Mohammed Abdul Waduud1,2, Awais Ul-Hassan1, Talha Naveed1, Pratik Adusumilli3, Thomas Alexander Slater2, Sam Straw2, Christopher Hammond3, David Julian Ashbridge Scott1,2. 1. Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds, LS1 3EX, United Kingdom. 2. Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, LS2 9JT, United Kingdom. 3. Department of Radiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds, LS1 3EX, United Kingdom.
Abstract
OBJECTIVE: The measurement of muscle area is routinely utilised in determining sarcopaenia in clinical research. However, this simple measure fails to factor in age-related morphometric changes in muscle quality such as myosteatosis. The aims of this study were to: firstly investigate the relationship between the masseter area (quantity) and density (quality), and secondly compare the prognostic clinical relevance of each parameter. METHODS: Cross-sectional CT head scans were reviewed for patients undergoing carotid endarterectomy. The masseter was manually delineated and the total masseter area (TMA) and the total masseter density (TMD) calculated. Measurements of the TMA were standardised against the cranial circumference. Observer variability in measurements were assessed using Bland-Altman plots. The relationship between TMA and TMD were evaluated using Pearson's correlation and linear regression analyses. The prognostic value of TMA and TMD were assessed using receiver operator curves and cox-regression analyses. RESULTS: In total, 149 patients who had undergone routine CT scans prior to a carotid endarterectomy were included in this study. No significant observer variations were observed in measuring the TMA, TMD and cranium circumference. There was a significant positive correlation between standardised TMA and TMD (Pearson's correlation 0.426, p < 0.001, adjusted R-squared 17.6%). The area under the curve for standardised TMA in predicting all-cause mortality at 30 days, 1 year and 4 years were higher when compared to TMD. Standardised TMA was only predictive of post-operative overall all-cause mortality (adjusted hazard ratio 0.38, 95% confidence interval 0.15-0.97, p = 0.043). CONCLUSION: We demonstrate a strong relationship between muscle size and density. However, the utilisation of muscle area is likely to be limited in routine clinical care. ADVANCES IN KNOWLEDGE: Our study supports the utilisation of muscle area in clinical sarcopaenia research. We did not observe any additional prognostic advantage in quantifying muscle density.
OBJECTIVE: The measurement of muscle area is routinely utilised in determining sarcopaenia in clinical research. However, this simple measure fails to factor in age-related morphometric changes in muscle quality such as myosteatosis. The aims of this study were to: firstly investigate the relationship between the masseter area (quantity) and density (quality), and secondly compare the prognostic clinical relevance of each parameter. METHODS: Cross-sectional CT head scans were reviewed for patients undergoing carotid endarterectomy. The masseter was manually delineated and the total masseter area (TMA) and the total masseter density (TMD) calculated. Measurements of the TMA were standardised against the cranial circumference. Observer variability in measurements were assessed using Bland-Altman plots. The relationship between TMA and TMD were evaluated using Pearson's correlation and linear regression analyses. The prognostic value of TMA and TMD were assessed using receiver operator curves and cox-regression analyses. RESULTS: In total, 149 patients who had undergone routine CT scans prior to a carotid endarterectomy were included in this study. No significant observer variations were observed in measuring the TMA, TMD and cranium circumference. There was a significant positive correlation between standardised TMA and TMD (Pearson's correlation 0.426, p < 0.001, adjusted R-squared 17.6%). The area under the curve for standardised TMA in predicting all-cause mortality at 30 days, 1 year and 4 years were higher when compared to TMD. Standardised TMA was only predictive of post-operative overall all-cause mortality (adjusted hazard ratio 0.38, 95% confidence interval 0.15-0.97, p = 0.043). CONCLUSION: We demonstrate a strong relationship between muscle size and density. However, the utilisation of muscle area is likely to be limited in routine clinical care. ADVANCES IN KNOWLEDGE: Our study supports the utilisation of muscle area in clinical sarcopaenia research. We did not observe any additional prognostic advantage in quantifying muscle density.
Authors: George A Antoniou; Djamila Rojoa; Stavros A Antoniou; Aws Alfahad; Francesco Torella; Maciej T Juszczak Journal: Eur J Vasc Endovasc Surg Date: 2019-06-13 Impact factor: 7.069
Authors: Mohammed Abdul Waduud; Michael Drozd; Emma Linton; Benjamin Wood; James Manning; Marc A Bailey; Christopher Hammond; Julian A Scott Journal: Br J Radiol Date: 2018-05-23 Impact factor: 3.039
Authors: Lucas Stone; Brennan Olson; Alia Mowery; Stephanie Krasnow; Angie Jiang; Ryan Li; Joshua Schindler; Mark K Wax; Peter Andersen; Daniel Marks; Virginie Achim; Daniel Clayburgh Journal: JAMA Otolaryngol Head Neck Surg Date: 2019-07-01 Impact factor: 6.223
Authors: Erica J Geraedts; Paula van Dommelen; Janina Caliebe; Remco Visser; Michael B Ranke; Stef van Buuren; Jan M Wit; Wilma Oostdijk Journal: Horm Res Paediatr Date: 2011-02-10 Impact factor: 2.852
Authors: M A Waduud; B Wood; P Keleabetswe; J Manning; E Linton; M Drozd; C J Hammond; M A Bailey; D J A Scott Journal: Br J Surg Date: 2019-01-31 Impact factor: 6.939
Authors: John S M Houghton; Andrew T O Nickinson; Alastair J Morton; Sarah Nduwayo; Coral J Pepper; Harjeet S Rayt; Laura J Gray; Simon P Conroy; Victoria J Haunton; Rob D Sayers Journal: Ann Surg Date: 2020-08 Impact factor: 12.969
Authors: S I Bril; A W Wendrich; J E Swartz; I Wegner; F Pameijer; E J Smid; G H Bol; A J Pothen; R de Bree Journal: Eur Arch Otorhinolaryngol Date: 2019-01-28 Impact factor: 2.503
Authors: Rianne N M Hogenbirk; Louise B D Banning; Anita Visser; Harriet Jager-Wittenaar; Robert A Pol; Clark J Zeebregts; Joost M Klaase Journal: J Clin Med Date: 2022-05-30 Impact factor: 4.964