Diagnosing Sarcopenia on Thoracic Computed Tomography

Quantitative Assessment of Skeletal Muscle Mass in Patients Undergoing Transcatheter Aortic Valve Replacement
Published:March 29, 2017DOI:

      Rationale and Objectives

      This study aims to assess the use of skeletal muscle mass measurements at two thoracic levels to diagnose sarcopenia on computed tomography (CT) chest examinations and to analyze the impact of these measurements on clinical outcome parameters following transcatheter aortic valve replacement.

      Materials and Methods

      This study retrospectively included 157 patients who underwent preoperative CT examinations. The total muscle area was measured on transverse CT images at the 3rd lumbar and 7th and 12th thoracic levels with skeletal muscle indices (SMIs) calculated at each level. SMIs were then compared to clinical outcome parameters, and thoracic cutoff values for sarcopenia at the 7th and 12th thoracic levels were calculated.


      Correlation between SMIs at the third lumbar vertebra (L3) and the 12th thoracic vertebra (T12) was stronger (r = 0.724, P < 0.001) than that between L3 and the seventh thoracic vertebra (T7) (r = 0.594, P < 0.001). SMIs at L3 and T12 significantly correlated with prolonged length of stay. Thoracic cutoff values for the 12th thoracic level were 42.6 cm2/m2 (men) and 30.6 cm2/m2 (women), and those for the 7th thoracic level were 46.5 cm2/m2 (men) and 32.3 cm2/m2 (women).


      Skeletal muscle measurements at the T12 level could permit the diagnosis of sarcopenia and could be used to correlate sarcopenia with outcome parameters in patients undergoing CT limited to the chest.

      Key Words

      Abbreviations and Acronyms:

      BMI (body mass index), CT (computed tomography), L3 (third lumbar vertebra), SC (subcutaneous tissue area), SMI3 (skeletal muscle index at L3), SMI7 (skeletal muscle index at T7), SMI12 (skeletal muscle index at T12), STS (Society for Thoracic Surgeons 2008 Cardiac Surgery Risk Models), T12 (12th thoracic vertebra), TAVR (transcatheter aortic valve replacement), VF (visceral adipose tissue area)
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