Clinical significance of the cross-sectional area of the psoas major muscle on a computed tomography image in cancer patients

MORI Naoharu, HIGASHIGUCHI Takashi, ITO Akihiro, FUTAMURA Akihiko, WATANABE Tetsuya, ISHIKAWA Atsuko

doi:10.11244/jjspen.29.1211

Rationale: Cachexia is characterized by wasting of muscle mass. Although computed tomography based quantification of skeletal muscle is the established standard for assessment of cachexia, a quicker and simpler method is still needed in clinical practice. In this study, use of the area of the psoas major muscle (PMMA) as measured on a CT scan was evaluated.<br>Methods: A retrospective analysis was performed in 17 cancer patients with abdominal malignancies who underwent abdominal CT scans at initial diagnosis while non-cachectic and follow-up while in severe cachectic status. Controls, patients that showed no recurrence of cancer after curative resection, were matched for gender and age. An axial CT image at the level of the top of the left iliac crest was obtained. PMMA was measured as the region of interest (ROI) by tracing the outline, using image viewer software.<br>Results: On the follow-up CT scan, a significant decrease of PMMA was found in cachectic patients, but not in controls. The percentage of PMMA change from reference value was 60.8±13.7% in cachectic patients and 99.1±8.5% in controls (p<0.0001).<br>Conclusion: A simple index, PMMA obtained from routine axial CT imaging, may be useful for evaluating muscle mass and cachectic status in cancer patients with abdominal malignancies.

Clinical significance of the cross-sectional area of the psoas major muscle on a computed tomography image in cancer patients

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