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Skeletal muscle analyses: agreement between non‐contrast and contrast CT scan measurements of skeletal muscle area and mean muscle attenuation
Author(s) -
Werf Anne,
Dekker Ingeborg M.,
Meijerink Martijn R.,
Wierdsma Nicolette J.,
Schueren Marian A. E.,
Langius Jacqueline A. E.
Publication year - 2018
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/cpf.12422
Subject(s) - medicine , sma* , nuclear medicine , intraclass correlation , skeletal muscle , contrast (vision) , limits of agreement , radiology , anatomy , mathematics , physics , clinical psychology , combinatorics , optics , psychometrics
Summary Low skeletal muscle area ( SMA ) and muscle radiation attenuation ( MRA ) have been associated with poor prognosis in various patient populations. Both non‐contrast and contrast CT scans are used to determine SMA and MRA . The effect of the use of a contrast agent on SMA and MRA is unknown. Therefore, we investigated agreement between these two scan options. SMA and MRA of 41 healthy individuals were analysed on a paired non‐contrast and contrast single CT scan, and agreement between paired scan results was assessed with use of Bland–Altman plots, intraclass correlation coefficients ( ICC s), standard error of measurements ( SEM ) and smallest detectable differences at a 95% confidence level ( SDD 95 ). Analyses were stratified by tube voltage. Difference in SMA between non‐contrast and contrast scans made with a different tube voltage was 7·0 ± 7·5 cm 2 ; for scans made with the same tube voltage this was 2·3 ± 1·7 cm 2 . Agreement was excellent for both methods: ICC : 0·952, SEM : 7·2 cm 2 , SDD 95 : 19·9 cm 2 and ICC : 0·997, SEM : 2·0 cm 2 , SDD 95 : 5·6 cm 2 , respectively. MRA of scans made with a different tube voltage differed 1·3 ± 11·3 HU , and agreement was poor ( ICC : 0·207, SEM : 7·9 HU , SDD 95 : 21·8 HU ). For scans made with the same tube voltage the difference was 6·7 ± 3·2 HU , and agreement was good ( ICC : 0·682, SEM : 5·3 HU , SDD 95 : 14·6 HU ). In conclusion, SMA and MRA can be slightly influenced by the use of contrast agent. To minimise measurement error, image acquisition parameters of the scans should be similar.