Imaging skeletal muscle volume, density, and FDG uptake before and after induction therapy for non-small cell lung cancer Journal Article


Authors: Goncalves, M. D.; Taylor, S.; Halpenny, D. F.; Schwitzer, E.; Gandelman, S.; Jackson, J.; Lukose, A.; Plodkowski, A. J.; Tan, K. S.; Dunphy, M.; Jones, L. W.; Downey, R. J.
Article Title: Imaging skeletal muscle volume, density, and FDG uptake before and after induction therapy for non-small cell lung cancer
Abstract: Aim: To assess whether changes in body composition could be assessed serially using conventional thoracic computed tomography (CT) and positron-emission tomography (PET)/CT imaging in patients receiving induction chemotherapy for non-small cell lung cancer (NSCLC). Materials and methods: CT-based skeletal muscle volume and density were measured retrospectively from thoracic and lumbar segment CT images from 88 patients with newly diagnosed and untreated NSCLC before and after induction chemotherapy. Skeletal muscle 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) uptake was measured from PET/CT images from a subset of patients (n=42). Comparisons of each metric before and after induction chemotherapy were conducted using the non-parametric Wilcoxon signed-rank test for paired data. The association between clinical factors and percentage change in muscle volume was examined using univariate linear regression models, with adjustment for baseline muscle volume. Results: Following induction chemotherapy, thoracic (–3.3%, p=0.0005) and lumbar (–2.6%, p=0.0101) skeletal muscle volume were reduced (adiposity remained unchanged). The proportion of skeletal muscle with a density <0 HU increased (7.9%, p<0.0001), reflecting a decrease in skeletal muscle density and skeletal muscle FDG uptake increased (10.4–31%, p<0.05). No imaging biomarkers were correlated with overall survival. Conclusion: Changes in body composition can be measured from routine thoracic imaging. During chemotherapy skeletal muscle volume and metabolism are altered; however, there was no impact on survival in this retrospective series, and further validation in prospective, well-controlled studies are required. © 2017 The Royal College of Radiologists
Journal Title: Clinical Radiology
Volume: 73
Issue: 5
ISSN: 0009-9260
Publisher: W B Saunders Co Ltd  
Date Published: 2018-05-01
Start Page: 505.e1
End Page: 505.e8
Language: English
DOI: 10.1016/j.crad.2017.12.004
PROVIDER: scopus
PUBMED: 29317048
PMCID: PMC6785997
DOI/URL:
Notes: Article -- Export Date: 1 May 2018 -- Source: Scopus
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  1. Mark Phillip Dunphy
    81 Dunphy
  2. Robert J Downey
    254 Downey
  3. Lee Winston Jones
    176 Jones
  4. Kay See   Tan
    241 Tan
  5. Annette Lukose
    1 Lukose