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Cross sectional imaging of truncal and quadriceps muscles relates to different functional outcomes in cancer

Mac Donald, Alisdair J and Miller, Janice and Ramage, Michael I and Greig, Carolyn and Stephans, Nathan A and Jacobi, Carsten and Preston, Thomas and Fearon, Kenneth CH and Skipworth, Richard JE (2018) Cross sectional imaging of truncal and quadriceps muscles relates to different functional outcomes in cancer. Clinical nutrition.. ISSN 1878-3368; 1744-1161

Abstract

Abstract: Introduction
Following the consensus definition of cancer cachexia, more studies are
using CT scan analysis of truncal muscles as a marker of muscle wasting.
However, how CT-derived body composition relates to function, strength
and power in patients with cancer is largely unknown.
Aims
We aimed to describe the relationship between CT truncal (L3) skeletal
muscle index (SMI) and MRI quadriceps cross sectional area with lower
limb strength, power and measures of complex function.
Methods
Patients undergoing assessment for potentially curative surgery for
oesophagogastric or pancreatic cancer were recruited from the regional
upper GI or HPB multi-disciplinary team meetings. Maximum Isometric Knee
Extensor Strength (IKES) and Maximum Leg Extensor Power (Nottingham Power
Rig) (LEP) were used as measures of lower limb performance. Both Sit to
Stand (STS) and Timed Up and Go (TUG) were used as measures of global
complex muscle function. Muscle SMI was measured from routine CT scans at
the level of the third lumbar vertebrae (L3) and MRI scan was used for
the assessment of quadriceps muscles. Linear regression analysis was
performed for CT SMI or MRI quadriceps as a predictor of each measure of
performance.
Results
Forty-four patients underwent assessment. Height and weight were
significantly related to function in terms of quadriceps power, while
only weight was associated with strength (P<0.001). CT SMI was not
related to measures of quadriceps strength or power but had significant
association with more complex functional measures (P=0.006, R2=0.234 and
0.0019, R2 = 0.175 for STS and TUG respectively). In comparison, both
gross and fat-subtracted measures of quadriceps muscle mass from MRI were
significantly correlated with quadriceps strength and power (P<0.001),
but did not show any significant association with complex functional
measures.
Conclusion
CT SMI and MRI quadriceps have been shown to reflect different aspects of
functional ability with CT SMI being a marker of global muscle function
and MRI quadriceps being specific to quadriceps power and strength. This
should therefore be considered when choosing outcome measures for trials
or definitions of muscle mass and function.

Item Type: Article
Date Deposited: 26 Feb 2019 00:45
Last Modified: 26 Feb 2019 00:45
URI: https://oak.novartis.com/id/eprint/37743

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