Sarcopenia – Definition, Radiological Diagnosis, Clinical Significance

Abstract

Background Sarcopenia is an age-related syndrome characterized by a loss of muscle mass and strength. As a result, the independence of the elderly is reduced and the hospitalization rate and mortality increase. The onset of sarcopenia often begins in middle age due to an unbalanced diet or malnutrition in association with a lack of physical activity. This effect is intensified by concomitant diseases such as obesity or metabolic diseases including diabetes mellitus.

Method With effective preventative diagnostic procedures and specific therapeutic treatment of sarcopenia, the negative effects on the individual can be reduced and the negative impact on health as well as socioeconomic effects can be prevented. Various diagnostic options are available for this purpose. In addition to basic clinical methods such as measuring muscle strength, sarcopenia can also be detected using imaging techniques like dual X-ray absorptiometry (DXA), computed tomography (CT), magnetic resonance imaging (MRI), and sonography. DXA, as a simple and cost-effective method, offers a low-dose option for assessing body composition. With cross-sectional imaging techniques such as CT and MRI, further diagnostic possibilities are available, including MR spectroscopy (MRS) for noninvasive molecular analysis of muscle tissue. CT can also be used in the context of examinations performed for other indications to acquire additional parameters of the skeletal muscles (opportunistic secondary use of CT data), such as abdominal muscle mass (total abdominal muscle area – TAMA) or the psoas as well as the pectoralis muscle index. The importance of sarcopenia is already well studied for patients with various tumor entities and also infections such as SARS-COV2.

Results and Conclusion Sarcopenia will become increasingly important, not least due to demographic changes in the population. In this review, the possibilities for the diagnosis of sarcopenia, the clinical significance, and therapeutic options are described. In particular, CT examinations, which are repeatedly performed on tumor patients, can be used for diagnostics. This opportunistic use can be supported by the use of artificial intelligence.

Key Points:

• Sarcopenia is an age-related syndrome with loss of muscle mass and strength.

• Early detection and therapy can prevent negative effects of sarcopenia.

• In addition to DEXA, cross-sectional imaging techniques (CT, MRI) are available for diagnostic purposes.

• The use of artificial intelligence (AI) offers further possibilities in sarcopenia diagnostics.

Citation Format

• Vogele D, Otto S, Sollmann N et al. Sarcopenia – Definition, Radiological Diagnosis, Clinical Significance. Fortschr Röntgenstr 2023; 195: 393 – 405

Key words

sarcopenia - radiological screening - body composition analysis - quantitative imaging - segmentation

Publication History

Received: 08 June 2022

Accepted: 29 October 2022

Article published online:
11 January 2023

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