Scripties UMCG - Rijksuniversiteit Groningen
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Can neck MRI also be used to assess skeletal muscle mass (SMM) in head and neck cancer patients? :Correlation and agreement of SMM in MRI and CT of the neck.

(2019) Becker, J. (Jan-Niklas)

Introduction: A condition of low skeletal muscle mass (SMM), called sarcopenia, has been shown to be a predictive factor for adverse outcome in head and neck cancer (HNC) patients. Currently, identification of low SMM in patients is possible through calculating the skeletal muscle index (SMI) by measuring skeletal muscle cross sectional area (SMCSA) at the level of the third cervical vertebra in neck CT scans. Because MRI is frequently used instead of CT in the diagnostic process, the aim of this study was to determine correlation and agreement of SMM in neck MRI and CT enabling also patients with solely MRI to be assessed on SMM.
Methods: SMCSA was measured retrospectively in HNC patients possessing within two weeks’ time a neck CT and MRI. CT and MRI was acquired at 1.5 Tesla for 92 patients (sequences: T1 pre- and post-contrast and T2). Additionally, 33 patients had a CT and MRI at 3 Tesla (sequences: T1 pre-contrast, T1 post-contrast with and without fat suppression, and T2). SMCSA and calculated SMI between CT and MRI measurements were compared using the Pearson correlation coefficient (r) and Bland-Altman plots. Also intra- and interobserver reliability was tested using the intraclass correlation coefficient (ICC).
Results: SMCSA and SMI correlated profoundly between CT and all 1.5 and 3 Tesla MRI sequences (r > 0.98, p < 0.001). Bland-Altman plots of the SMI revealed a good agreement and almost no constant bias, but a small proportional, biphasic bias between CT and all employed MRI sequences. Intra- and interobserver reliability was excellent (ICC > 0.98, p < 0.001).
Conclusion: All examined MRI sequences show a sufficient correlation and agreement with CT and can be used interchangeably with neck CT to assess the SMM in HNC patients.

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