Evaluating CMR

Imaging Techniques

Computed Tomography (CT)

Measuring Skeletal Muscle Mass Using CT


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CT is one of the gold standard techniques used for in vivo quantification of skeletal muscle mass (Figure 2). Muscle mass and changes to it are related to muscle strength (11-13), and accurately determining skeletal muscle mass is particularly important in elderly populations, who are at increased risk of sarcopenia and functional impairment due to low muscle mass. Measures of skeletal muscle by a single CT image have been validated using cadaver measures and show a high level of agreement (R2=0.94, standard error of estimate=9.5%), with a coefficient of variation of approximately 2% (14). When compared to cadaver values, CT error improved to approximately 1% when volume measures were acquired from multiple images. However, as CT involves radiation exposure, a single image at the mid-thigh is commonly used as a proxy measure of whole body skeletal muscle in both men and women (R2=0.77 to 0.79) (15).


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11. Hughes VA, Frontera WR, Wood M, et al. Longitudinal muscle strength changes in older adults: influence of muscle mass, physical activity, and health. J Gerontol A Biol Sci Med Sci 2001; 56: B209-17.
12. Newman AB, Haggerty CL, Goodpaster B, et al. Strength and muscle quality in a well-functioning cohort of older adults: the Health, Aging and Body Composition Study. J Am Geriatr Soc 2003; 51: 323-30.
13. Visser M, Goodpaster BH, Kritchevsky SB, et al. Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci 2005; 60: 324-33.
14. Mitsiopoulos N, Baumgartner RN, Heymsfield SB, et al. Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol 1998; 85: 115-22.
15. Lee SJ, Janssen I, Heymsfield SB, et al. Relation between whole-body and regional measures of human skeletal muscle. Am J Clin Nutr 2004; 80: 1215-21.

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