Fat-free muscle area measured by magnetic resonance imaging predicts overall survival of patients undergoing radioembolization of colorectal cancer liver metastases

Anton Faron, Claus C Pieper, Frederic C Schmeel, Alois M Sprinkart, Daniel L R Kuetting, Rolf Fimmers, Jonel Trebicka, Hans H Schild, Carsten Meyer, Daniel Thomas, Julian A Luetkens*

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Resumé

Objectives: To investigate the clinical potential of fat-free muscle area (FFMA) to predict outcome in patients with liver-predominant metastatic colorectal cancer (mCRC) undergoing radioembolization (RE) with 90Yttrium microspheres. Methods: Patients with mCRC who underwent RE in our center were included in this retrospective study. All patients received liver magnetic resonance imaging including standard T2-weighted images. The total erector spinae muscle area and the intramuscular adipose tissue area were measured at the level of the origin of the superior mesenteric artery and subtracted to calculate FFMA. Cutoff values for definition of low FFMA were 3644 mm 2 in men and 2825 mm 2 in women. The main outcome was overall survival (OS). For survival analysis, the Kaplan-Meier method and Cox regressions comparing various clinic-oncological parameters which potentially may affect OS were performed. Results: Seventy-seven patients (28 female, mean age 60 ± 11 years) were analyzed. Mean time between MRI and the following RE was 17 ± 31 days. Median OS after RE was 178 days. Patients with low FFMA had significantly shortened OS compared to patients with high FFMA (median OS: 128 vs. 273 days, p = 0.017). On multivariate Cox regression analysis, OS was best predicted by FFMA (hazard ratio (HR) 2.652; p < 0.001). Baseline bilirubin (HR 1.875; p = 0.030), pattern of tumor manifestation (HR 1.679; p = 0.001), and model of endstage liver disease (MELD) score (HR 1.164; p < 0.001) were also significantly associated with OS. Conclusions: FFMA was associated with OS in patients receiving RE for treatment of mCRC and might be a new prognostic biomarker for survival prognosis. Key Points: • Fat-free muscle area (FFMA) as a measure of lean muscle area predicts survival in metastatic colorectal liver cancer following radioembolization. • FFMA can easily be assessed from routine pre-interventional liver magnetic resonance imaging. • FFMA might be a new promising biomarker for assessment of sarcopenia.

OriginalsprogEngelsk
TidsskriftEuropean Radiology
Vol/bind29
Udgave nummer9
Sider (fra-til)4709-4717
ISSN0938-7994
DOI
StatusUdgivet - sep. 2019

Fingeraftryk

Liver Neoplasms
Colorectal Neoplasms
Fats
Muscles
Liver
Interventional Magnetic Resonance Imaging
Sarcopenia
Superior Mesenteric Artery
Survival Analysis
Microspheres
Adipose Tissue
Liver Diseases
Retrospective Studies
Regression Analysis

Citer dette

Faron, Anton ; Pieper, Claus C ; Schmeel, Frederic C ; Sprinkart, Alois M ; Kuetting, Daniel L R ; Fimmers, Rolf ; Trebicka, Jonel ; Schild, Hans H ; Meyer, Carsten ; Thomas, Daniel ; Luetkens, Julian A. / Fat-free muscle area measured by magnetic resonance imaging predicts overall survival of patients undergoing radioembolization of colorectal cancer liver metastases. I: European Radiology. 2019 ; Bind 29, Nr. 9. s. 4709-4717.
@article{8e5c80cc397d4ee699d4442a2579c732,
title = "Fat-free muscle area measured by magnetic resonance imaging predicts overall survival of patients undergoing radioembolization of colorectal cancer liver metastases",
abstract = "Objectives: To investigate the clinical potential of fat-free muscle area (FFMA) to predict outcome in patients with liver-predominant metastatic colorectal cancer (mCRC) undergoing radioembolization (RE) with 90Yttrium microspheres. Methods: Patients with mCRC who underwent RE in our center were included in this retrospective study. All patients received liver magnetic resonance imaging including standard T2-weighted images. The total erector spinae muscle area and the intramuscular adipose tissue area were measured at the level of the origin of the superior mesenteric artery and subtracted to calculate FFMA. Cutoff values for definition of low FFMA were 3644 mm 2 in men and 2825 mm 2 in women. The main outcome was overall survival (OS). For survival analysis, the Kaplan-Meier method and Cox regressions comparing various clinic-oncological parameters which potentially may affect OS were performed. Results: Seventy-seven patients (28 female, mean age 60 ± 11 years) were analyzed. Mean time between MRI and the following RE was 17 ± 31 days. Median OS after RE was 178 days. Patients with low FFMA had significantly shortened OS compared to patients with high FFMA (median OS: 128 vs. 273 days, p = 0.017). On multivariate Cox regression analysis, OS was best predicted by FFMA (hazard ratio (HR) 2.652; p < 0.001). Baseline bilirubin (HR 1.875; p = 0.030), pattern of tumor manifestation (HR 1.679; p = 0.001), and model of endstage liver disease (MELD) score (HR 1.164; p < 0.001) were also significantly associated with OS. Conclusions: FFMA was associated with OS in patients receiving RE for treatment of mCRC and might be a new prognostic biomarker for survival prognosis. Key Points: • Fat-free muscle area (FFMA) as a measure of lean muscle area predicts survival in metastatic colorectal liver cancer following radioembolization. • FFMA can easily be assessed from routine pre-interventional liver magnetic resonance imaging. • FFMA might be a new promising biomarker for assessment of sarcopenia.",
keywords = "Brachytherapy, Colorectal cancer, Magnetic resonance imaging, Sarcopenia",
author = "Anton Faron and Pieper, {Claus C} and Schmeel, {Frederic C} and Sprinkart, {Alois M} and Kuetting, {Daniel L R} and Rolf Fimmers and Jonel Trebicka and Schild, {Hans H} and Carsten Meyer and Daniel Thomas and Luetkens, {Julian A}",
year = "2019",
month = "9",
doi = "10.1007/s00330-018-5976-z",
language = "English",
volume = "29",
pages = "4709--4717",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Heinemann",
number = "9",

}

Faron, A, Pieper, CC, Schmeel, FC, Sprinkart, AM, Kuetting, DLR, Fimmers, R, Trebicka, J, Schild, HH, Meyer, C, Thomas, D & Luetkens, JA 2019, 'Fat-free muscle area measured by magnetic resonance imaging predicts overall survival of patients undergoing radioembolization of colorectal cancer liver metastases', European Radiology, bind 29, nr. 9, s. 4709-4717. https://doi.org/10.1007/s00330-018-5976-z

Fat-free muscle area measured by magnetic resonance imaging predicts overall survival of patients undergoing radioembolization of colorectal cancer liver metastases. / Faron, Anton; Pieper, Claus C; Schmeel, Frederic C; Sprinkart, Alois M; Kuetting, Daniel L R; Fimmers, Rolf; Trebicka, Jonel; Schild, Hans H; Meyer, Carsten; Thomas, Daniel; Luetkens, Julian A.

I: European Radiology, Bind 29, Nr. 9, 09.2019, s. 4709-4717.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Fat-free muscle area measured by magnetic resonance imaging predicts overall survival of patients undergoing radioembolization of colorectal cancer liver metastases

AU - Faron, Anton

AU - Pieper, Claus C

AU - Schmeel, Frederic C

AU - Sprinkart, Alois M

AU - Kuetting, Daniel L R

AU - Fimmers, Rolf

AU - Trebicka, Jonel

AU - Schild, Hans H

AU - Meyer, Carsten

AU - Thomas, Daniel

AU - Luetkens, Julian A

PY - 2019/9

Y1 - 2019/9

N2 - Objectives: To investigate the clinical potential of fat-free muscle area (FFMA) to predict outcome in patients with liver-predominant metastatic colorectal cancer (mCRC) undergoing radioembolization (RE) with 90Yttrium microspheres. Methods: Patients with mCRC who underwent RE in our center were included in this retrospective study. All patients received liver magnetic resonance imaging including standard T2-weighted images. The total erector spinae muscle area and the intramuscular adipose tissue area were measured at the level of the origin of the superior mesenteric artery and subtracted to calculate FFMA. Cutoff values for definition of low FFMA were 3644 mm 2 in men and 2825 mm 2 in women. The main outcome was overall survival (OS). For survival analysis, the Kaplan-Meier method and Cox regressions comparing various clinic-oncological parameters which potentially may affect OS were performed. Results: Seventy-seven patients (28 female, mean age 60 ± 11 years) were analyzed. Mean time between MRI and the following RE was 17 ± 31 days. Median OS after RE was 178 days. Patients with low FFMA had significantly shortened OS compared to patients with high FFMA (median OS: 128 vs. 273 days, p = 0.017). On multivariate Cox regression analysis, OS was best predicted by FFMA (hazard ratio (HR) 2.652; p < 0.001). Baseline bilirubin (HR 1.875; p = 0.030), pattern of tumor manifestation (HR 1.679; p = 0.001), and model of endstage liver disease (MELD) score (HR 1.164; p < 0.001) were also significantly associated with OS. Conclusions: FFMA was associated with OS in patients receiving RE for treatment of mCRC and might be a new prognostic biomarker for survival prognosis. Key Points: • Fat-free muscle area (FFMA) as a measure of lean muscle area predicts survival in metastatic colorectal liver cancer following radioembolization. • FFMA can easily be assessed from routine pre-interventional liver magnetic resonance imaging. • FFMA might be a new promising biomarker for assessment of sarcopenia.

AB - Objectives: To investigate the clinical potential of fat-free muscle area (FFMA) to predict outcome in patients with liver-predominant metastatic colorectal cancer (mCRC) undergoing radioembolization (RE) with 90Yttrium microspheres. Methods: Patients with mCRC who underwent RE in our center were included in this retrospective study. All patients received liver magnetic resonance imaging including standard T2-weighted images. The total erector spinae muscle area and the intramuscular adipose tissue area were measured at the level of the origin of the superior mesenteric artery and subtracted to calculate FFMA. Cutoff values for definition of low FFMA were 3644 mm 2 in men and 2825 mm 2 in women. The main outcome was overall survival (OS). For survival analysis, the Kaplan-Meier method and Cox regressions comparing various clinic-oncological parameters which potentially may affect OS were performed. Results: Seventy-seven patients (28 female, mean age 60 ± 11 years) were analyzed. Mean time between MRI and the following RE was 17 ± 31 days. Median OS after RE was 178 days. Patients with low FFMA had significantly shortened OS compared to patients with high FFMA (median OS: 128 vs. 273 days, p = 0.017). On multivariate Cox regression analysis, OS was best predicted by FFMA (hazard ratio (HR) 2.652; p < 0.001). Baseline bilirubin (HR 1.875; p = 0.030), pattern of tumor manifestation (HR 1.679; p = 0.001), and model of endstage liver disease (MELD) score (HR 1.164; p < 0.001) were also significantly associated with OS. Conclusions: FFMA was associated with OS in patients receiving RE for treatment of mCRC and might be a new prognostic biomarker for survival prognosis. Key Points: • Fat-free muscle area (FFMA) as a measure of lean muscle area predicts survival in metastatic colorectal liver cancer following radioembolization. • FFMA can easily be assessed from routine pre-interventional liver magnetic resonance imaging. • FFMA might be a new promising biomarker for assessment of sarcopenia.

KW - Brachytherapy

KW - Colorectal cancer

KW - Magnetic resonance imaging

KW - Sarcopenia

U2 - 10.1007/s00330-018-5976-z

DO - 10.1007/s00330-018-5976-z

M3 - Journal article

C2 - 30689036

VL - 29

SP - 4709

EP - 4717

JO - European Radiology

JF - European Radiology

SN - 0938-7994

IS - 9

ER -