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Contrast-enhancement influences skeletal muscle density, but not skeletal muscle mass, measurements on computed tomography. / van Vugt, Jeroen L.A.; Coebergh van den Braak, Robert R.J.; Schippers, Henk J.W.; Veen, Kevin M.; Levolger, Stef; de Bruin, Ron W.F.; Koek, Marcel; Niessen, Wiro J.; IJzermans, Jan N.M.; Willemsen, François E.J.A.

In: Clinical Nutrition, Vol. 37, No. 5, 2018, p. 1707-1714.

Research output: Contribution to journalArticleScientificpeer-review

Harvard

van Vugt, JLA, Coebergh van den Braak, RRJ, Schippers, HJW, Veen, KM, Levolger, S, de Bruin, RWF, Koek, M, Niessen, WJ, IJzermans, JNM & Willemsen, FEJA 2018, 'Contrast-enhancement influences skeletal muscle density, but not skeletal muscle mass, measurements on computed tomography' Clinical Nutrition, vol. 37, no. 5, pp. 1707-1714. https://doi.org/10.1016/j.clnu.2017.07.007

APA

van Vugt, J. L. A., Coebergh van den Braak, R. R. J., Schippers, H. J. W., Veen, K. M., Levolger, S., de Bruin, R. W. F., ... Willemsen, F. E. J. A. (2018). Contrast-enhancement influences skeletal muscle density, but not skeletal muscle mass, measurements on computed tomography. Clinical Nutrition, 37(5), 1707-1714. https://doi.org/10.1016/j.clnu.2017.07.007

Vancouver

van Vugt JLA, Coebergh van den Braak RRJ, Schippers HJW, Veen KM, Levolger S, de Bruin RWF et al. Contrast-enhancement influences skeletal muscle density, but not skeletal muscle mass, measurements on computed tomography. Clinical Nutrition. 2018;37(5):1707-1714. https://doi.org/10.1016/j.clnu.2017.07.007

Author

van Vugt, Jeroen L.A. ; Coebergh van den Braak, Robert R.J. ; Schippers, Henk J.W. ; Veen, Kevin M. ; Levolger, Stef ; de Bruin, Ron W.F. ; Koek, Marcel ; Niessen, Wiro J. ; IJzermans, Jan N.M. ; Willemsen, François E.J.A. / Contrast-enhancement influences skeletal muscle density, but not skeletal muscle mass, measurements on computed tomography. In: Clinical Nutrition. 2018 ; Vol. 37, No. 5. pp. 1707-1714.

BibTeX

@article{f904bbff9d7c463db40bd6e0da755b92,
title = "Contrast-enhancement influences skeletal muscle density, but not skeletal muscle mass, measurements on computed tomography",
abstract = "Background & aims: Low skeletal muscle mass and density have recently been discovered as prognostic and predictive parameters to guide interventions in various populations, including cancer patients. The gold standard for body composition analysis in cancer patients is computed tomography (CT). To date, the effect of contrast-enhancement on muscle composition measurements has not been established. The aim of this study was to determine the effect of contrast-enhancement on skeletal muscle mass and density measurements on four-phase CT studies. Design: In this observational study, two observers measured cross-sectional skeletal muscle area corrected for patients' height (skeletal muscle index [SMI]) and density (SMD) at the level of the third lumbar vertebra on 50 randomly selected CT examinations with unenhanced, arterial, and portal-venous phases. The levels of agreement between enhancement phases for SMI and SMD were calculated using intra-class correlation coefficients (ICCs). Results: Mean SMI was 42.5 (±9.9) cm2/m2 on the unenhanced phase, compared with 42.8 (±9.9) and 43.6 (±9.9) cm2/m2 for the arterial and portal-venous phase, respectively (both p < 0.01). Mean SMD was lower for the unenhanced phase (30.9 ± 8.0 Hounsfield units [HU]) compared with the arterial (38.0 ± 9.9 HU) and portal-venous (38.7 ± 9.2 HU) phase (both p < 0.001). No significant difference was found between SMD in the portal-venous and arterial phase (p = 0.161). The ICCs were excellent (≥0.992) for all SMIs and for SMD between the contrast-enhanced phases (0.949). The ICCs for the unenhanced phase compared with the arterial (0.676) and portal-venous (0.665) phase were considered fair to good. Conclusions: Statistically significant differences in SMI were observed between different enhancement phases. However, further work is needed to assess the clinical relevance of these small differences. Contrast-enhancement strongly influenced SMD values. Studies using this measure should therefore use the portal-venous phase of contrast-enhanced CT examinations.",
keywords = "Computed tomography, Contrast-enhancement, Sarcopenia, Skeletal muscle density, Skeletal muscle mass",
author = "{van Vugt}, {Jeroen L.A.} and {Coebergh van den Braak}, {Robert R.J.} and Schippers, {Henk J.W.} and Veen, {Kevin M.} and Stef Levolger and {de Bruin}, {Ron W.F.} and Marcel Koek and Niessen, {Wiro J.} and IJzermans, {Jan N.M.} and Willemsen, {Fran{\cc}ois E.J.A.}",
year = "2018",
doi = "10.1016/j.clnu.2017.07.007",
language = "English",
volume = "37",
pages = "1707--1714",
journal = "Clinical Nutrition",
issn = "0261-5614",
publisher = "Churchill Livingstone",
number = "5",

}

RIS

TY - JOUR

T1 - Contrast-enhancement influences skeletal muscle density, but not skeletal muscle mass, measurements on computed tomography

AU - van Vugt, Jeroen L.A.

AU - Coebergh van den Braak, Robert R.J.

AU - Schippers, Henk J.W.

AU - Veen, Kevin M.

AU - Levolger, Stef

AU - de Bruin, Ron W.F.

AU - Koek, Marcel

AU - Niessen, Wiro J.

AU - IJzermans, Jan N.M.

AU - Willemsen, François E.J.A.

PY - 2018

Y1 - 2018

N2 - Background & aims: Low skeletal muscle mass and density have recently been discovered as prognostic and predictive parameters to guide interventions in various populations, including cancer patients. The gold standard for body composition analysis in cancer patients is computed tomography (CT). To date, the effect of contrast-enhancement on muscle composition measurements has not been established. The aim of this study was to determine the effect of contrast-enhancement on skeletal muscle mass and density measurements on four-phase CT studies. Design: In this observational study, two observers measured cross-sectional skeletal muscle area corrected for patients' height (skeletal muscle index [SMI]) and density (SMD) at the level of the third lumbar vertebra on 50 randomly selected CT examinations with unenhanced, arterial, and portal-venous phases. The levels of agreement between enhancement phases for SMI and SMD were calculated using intra-class correlation coefficients (ICCs). Results: Mean SMI was 42.5 (±9.9) cm2/m2 on the unenhanced phase, compared with 42.8 (±9.9) and 43.6 (±9.9) cm2/m2 for the arterial and portal-venous phase, respectively (both p < 0.01). Mean SMD was lower for the unenhanced phase (30.9 ± 8.0 Hounsfield units [HU]) compared with the arterial (38.0 ± 9.9 HU) and portal-venous (38.7 ± 9.2 HU) phase (both p < 0.001). No significant difference was found between SMD in the portal-venous and arterial phase (p = 0.161). The ICCs were excellent (≥0.992) for all SMIs and for SMD between the contrast-enhanced phases (0.949). The ICCs for the unenhanced phase compared with the arterial (0.676) and portal-venous (0.665) phase were considered fair to good. Conclusions: Statistically significant differences in SMI were observed between different enhancement phases. However, further work is needed to assess the clinical relevance of these small differences. Contrast-enhancement strongly influenced SMD values. Studies using this measure should therefore use the portal-venous phase of contrast-enhanced CT examinations.

AB - Background & aims: Low skeletal muscle mass and density have recently been discovered as prognostic and predictive parameters to guide interventions in various populations, including cancer patients. The gold standard for body composition analysis in cancer patients is computed tomography (CT). To date, the effect of contrast-enhancement on muscle composition measurements has not been established. The aim of this study was to determine the effect of contrast-enhancement on skeletal muscle mass and density measurements on four-phase CT studies. Design: In this observational study, two observers measured cross-sectional skeletal muscle area corrected for patients' height (skeletal muscle index [SMI]) and density (SMD) at the level of the third lumbar vertebra on 50 randomly selected CT examinations with unenhanced, arterial, and portal-venous phases. The levels of agreement between enhancement phases for SMI and SMD were calculated using intra-class correlation coefficients (ICCs). Results: Mean SMI was 42.5 (±9.9) cm2/m2 on the unenhanced phase, compared with 42.8 (±9.9) and 43.6 (±9.9) cm2/m2 for the arterial and portal-venous phase, respectively (both p < 0.01). Mean SMD was lower for the unenhanced phase (30.9 ± 8.0 Hounsfield units [HU]) compared with the arterial (38.0 ± 9.9 HU) and portal-venous (38.7 ± 9.2 HU) phase (both p < 0.001). No significant difference was found between SMD in the portal-venous and arterial phase (p = 0.161). The ICCs were excellent (≥0.992) for all SMIs and for SMD between the contrast-enhanced phases (0.949). The ICCs for the unenhanced phase compared with the arterial (0.676) and portal-venous (0.665) phase were considered fair to good. Conclusions: Statistically significant differences in SMI were observed between different enhancement phases. However, further work is needed to assess the clinical relevance of these small differences. Contrast-enhancement strongly influenced SMD values. Studies using this measure should therefore use the portal-venous phase of contrast-enhanced CT examinations.

KW - Computed tomography

KW - Contrast-enhancement

KW - Sarcopenia

KW - Skeletal muscle density

KW - Skeletal muscle mass

UR - http://www.scopus.com/inward/record.url?scp=85025088517&partnerID=8YFLogxK

U2 - 10.1016/j.clnu.2017.07.007

DO - 10.1016/j.clnu.2017.07.007

M3 - Article

VL - 37

SP - 1707

EP - 1714

JO - Clinical Nutrition

T2 - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

IS - 5

ER -

ID: 33424359