Affiliation:
1. Nutritional Sciences
2. Department of Medicine, Cardiovascular Division
3. Institute for Clinical and Translational Research, University of Wisconsin-Madison, Madison, WI
4. Radiology
5. Medical Physics
6. Biomedical Engineering
Abstract
Purpose:
Intravenous contrast poses challenges to computed tomography (CT) muscle density analysis. We developed and tested corrections for contrast-enhanced CT muscle density to improve muscle analysis and the utility of CT scans for the assessment of myosteatosis.
Materials and Methods:
Using retrospective images from 240 adults who received routine abdominal CT imaging from March to November 2020 with weight-based iodine contrast, we obtained paraspinal muscle density measurements from noncontrast (NC), arterial, and venous-phase images. We used a calibration sample to develop 9 different mean and regression–based corrections for the effect of contrast. We applied the corrections in a validation sample and conducted equivalence testing.
Results:
We evaluated 140 patients (mean age 52.0 y [SD: 18.3]; 60% female) in the calibration sample and 100 patients (mean age 54.8 y [SD: 18.9]; 60% female) in the validation sample. Contrast-enhanced muscle density was higher than NC by 8.6 HU (SD: 6.2) for the arterial phase (female, 10.4 HU [SD: 5.7]; male, 6.0 HU [SD:6.0]) and by 6.4 HU [SD:8.1] for the venous phase (female, 8.0 HU [SD: 8.6]; male, 4.0 HU [SD: 6.6]). Corrected contrast-enhanced and NC muscle density was equivalent within 3 HU for all correctionns. The −7.5 HU correction, independent of sex and phase, performed well for arterial (95% CI: −0.18, 1.80 HU) and venous-phase data (95% CI: −0.88, 1.41 HU).
Conclusions:
Our validated correction factor of −7.5 HU renders contrast-enhanced muscle density statistically similar to NC density and is a feasible rule-of-thumb for clinicians to implement.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Pulmonary and Respiratory Medicine,Radiology, Nuclear Medicine and imaging
Cited by
1 articles.
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