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评估肾癌患者的身体成分:比较 CT 和 MRI 测量结果。

Quantification of body composition in renal cell carcinoma patients: Comparing computed tomography and magnetic resonance imaging measurements.

机构信息

Department of Urology, Emory University School of Medicine, Atlanta, GA, United States.

Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, United States; Winship Cancer Institute of Emory University, Atlanta, GA, United States.

出版信息

Eur J Radiol. 2020 Nov;132:109307. doi: 10.1016/j.ejrad.2020.109307. Epub 2020 Sep 28.

Abstract

PURPOSE

Body composition measures provide valuable information for prognostication and treatment election in cancer patients. We investigated the novel use of magnetic resonance imaging (MRI) for skeletal muscle and adipose tissue cross-sectional area measurements in preoperative renal cell carcinoma (RCC) patients.

MATERIALS AND METHODS

RCC patients with pre-operative CT and MRI abdominal imaging were identified. Semi-automatic segmentation measurement of skeletal muscle area (SMA), intramuscular fat area (IMFA), visceral fat area (VFA), subcutaneous fat area (SFA), linear measurements of psoas, paraspinal muscles were performed. Pearson correlation coefficients, Bland-Altman plot analyses were done. Multivariable regression analysis examined the relationship between patient characteristics and skeletal muscle.

RESULTS

Image analysis was performed on 58 RCC patients with preoperative CT and MRI imaging. For segmentation measures, r = 0.99, 0.99, 0.99, and 0.98 for SMA, IMFA, VFA, SFA, respectively, and 0.96 for linear measures of skeletal muscle. Bland-Altman analysis revealed a bias toward larger CT value for SMA (1.35 %), linear muscle measures (2.79 %), and SFA (10.34 %), and toward larger MRI values for IMFA (0.75 %) and VFA (5.81 %). ECOG ≥ 1 was associated with lower skeletal muscle than ECOG 0 for all measurements.

CONCLUSIONS

Strong correlation of CT and MRI cross sectional measurements of skeletal muscle and adipose tissues supports the use of axial MRI images for comprehensive measurement of body composition. This has widespread implications for body composition research and cancer patient care.

摘要

目的

体成分测量为癌症患者的预后和治疗选择提供了有价值的信息。我们研究了磁共振成像(MRI)在术前肾细胞癌(RCC)患者骨骼肌和脂肪组织横截面积测量中的新应用。

材料与方法

确定了术前 CT 和 MRI 腹部成像的 RCC 患者。对骨骼肌面积(SMA)、肌内脂肪面积(IMFA)、内脏脂肪面积(VFA)、皮下脂肪面积(SFA)进行半自动分割测量,对腰大肌、椎旁肌肉进行线性测量。进行 Pearson 相关系数、Bland-Altman 图分析。多变量回归分析检查了患者特征与骨骼肌之间的关系。

结果

对 58 例有术前 CT 和 MRI 成像的 RCC 患者进行了图像分析。对于分割测量,SMA、IMFA、VFA 和 SFA 的 r 值分别为 0.99、0.99、0.99 和 0.98,骨骼肌的线性测量为 0.96。Bland-Altman 分析显示 SMA(1.35%)、线性肌肉测量(2.79%)和 SFA(10.34%)的 CT 值存在偏差,IMFA(0.75%)和 VFA(5.81%)的 MRI 值存在偏差。ECOG≥1 的骨骼肌水平低于 ECOG 0,所有测量指标均如此。

结论

CT 和 MRI 骨骼肌和脂肪组织横截面积测量的相关性较强,支持使用轴向 MRI 图像对身体成分进行全面测量。这对身体成分研究和癌症患者护理具有广泛的影响。

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