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Radiological Sarcopenia Assessment on Pectoralis

body compositionComputed Tomographymagnetic risonanceskeletal muscle indexUltrasound

Introduction

The evaluation of sarcopenia can be done through a magnetic resonance imaging (MRI) of the breast in the normal diagnostic and therapeutic process. In order to make this measurement more correct and reproducible, we have found that the evaluation of the pectoral muscle in breast MRI is feasible. A similar evaluation can be made for 2D, 3D ultrasound and for Computed Tomography (CT).

Technical features

We considered that for the evaluation of the pectoral muscle it is more appropriate to use the FLASH T1-weighted axial sequences before the administration of the contrast medium for the best anatomic and contrast resolution. In TC it is possible to speak of sarcopenia, when the skeletal muscle index (SMI) parameter has values ​​lower than the cut-off of about 41cm2 / m2. Since the pectoral area has a proportional correlation with the psoas area, by means of a proportion it is also possible to obtain a numerical cut-off for the pectoral muscle area calculated at the level of the relative Louis angle. at the height of the Patient, since it is obtained together with the weight before each MRI exam. Analogously for 2D and 3D ultrasound. Current technologies do not provide for the automatic or semi-automatic calculation of the muscular mass.
Formula: psoas area: pectoral area = psoas SMI cut-off: pectoral SMI cut-off. The cut-offs will be calibrated on the current literature.

Possible Applications

  • Clinical trials;
  • Daily routine.

Advantages

  • Measurement of sarcopenia in women with breast cancer;
  • Breast MRI;
  • Ultrasound and, in the most advanced scenario, automatic ultrasound;
  • Computed tomography;
  • Muscle mass can be calculated in patients who do NOT have a CT scan of the abdomen but do chest imaging. That group of patients are the vastly used.