Analysis of computer tomographic image: skeleto-muscle index as a criterion of sarcopenia in patients with patients with patients
DOI:
https://doi.org/10.15587/2519-4798.2019.155668Keywords:
pancreatic cancer, sarcopenia, computed tomography, skeletal muscle index, somatotypeAbstract
Aim of the study. The study of the possibility and informativeness of the detection of sarcopenia in a patient with pancreatic cancer (PC) by post-processing obtained using computed tomography (CT) images.
Materials and methods. A total of 108 patients with obstructive jaundice syndrome (probably of tumor etiology, and later diagnosed with pancreas cancer) were studied using the «Activion 16» spiral tomograph (Toshiba Medical Systems Corporation) according to a common protocol. The control group consisted of 60 patients aged from 22 to 74 years. We determined sarcopenia criteria on CT images: musculoskeletal L3 index (MSI) as the ratio of the area indicator of skeletal muscle in the body to the level L3 square growth patient. The somatotype index (SI) was determined by the formula: SI = BL x 100 / TSCH, where BL is the body length, TSCH is the transverse size of the chest, measurement in centimeters.
Results. Based on media values at the L3 level, sarcopenia was generally detected in 85.18 % of patients with pancreas cancer. Sarcopenia was observed in 100 % of patients with a dolichomorphic type, in 87.8 % of patients with a mesomorphic type, and in 65.5 % of patients with a brachiomorphic type of somatotype. Sarcopenia based on SMI at the L3 level is set in 85.2 % of patients with pancreas cancer: 47.8±4.3 cm² / m² for men, 36.2±4.1 cm² / m² for women, 58.4±3 6 cm² / m² and 44.2±3.5 cm² / m² for conditionally healthy men and women, respectively (p<0.01). The reliable differences of SMI according to gender were established in conditionally healthy men and women suffering from pancreatic cancer with inaccurate differences in BMI. In patients, the statistically significant difference of SMI (p = 0.001), corresponds to the various distribution of fatty mass in the body structure, was accompanied by statistical misleading differences in BMI.
Findings. CT as a standard method of diagnosis of pancreatic cancer and inflammatory diseases of the pancreas by calculating the SMI allows evaluating the degree of sarcopenia. SMI is more informative and personalized indicators to assess body composition than the standard used BMI as CT allows differentiation of muscle and fat components in the composition of the human body and to quantify
References
- Cancer in Ukraine, 2014–2015 (2017). Bulletin of the National Chancellery-the Register of Ukraine No. 16. Kyiv, 173.
- Dewys, W. D., Begg, C., Lavin, P. T., Band, P. R., Bennett, J. M., Bertino, J. R. et. al. (1980). Prognostic effect of weight loss prior tochemotherapy in cancer patients. The American Journal of Medicine, 69 (4), 491–497. doi: http://doi.org/10.1016/s0149-2918(05)80001-3
- Tisdale, M. J. (2009). Mechanisms of Cancer Cachexia. Physiological Reviews, 89 (2), 381–410. doi: http://doi.org/10.1152/physrev.00016.2008
- Anker, S. D., Morley, J. E., von Haehling, S. (2016). Welcome to the ICD-10 code for sarcopenia. Journal of Cachexia, Sarcopenia and Muscle, 7 (5), 512–514. doi: http://doi.org/10.1002/jcsm.12147
- Lyadov, V. K., Bulanova, E. A., Seryakov, A. P. (2012). Sarcophenia as a leading component of cancerous cachexia syndrome. Russian Journal of Gastroenterology, Hepatology, Coloproctology, 1, 4–8.
- Muscaritoli, M., Lucia, S., Molfino, A. (2013). Sarcopenia in critically ill patients: the new pandemic. Minerva Anestesiologica, 79 (7), 717.
- Kamimoto, L. A., Easton, A. N., Maurice, E., Husten, C. G., Macera, C. A. (1999). Surveillance for Five Health Risks Among Older Adults – United States, 1993–1997. CDC MMWR Surveillance Summaries, 48, 89–130.
- Fearon, K., Strasser, F., Anker, S. D., Bosaeus, I., Bruera, E., Fainsinger, R. L. et. al. (2011). Definition and classification of cancer cachexia: an international consensus. The Lancet Oncology, 12 (5), 489–495. doi: http://doi.org/10.1016/s1470-2045(10)70218-7
- Kolotyolov, N. N. (2012). Water – a new point of view on the subject of radiation diagnostics. Radiation diagnostics, radiation therapy, 1, 63–69.
- Morley, J. E., Thomas, D. R., Wilson, M.-M. G. (2006). Cachexia: pathophysiology and clinical relevance. The American Journal of Clinical Nutrition, 83 (4), 735–743. doi: http://doi.org/10.1093/ajcn/83.4.735
- Kolotilov, N. N. (2017). Intellectualization of the organs' morphometry: golden section. Radiation Diagnostics, Radiation Therapy, 4, 80–82.
- Gordienko, K. P. (2004). Possibilities of X-ray computer and magnetic resonance imaging in differential diagnosis of pancreatic tumors. Radiation diagnostics, radiation therapy, 4, 38–42.
- Rosenfeld, L. G., Makomela, N. M., Sinitsky, S. I., Kolotilov, N. N., Ogir, A. S. (2006). Possibilities of post-processing of diagnostic CT and MRI images on a personal computer. Ukrainian medical journal, 6, 69–73.
- Ternovaya, K. S., Rosenfeld, L. G., Kolotyolov, N. N. (1990). Principles for solving medical problems. Kyiv: Science thought, 220.
- Nikolayev, V. G., Nikolaev, N. N., Sindeeva, L. V. et. al. (2007). Anthropological examination in clinical practice. Krasnoyarsk: Verso, 172.
- Baracos, V. E., Reiman, T., Mourtzakis, M., Gioulbasanis, I., Antoun, S. (2010). Body composition in patients with non−small cell lung cancer: a contemporary view of cancer cachexia with the use of computed tomography image analysis. The American Journal of Clinical Nutrition, 91 (4), 1133S–1137S. doi: http://doi.org/10.3945/ajcn.2010.28608c
- Prado, C. M., Lieffers, J. R., McCargar, L. J., Reiman, T., Sawyer, M. B., Martin, L., Baracos, V. E. (2008). Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. The Lancet Oncology, 9 (7), 629–635. doi: http://doi.org/10.1016/s1470-2045(08)70153-0
- Tan, B. H. L., Birdsell, L. A., Martin, L., Baracos, V. E., Fearon, K. C. H. (2009). Sarcopenia in an Overweight or Obese Patient Is an Adverse Prognostic Factor in Pancreatic Cancer. Clinical Cancer Research, 15 (22), 6973–6979. doi: http://doi.org/10.1158/1078-0432.ccr-09-1525
- Petri, A., Sabin, K.; Leonova, V. P. (Ed.) (2015). Visual medical statistics. Moscow: GEOTAR-MEDIA, 216.
- Lyadov, V. K., Bulanova, E. A., Sinitsyn, V. E. (2012). Possibilities of CT in detecting sarcopenia in patients with tumorous and inflammatory diseases of the pancreas. Diagnostic and Interventional Radiology, 1, 13–18.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 Liubov Zabudska, Elena Kolesnik
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.