Diagnosis of pre-sarcopenia from a single selectional crosscut at C3 region, using CT scans before radiotherapy / Diagnóstico de pre-sarcopenia mediante un único corte axial en C3 utilizando el TC de planificación de radioterapia

ABSTRACT

Purpose: the main purpose of this study was to diagnose pre-sarcopenia in cancer patients who had lack of computed tomography (CT) abdominal images, with a newly discovered method based on cervical images. Material and methods: a sample of 37 patients with either lung cancer or a cancer that affected the upper digestive system underwent radiotherapy computed simulation which included measurements at C3 and L3 regions. Skeletal muscle mass (SMM) and skeletal muscle index (SMI) were determined by Hounsfield units and compared in both regions. Pre-sarcopenia was identified according to the cut-points currently established ≤ 41 cm2/m2 in females, ≤ 43 cm2/m2 in males with a BMI ≤ 25 kg/m2, and ≤ 53 cm2/m2 in males with a BMI > 25 kg/m2. Results: the correlation of SMM and SMI between the C3 and L3 regions was R2 = 0.876 and R2 = 0.805, respectively. Moreover, there was a positive association (86.49%) in terms of the diagnosis of pre-sarcopenia according to both regions. In total, eleven pre-sarcopenic patients (29.37%) were identified; three of them being overweight (27.27%) and two of them being obese (18.18%). Conclusion: a single sectional cross at the level of C3 can be used for the diagnosis of pre-sarcopenia. This new method avoids unnecessary irradiation, saves hospital costs and detects malnutrition before starting radiotherapy treatment in cancer patients who have lack of CT abdominal imaging

RESUMEN

Propósito el propósito de este estudio fue diagnosticar la presarcopenia en pacientes con cáncer que no disponen de imágenes por tomografía computarizada (TC) a nivel abdominal mediante un método novedoso basado en cortes a nivel cervical. Material y métodos: se analizaron y se compararon mediante unidades la masa muscular y la masa muscular esquelética en 37 pacientes con cáncer de pulmón y neoplasias del aparato digestivo superior que incluían cortes en la TC de planificación a nivel de C3 y L3. La presarcopenia se identificó de acuerdo con los puntos de corte establecidos actualmente ≤ 41 cm2/m2 para mujeres, ≤ 43 cm2/m2 en hombres con un IMC ≤ 25 kg/m2 y ≤ 53 cm2/m2 en hombres con IMC > 25 kg/m2. Resultados: la correlación de la masa muscular y el índice musculoesquelético entre las regiones C3 y L3 fue R2 = 0.876 y R2 = 0.805, respectivamente. Además, hubo una asociación positiva (86,49%) en términos del diagnóstico de presarcopenia según ambas regiones. En total, se identificaron once pacientes con presarcopenia (29,37%); tres de ellos con sobrepeso (27,27%) y dos con obesidad (18,18%). Conclusión: un solo corte transversal a nivel de la vértebra C3 puede diagnosticar la presarcopenia. Este nuevo método evita la irradiación innecesaria, ahorra costos hospitalarios y detecta la desnutrición antes de iniciar el tratamiento de radioterapia en pacientes con cáncer que no disponen de imágenes a nivel abdominal