Masseter muscle parameters can function as an alternative for skeletal muscle mass assessments on cross-sectional imaging at lumbar or cervical vertebral levels

Quantitative Imaging in Medicine and Surgery

article

Hugo C. van Heusden¹  Najiba Chargi¹  Jan Willem Dankbaar²  Ernst J. Smid³  Remco de Bree¹ 

[1] Department of Head and Neck Surgical Oncology , University Medical Center Utrecht and Utrecht University;Department of Radiology and Nuclear Medicine , University Medical Center Utrecht and Utrecht University;Department of Radiation Oncology , University Medical Center Utrecht and Utrecht University

关键词: Sarcopenia;    head and neck cancer;    skeletal muscle mass (SMM);    masseter muscle;    computed tomography;   

DOI  :  10.21037/qims-21-43

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: Patients with head and neck cancer are at increased risk of developing low skeletal muscle mass (SMM), which is associated with adverse treatment outcomes and prognosis. Low SMM is most commonly assessed by the skeletal muscle cross sectional area (CSA) at the third lumbar vertebra (L3) or more recently the third cervical vertebra (C3). L3 is not routinely imaged and C3 may be impacted by disease or treatment. As an alternative we analyzed masseter muscle characteristics and their relationship with L3 and C3 skeletal muscle CSA and overall survival (OS). Methods: In this single-center retrospective study, 99 patients with head and neck cancer who underwent whole body FDG-PET/CT-scans were reviewed. Of these patients, L3 CSA, C3 CSA, masseter CSA, masseter thickness, masseter volume, masseter Hounsfield Unit values, lumbar skeletal muscle index (LSMI), cervical skeletal muscle index (CSMI), and masseter skeletal muscle index (MSMI) were recorded and correlated with each other and with OS. Results: We included 72 male and 27 female patients. The masseter muscle parameters differed significantly between sexes. The Spearman correlation coefficients for C3 CSA–Masseter volume and L3 CSA–Masseter volume were 0.639 and 0.531 (P<0.001) respectively. In multivariate analysis low MSMI was a predictor of OS (HR 2.227, P=0.009). Conclusions: There is a moderate to strong association between the masseter muscle volume (MV) and C3 CSA and L3 CSA. MSMI predicts OS. Further research should investigate the relationship between muscle function and masseter muscle parameters and impacting factors on masseter muscle dimensions.

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