Keywords:
Pancreas, Oncology, CT, Computer Applications-General, Metabolic disorders
Authors:
E. Kasatkina, V. K. Lyadov, E. A. Mershina, V. Sinitsyn; Moscow/RU
DOI:
10.1594/ecr2012/B-0563
Methods and Materials
We evaluated 49 CT-images of patients with stage II pancreatic cancer and chronic pancreatitis,
which underwent operative treatment in 2009-2011.
There were 20 patients (Group 1) with pancreatic cancer (9 men and 11 women,
age range 47-82 years) and 29 patients (Group 2) with chronic pancreatitis (23 men and 6 women,
age range 29-63 years).
In all the patients CT was performed for diagnostic and staging purposes,
no additional studies were made for body composition assessment.
Images were analyzed using commercially available software (Slice-O-Matic V4.3,
Tomovision).
A single axial CT-image at the level of the third lumbar vertebrae was assessed to measure cross-sectional areas (cm2) of skeletal muscle (m.
psoas major,
m.
erector spinae,
m.
quadratus lumborum,
m.
obliquus externus abdominis,
m.
obliquus internus abdominis,
m.
transversus abdominis,
m.
rectus abdominis).
Hounsfield units (HU) threshold for skeletal muscle was 150 to -29 HU (Fig. 1).
Also we measured the area of adipose tissue compartments (cm2).
HU thresholds for adipose tissue compartments were: -150 to -50 for visceral adipose tissue (VAT),
-190 to -30 for subcutaneous adipose tissue (SAT) and intramuscular adipose tissue (IAT) (Fig. 2).
The values were normalized for the height of the patient to get the lumbar skeletal muscle index (L3 SMI) in cm2/m2 [7-8].
The sex-specific sarcopenia cut-offs were 52.4 cm2/m2 for men and 38.5 cm2/m2 for women (Prado et al.) [7].
As it’s especially important to diagnose sarcopenia in overweighed patients,
we compared our results with body-mass index (BMI) which was measured for each patient.
The range normal of BMI was 18.6 to 24.9 kg/m².
We also evaluated the rate of complications and mortality in patients with and without sarcopenia.