Journal
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
Volume 42, Issue 7, Pages 1148-1155Publisher
WILEY
DOI: 10.1002/jpen.1067
Keywords
body composition; computed tomography; sarcopenia; visceral adipose; muscle quality
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Funding
- National Cancer Institute Cancer Center Core Grant [P30 CA008748]
- Chanel Endowment for Survivorship Research from Memorial Sloan Kettering Cancer Center
- Early Researcher Award
- Canadian Foundation for Innovation
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BackgroundComputed tomography (CT) scans are being utilized to examine the influence of skeletal muscle and visceral adipose quantity and quality on health-related outcomes in clinical populations. However, little is known about the influence of contrast administration on these parameters. MethodsPrecontrast, arterial, and 3-minute postcontrast CT images of 45 patients with clear cell renal cell carcinoma were downloaded from The Cancer Imaging Archive and retrospectively analyzed for visceral adipose cross-sectional area (CSA) and density, and muscle CSA and density at the third lumbar vertebrae. Low muscle CSA index was defined as 38.9cm(2)/m(2) for women and 55.4cm(2)/m(2) for men. Low muscle density was defined as <41 Hounsfield units (HU) for body mass index (BMI) <24.9kg/m(2) and <33 HU for BMI 25.0kg/m(2). ResultsIn both the arterial and 3-minute phases, contrast administration decreased visceral adipose CSA (-20.9 and -20.9cm(2); P < .001) and increased visceral adipose density (4.8 and 5.8 HU; P < .001), relative to precontrast images. Muscle CSA index marginally increased in the arterial (0.6cm(2)/m(2); P = .007) and 3-minute phases (0.8cm(2)/m(2); P < .001). This likely represents clinically insignificant changes because it does not alter the identification of low muscle CSA (44.4% vs 42.2%; P = 1.00). Skeletal muscle density increased in the arterial (6.4 HU; P < .001) and 3-minute phases (8.7 HU; P < .001), which altered the identification of low muscle density (6.7% vs 31.1%; P < .001). ConclusionsFuture analyses should consider the phase of contrast during CT imaging because it may alter the interpretations of several parameters.
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