Korean Journal of Radiology

  • 제22권11호
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  • Pages.1909-1917
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  • 2021
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Effects of Contrast Phases on Automated Measurements of Muscle Quantity and Quality Using CT

  • Dong Wook Kim (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kyung Won Kim (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Yousun Ko (Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center) ;
  • Taeyong Park (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Jeongjin Lee (School of Computer Science and Engineering, Soongsil University) ;
  • Jung Bok Lee (Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Jiyeon Ha (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Hyemin Ahn (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Yu Sub Sung (Clinical Research Center, Asan Medical Center) ;
  • Hong-Kyu Kim (Health Screening & Promotion Center, University of Ulsan College of Medicine, Asan Medical Center)
  • 투고 : 2020.11.24
  • 심사 : 2021.05.16
  • 발행 : 2021.11.01
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초록

Objective: Muscle quantity and quality can be measured with an automated system on CT. However, the effects of contrast phases on the muscle measurements have not been established, which we aimed to investigate in this study. Materials and Methods: Muscle quantity was measured according to the skeletal muscle area (SMA) measured by a convolutional neural network-based automated system at the L3 level in 89 subjects undergoing multiphasic abdominal CT comprising unenhanced phase, arterial phase, portal venous phase (PVP), or delayed phase imaging. Muscle quality was analyzed using the mean muscle density and the muscle quality map, which comprises normal and low-attenuation muscle areas (NAMA and LAMA, respectively) based on the muscle attenuation threshold. The SMA, mean muscle density, NAMA, and LAMA were compared between PVP and other phases using paired t tests. Bland-Altman analysis was used to evaluate the inter-phase variability between PVP and other phases. Based on the cutoffs for low muscle quantity and quality, the counts of individuals who scored lower than the cutoff values were compared between PVP and other phases. Results: All indices showed significant differences between PVP and other phases (p < 0.001 for all). The SMA, mean muscle density, and NAMA increased during the later phases, whereas LAMA decreased during the later phases. Bland-Altman analysis showed that the mean differences between PVP and other phases ranged -2.1 to 0.3 cm2 for SMA, -12.0 to 2.6 cm2 for NAMA, and -2.2 to 9.9 cm2 for LAMA.The number of patients who were categorized as low muscle quantity did not significant differ between PVP and other phases (p ≥ 0.5), whereas the number of patients with low muscle quality significantly differed (p ≤ 0.002). Conclusion: SMA was less affected by the contrast phases. However, the muscle quality measurements changed with the contrast phases to greater extents and would require a standardization of the contrast phase for reliable measurement.

키워드

과제정보

This study was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C1216).

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