Evaluation of muscle quality and quantity for the assessment of sarcopenia using mid-thigh computed tomography: a cohort study

Abstract BackgroundPreviously, sarcopenia was diagnosed based on walking speed, grip strength and muscle mass. However, recent consensus has proposed a concern regarding the use of muscle mass measurement for sarcopenia diagnosis due to lack of accuracy; therefore, new assessment methods in clinical practice are required. We investigated the correlation between computed tomography (CT) and various motor function tests to assess the utility of CT as a potential diagnostic method for sarcopenia.MethodsIn total, 214 patients who were examined at our center during the study period (2016–2017) were included in the study. Single-slice CT scan of the mid-thigh region was performed, from which cross-sectional area (CSA) and CT attenuation value (CTV) of quadriceps femoris were evaluated for each subject. Other assessments included skeletal muscle mass index, muscle strength and physical performance. Furthermore, subjects were classified into four groups as per the Asia Working Group of Sarcopenia (AWGS) 2019 criteria as those with: normal, poor muscle function/strength (poor function), sarcopenia and severe sarcopenia.ResultsCSA and muscle strength exhibited the strongest correlation. Some physical performance tests showed the strongest correlation with CTV. The CSA was significantly lower in women with sarcopenia group and in both men and women with severe sarcopenia (all p < 0.01); furthermore, the CTV was significantly lower in women with poor-function and in both men and women with severe sarcopenia group (all p < 0.01).ConclusionsCSA mostly correlated with muscle strength, whereas CTV mostly correlated with physical performance. CT with measurements of CSA and CTV enables the evaluation of muscle mass and quality simultaneously. CT is believed to be useful in inferring evaluation of motor function and assessment of sarcopenia.