and neck CT imaging to assess skeletal muscle mass in head and neck cancer patients
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DOI：
10.1016/j.oraloncology.2016.09.006
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发表时间：
2016-11-01
期刊：
影响因子：
4.8
通讯作者：
Grolman, Wilko
中科院分区：
文献类型：
--
作者：
Swartz, Justin E.;Pothen, Ajit J.;Grolman, Wilko
目的：头颈癌患者营养不良和骨质疏松症的风险较高，临床转归不良。由于腹部CT成像经常被用来检测骨质疏松症，这种扫描在HNC患者中很少使用，这可能解释了为什么没有研究调查骨质疏松症在这一人群中的影响。方法：对51例创伤患者和52例HNC患者的头颈部CT扫描和腹部CT扫描结果进行对比分析。头颈部CT扫描显示椎旁肌和胸锁乳突肌。在腹部CT扫描上，所有肌肉都被勾画出来。用线性回归的方法比较C3椎体水平和L3水平的肌肉横截面积(CSA)。结果：经性别和年龄校正后，HNC患者的肌肉CSA显著低于创伤患者(37.9vs.45.1 cm(2)，p<；0.001)。C3肌肉CSA对L3肌肉CSA有较强的预测作用(r=0.785，p<；0.001)。在包括性别、年龄和体重的多变量模型中，这种相关性更强(r=0.891，p<；0.001)。讨论：头颈部CT扫描评估骨骼肌块是可行的，可能是腹部CT成像的替代方法。这种方法可以使用常规扫描来评估骨质疏松症，而不需要额外的成像或额外的患者负担。确定骨痂生成患者可能有助于治疗选择，或选择HNC患者进行物理治疗或营养干预，以改善他们的预后。(C)2016爱思唯尔有限公司。保留所有权利。
Objectives: Patients with head and neck cancer (HNC) have a higher risk of malnutrition and sarcopenia, which is associated with adverse clinical outcome. As abdominal CT-imaging is often used to detect sarcopenia, such scans are rarely available in HNC patients, possibly explaining why no studies investigate the effect of sarcopenia in this population. We correlated skeletal muscle mass assessed on head and neck CT-scans with abdominal CT-imaging.Methods: Head and neck, and abdominal CT-scans of trauma (n = 51) and HNC-patients (n = 52) were retrospectively analyzed. On the head and neck CT-scans, the paravertebral and sternocleidomastoid muscles were delineated. On the abdominal CT-scans, all muscles were delineated. Cross-sectional area (CSA) of the muscles at the level of the C3 vertebra was compared to CSA at the L3 level using linear regression. A multivariate linear regression model was established.Results: HNC-patients had significantly lower muscle CSA than trauma patients (37.9 vs. 45.1 cm(2), p < 0.001, corrected for sex and age). C3 muscle CSA strongly predicted L3 muscle CSA (r = 0.785, p < 0.001). This correlation was stronger in a multivariate model including sex, age and weight (r = 0.891, p < 0.001).Discussion: Assessment of skeletal muscle mass on head and neck CT-scans is feasible and may be an alternative to abdominal CT-imaging. This method allows assessment of sarcopenia using routinely performed scans without additional imaging or additional patient burden. Identifying sarcopenic patients may help in treatment selection, or to select HNC patients for physiotherapeutic or nutritional interventions to improve their outcome. (C) 2016 Elsevier Ltd. All rights reserved.