Abstract
Purpose of the reviewWe aim to review the methods, current research evidence, and future directions in body composition analysis (BCA) with CT imaging. Recent findingsCT images can be used to evaluate muscle tissue, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) compartments. Manual and semiautomatic segmentation methods are still the gold standards. The segmentation of skeletal muscle tissue and VAT and SAT compartments is most often performed at the level of the 3rd lumbar vertebra. A decreased amount of CT-determined skeletal muscle mass is a marker of impaired survival in many patient populations, including patients with most types of cancer, some surgical patients, and those admitted to the intensive care unit (ICU). Patients with increased VAT are more susceptible to impaired survival / worse outcomes; however, those patients who are critically ill or admitted to the ICU or who will undergo surgery appear to be exceptions. The independent significance of SAT is less well established. Recently, the roles of the CT-determined decrease of muscle mass and increased VAT area and epicardial adipose tissue (EAT) volume have been shown to predict a more debilitating course of illness in patients suffering from severe acute respiratory syndrome coronavirus 2 (COVID-19) infection. SummaryThe field of CT-based body composition analysis is rapidly evolving and shows great potential for clinical implementation.
Highlights
The understanding of the significance of sarcopenia and cachexia is evolving
An observational study found that a decreased paraspinal muscle area at the level of the 5th thoracic vertebra correlated with an increased risk of intensive care unit (ICU) admission and death in hospitalized adults and elderly patients with a COVID-19 infection who were scanned as a part of their routine care [123]
Peng et al found contradictory results showing that only sarcopenia was a marker of impaired survival in patients with pancreatic adenocarcinoma, not sarcopenic obesity
Summary
Sarcopenia is characterized as a progressive syndrome in which there is a decrease of muscle mass and strength whereas cachexia is a syndrome with the severe loss of body weight, fat and muscle loss due to an underlying illness [1], [2], [3], [4], [5]. E.g. densitometry, bioimpedance analysis, dual-energy X-ray absorptiometry, are beyond the scope of this review and we refer the reader to Fosbøl [14] and Albano [15] for a detailed overview In addition to their superior accuracy, both CT and MRI make it possible to obtain a detailed evaluation of individual skeletal muscles and muscle and adipose tissue compartments. Given the already broad scope of this review, we will not examine the clinical significance of intra- and intermuscular fat compartments and the Hounsfield unit attenuation in muscle and fat tissues’ compartments
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
