Opportunistic body composition evaluation in patients with esophageal adenocarcinoma: association of survival with 18F-FDG PET/CT muscle metrics

Cathy Zhou, Brent Foster, Rosalie Hagge, Cameron Foster, Leon Lenchik, Abhijit J. Chaudhari, Robert D. Boutin

Research output: Contribution to journalArticle

Abstract

Objective: 18F-FDG PET is widely used to accurately stage numerous types of cancers. Although 18F-FDG PET/CT features of tumors aid in predicting patient prognosis, there is increasing interest in mining additional quantitative body composition data that could improve the prognostic power of 18F-FDG PET/CT, without additional examination costs or radiation exposure. The aim of this study was to determine the association between overall survival and body composition metrics derived from routine clinical 18F-FDG PET/CT examinations. Methods: Patients who received baseline 18F-FDG PET/CT imaging during workup for newly diagnosed esophageal adenocarcinoma (EAC) were included. From these studies, psoas cross-sectional area (CSA), muscle attenuation (MA), SUVmean, and SUVmax were obtained. Correlation with overall survival was assessed using a Cox Proportional Hazards model, controlling for age, body mass index, 18F-FDG dose, glucose level, diabetes status, in-hospital status, and tumor stage. Results: Among the 59 patients studied, psoas MA and SUVmax were found to be significant predictors of survival (HR 0.94, 95% CI 0.88–0.99, p = 0.04, and HR 0.37, 95% CI 0.14–0.97, p = 0.04, respectively) and remained independent predictors. Psoas CSA and SUVmean did not significantly influence survival outcomes. Conclusions: Characterization of psoas muscles as a surrogate marker for sarcopenia on baseline 18F-FDG PET/CT imaging is relatively easily obtained and may offer additional prognostic value in patients with EAC.

Original languageEnglish (US)
JournalAnnals of Nuclear Medicine
DOIs
StateAccepted/In press - Jan 1 2019

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Fluorodeoxyglucose F18
Body Composition
Adenocarcinoma
Muscles
Survival
Psoas Muscles
Sarcopenia
Neoplasms
Proportional Hazards Models
Body Mass Index
Cross-Sectional Studies
Biomarkers
Costs and Cost Analysis
Glucose

Keywords

  • Body composition
  • Esophageal adenocarcinoma
  • Myosteatosis
  • PET/CT
  • Sarcopenia

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Opportunistic body composition evaluation in patients with esophageal adenocarcinoma : association of survival with 18F-FDG PET/CT muscle metrics. / Zhou, Cathy; Foster, Brent; Hagge, Rosalie; Foster, Cameron; Lenchik, Leon; Chaudhari, Abhijit J.; Boutin, Robert D.

In: Annals of Nuclear Medicine, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Objective: 18F-FDG PET is widely used to accurately stage numerous types of cancers. Although 18F-FDG PET/CT features of tumors aid in predicting patient prognosis, there is increasing interest in mining additional quantitative body composition data that could improve the prognostic power of 18F-FDG PET/CT, without additional examination costs or radiation exposure. The aim of this study was to determine the association between overall survival and body composition metrics derived from routine clinical 18F-FDG PET/CT examinations. Methods: Patients who received baseline 18F-FDG PET/CT imaging during workup for newly diagnosed esophageal adenocarcinoma (EAC) were included. From these studies, psoas cross-sectional area (CSA), muscle attenuation (MA), SUVmean, and SUVmax were obtained. Correlation with overall survival was assessed using a Cox Proportional Hazards model, controlling for age, body mass index, 18F-FDG dose, glucose level, diabetes status, in-hospital status, and tumor stage. Results: Among the 59 patients studied, psoas MA and SUVmax were found to be significant predictors of survival (HR 0.94, 95{\%} CI 0.88–0.99, p = 0.04, and HR 0.37, 95{\%} CI 0.14–0.97, p = 0.04, respectively) and remained independent predictors. Psoas CSA and SUVmean did not significantly influence survival outcomes. Conclusions: Characterization of psoas muscles as a surrogate marker for sarcopenia on baseline 18F-FDG PET/CT imaging is relatively easily obtained and may offer additional prognostic value in patients with EAC.",
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AU - Zhou, Cathy

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AU - Foster, Cameron

AU - Lenchik, Leon

AU - Chaudhari, Abhijit J.

AU - Boutin, Robert D.

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N2 - Objective: 18F-FDG PET is widely used to accurately stage numerous types of cancers. Although 18F-FDG PET/CT features of tumors aid in predicting patient prognosis, there is increasing interest in mining additional quantitative body composition data that could improve the prognostic power of 18F-FDG PET/CT, without additional examination costs or radiation exposure. The aim of this study was to determine the association between overall survival and body composition metrics derived from routine clinical 18F-FDG PET/CT examinations. Methods: Patients who received baseline 18F-FDG PET/CT imaging during workup for newly diagnosed esophageal adenocarcinoma (EAC) were included. From these studies, psoas cross-sectional area (CSA), muscle attenuation (MA), SUVmean, and SUVmax were obtained. Correlation with overall survival was assessed using a Cox Proportional Hazards model, controlling for age, body mass index, 18F-FDG dose, glucose level, diabetes status, in-hospital status, and tumor stage. Results: Among the 59 patients studied, psoas MA and SUVmax were found to be significant predictors of survival (HR 0.94, 95% CI 0.88–0.99, p = 0.04, and HR 0.37, 95% CI 0.14–0.97, p = 0.04, respectively) and remained independent predictors. Psoas CSA and SUVmean did not significantly influence survival outcomes. Conclusions: Characterization of psoas muscles as a surrogate marker for sarcopenia on baseline 18F-FDG PET/CT imaging is relatively easily obtained and may offer additional prognostic value in patients with EAC.

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