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JFSF Vol 9, No 1, March 2024, p.16-24

doi: 10.22540/JFSF-09-016

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Original Article

The identification of an optimal body size parameter to adjust skeletal muscle area on chest CT in COVID-19 patients

Numan Kutaiba1,2, Julie Dobson1, Mark Finnis3,4,5, Rinaldo Bellomo3,6,7,8,9

  1. Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
  2. Department of Radiology, The University of Melbourne, Parkville, Victoria, Australia
  3. Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  4. Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
  5. Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
  6. Department of Critical Care, The University of Melbourne, Parkville, Victoria, Australia
  7. Department of Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia
  8. Data Analytics Research and Evaluation Centre, Austin Hospital, Melbourne, Australia
  9. Department of Critical Care, Royal Melbourne Hospital, Melbourne, Australia

Keywords: Chest computed tomography, Sarcopenia, Skeletal muscle area

Abstract

Objectives: The most efficient way to adjust skeletal muscle area (SMA) derived from chest CT to body size remains unclear. We hypothesized that vertebral body area (VBA) measurement would allow such efficient adjustment. Methods: We conducted a retrospective observational study of chest CT imaging in a cohort of critically ill COVID-19 patients. We measured paravertebral SMA at T5 level and T5 vertebral body anteroposterior length, width, and area. We used linear regression and multivariable modelling to assess the association of VBA with SMA. Results: In 48 COVID-19 patients in ICU, T5 VBA could be easily derived from simple width and anteroposterior length linear measurements. T5 VBA (measured manually or estimated from width and length) performed similarly to height (R2 of 0.22) as an adjustment variable for SMA, with R2 of 0.23 and 0.22, respectively. Gender had the strongest correlation with SMA (R2 = 0.28). Adding height or age to a model using gender and VBA did not improve correlation. Conclusions: Gender and estimated VBA from simple linear measurements at T5 level on CT images can be utilized for adjustment of SMA without the need for height. Validation of these findings in larger cohorts of critically ill patients is now needed.
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