期刊
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
卷 44, 期 5, 页码 1047-1056出版社
WILEY
DOI: 10.1002/hed.27000
关键词
body composition; computed tomography; head and neck cancer; sarcopenia
资金
- Australian Government Research Training Program Scholarship
This study compared the use of cross-sectional area (CSA) measurements at the third cervical vertebra (C3) and the third lumbar vertebra (L3) to evaluate the muscle status in head and neck cancer patients. The results showed weak agreement between the two methods, indicating that using C3 to estimate CSA cannot replace actual measurements at L3.
Background: Computed tomography (CT)-defined sarcopenia is a prognostic indicator in head and neck cancer (HNC), with the gold standard for muscle evaluation using cross-sectional area (CSA) at the third lumbar vertebra (L3). We compared methods using CSA at the third cervical vertebra (C3). Methods: Muscle CSA was measured at L3, and CSA at C3 was used to estimate L3 CSA using a prediction model. Agreement and sarcopenia diagnosis were evaluated. Results: Good correlation was found between measured and estimated CSA (101 scans; r = 0.86, p < 0.001). CSA mean difference (bias) 9.99 cm(2), (SD = 20.3 cm(2)). Skeletal muscle index bias 5.85% (SD = 13.4%), 95% limits of agreement (LoA) (-20.4 to 32.1%, r = 0.29), exceeded clinically accepted limits of 5%. Sarcopenia was diagnosed in 26%-(L3), 45%-(C3), with weak agreement (R = 0.368, 95% confidence interval, 0.192-0.544, p < 0.001) (sensitivity 79.2%, specificity 66.7%). Conclusion: Agreement between measures was weak. Widespread LoA, proportional bias, and sarcopenia misclassification indicates that estimates using C3 cannot replace actual measures at L3.
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