Fujiwara et al correlated several measures of body composition with outcomes in patients with hepatocellular carcinoma.  The authors are from the University of Tokyo, Yokohama City University and Juntendo University in Japan.

Analysis: abdominal CT at the level of the third lumbar vertebra



(1) skeletal muscle index (SMI) based on muscle area (psoas, erector spinae, quadratus lumborum, transversus abdominis, external oblique, internal oblique, rectus abdominus) divided by height squared

(2) intramuscular fat deposition, as measured by mean muscle attenuation (MMA) in HU

(3) abdominal adipose tissue distribution as measured by visceral-to-subcutaneous adipose tissue area ratio (VSR)

(4) sex



(1) skeletal muscle index <= 36.2 square cm per square meter in male

(2) skeletal muscle index <= 29.6 square cm per square meter in female


Intramuscular fat deposition:

(1) mean muscle attenuation <= 44.4 HU in male

(2) mean muscle attenuation <= 39.3 HU in female


Visceral adiposity (high VSR)

(1) ratio > 1.33 in male

(2) ratio > 0.93 in female


The presence of sarcopenia, intramuscular fat deposition and/or visceral adiposity was associated with worse outcomes.

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