Highlights
- •AutoMATiCA and manual measurements of body composition are strongly correlated.
- •Overestimation of muscle area by AutoMATiCA can be reliably adjusted for.
- •AutoMATiCA is a reliable tool for the study of sarcopenia in pancreatic cancer.
Abstract
Background
Sarcopenia is associated with complications and inferior oncologic outcomes in solid
tumors. Axial computed tomography (CT) scans can be used to evaluate sarcopenia, however
manual quantification is laborious. We sought to validate an automated method of quantifying
muscle cross-sectional area (CSA) in patients with pancreatic adenocarcinoma (PDAC).
Methods
Mid-L3 CT images from patients with PDAC were analyzed: CSAs of skeletal muscle (SM)
were measured using manual segmentation and the software AutoMATiCA, and then compared
with linear regression.
Results
Five-hundred-twenty-five unique scans were analyzed. There was robust correlation
between manual and automated segmentation for L3 CSA (R2 0.94, P < 0.001). Bland-Altman analysis demonstrated a consistent overestimation of muscle
CSA by AutoMATiCA with a mean difference of 5.7%. A correction factor of 1.06 was
validated using a unique test dataset of 36 patients with non-PDAC peripancreatic
malignancies.
Conclusions
Automated muscle CSA measurement with AutoMATiCA is highly efficient and yields results
highly correlated with manual measurement. These findings support the potential use
of high-throughput sarcopenia analysis with abdominal CT scans for both clinical and
research purposes.
Keywords
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References
- Impact total psoas volume on short- and long-term outcomes in patients undergoing curative resection for pancreatic adenocarcinoma: a new tool to assess sarcopenia.J Gastrointest Surg. 2015 Sep; 19 (PubMed PMID: 25925237. Pubmed Central PMCID: PMC4844366. Epub 2015/05/01. eng): 1593-1602
- Sarcopenia is an independent predictor of complications following pancreatectomy for adenocarcinoma.J Surg Oncol. 2015 May; 111 (PubMed PMID: 25556324. Pubmed Central PMCID: PMC4406850. Epub 2015/01/06. eng): 771-775
- Sarcopenia is an independent predictor of complications after colorectal cancer surgery.Surg Today. 2018 Feb; 48 (PubMed PMID: 28699003. Epub 2017/07/13. eng): 151-157
- Association between sarcopenia and mortality in patients undergoing surgical excision of head and neck cancer.JAMA Otol. Head Neck. Surg. 2019 Jul 1; 145 (PubMed PMID: 31169874. Pubmed Central PMCID: PMC6555480 grants from the National Institutes of Health during the conduct of the study. No other disclosures were reported. Epub 2019/06/07. eng): 647-654
- The impact of properly diagnosed sarcopenia on postoperative outcomes after gastrointestinal surgery: a systematic review and meta-analysis.PLoS One. 2020; 15 (PubMed PMID: 32822372. Pubmed Central PMCID: PMC7446889. Epub 2020/08/22. eng)e0237740
- A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care.Appl. Physiol. Nutr. Metabol. 2008 Oct; 33 (PubMed PMID: 18923576. Epub 2008/10/17. eng): 997-1006
- Body composition assessment and sarcopenia in patients with pancreatic cancer: a systematic review and meta-analysis.HPB. 2019 Dec; 21 (PubMed PMID: 31266698. Epub 2019/07/04. eng): 1603-1612
- Automated body composition analysis of clinically acquired computed tomography scans using neural networks.Clin.Nutr. 2020 Oct; 39 (PubMed PMID: 32007318. Pubmed Central PMCID: PMC7374050. Epub 2020/02/03. eng): 3049-3055
- Influence of cachexia and sarcopenia on survival in pancreatic ductal adenocarcinoma: a systematic review.Pancreatology. 2015 Jan-Feb; 15 (PubMed PMID: 25524484. Epub 2014/12/20. eng): 19-24
- Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer.Clin Cancer Res. 2009 Nov 15; 15 (PubMed PMID: 19887488. Epub 2009/11/06. eng): 6973-6979
- Sarcopenia is a reliable prognostic factor in patients with advanced pancreatic cancer receiving FOLFIRINOX chemotherapy.Pancreatology. 2019 Jan; 19 (PubMed PMID: 30473464. Epub 2018/11/27. eng): 127-135
- Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study.Lancet Oncol. 2008 Jul; 9 (PubMed PMID: 18539529. Epub 2008/06/10. eng): 629-635
- The impact of sarcopenia and myosteatosis on outcomes of unresectable pancreatic cancer or distal cholangiocarcinoma.Clin. Nutr. 2016 Oct; 35 (PubMed PMID: 26411749. Epub 2015/09/29. eng): 1103-1109
- Clinical significance of skeletal muscle density and sarcopenia in patients with pancreatic cancer undergoing first-line chemotherapy: a retrospective observational study.BMC Cancer. 2021 Jan 18; 21 (PubMed PMID: 33461517. Pubmed Central PMCID: PMC7814715. Epub 2021/01/20. eng): 77
- The IMPACT study: early loss of skeletal muscle mass in advanced pancreatic cancer patients.J Cachexia Sarcopenia Muscle. 2019 Apr; 10 (PubMed PMID: 30719874. Pubmed Central PMCID: PMC6463465. Epub 2019/02/06. eng): 368-377
- Skeletal muscle depletion predicts the prognosis of patients with advanced pancreatic cancer undergoing palliative chemotherapy, independent of body mass index.PLoS One. 2015; 10 (PubMed PMID: 26437072. Pubmed Central PMCID: PMC4593598. Epub 2015/10/06. eng)e0139749
- Maintenance of skeletal muscle mass during FOLFIRINOX is a favorable prognostic factor in pancreatic cancer patients.BMC Res Notes. 2021 Jul 15; 14 (PubMed PMID: 34266478. Pubmed Central PMCID: PMC8281692. Epub 2021/07/17. eng): 272
- Prognostic impact of early nutritional support in patients affected by locally advanced and metastatic pancreatic ductal adenocarcinoma undergoing chemotherapy.Eur J Clin Nutr. 2018 May; 72 (PubMed PMID: 29581564. Epub 2018/03/28. eng): 772-779
- Exercise medicine in the management of pancreatic cancer: a systematic review.Pancreas. 2021 Mar 1; 50 (PubMed PMID: 33835957. Pubmed Central PMCID: PMC8041568. Epub 2021/04/10. eng): 280-292
Article info
Publication history
Published online: March 25, 2022
Accepted:
March 22,
2022
Received in revised form:
February 19,
2022
Received:
November 15,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
