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Assessment of body composition derived from CT may indicate a risk of mortality in COPD



April 6, 2021

2 min reading

Source / Disclosures

Disclosures:
Cademartiri, Pishgar and Sverzellati do not report relevant financial disclosures. See the study for relevant financial information from all other authors.


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Information on body composition derived from routine chest CT may provide information on the overall health and mortality risk of patients with COPD, the researchers reported in Radiology.

“Chest CT scans are routinely performed in patients with COPD and the availability of these tests may allow assessment of the distribution of fat deposits and sarcopenia to predict mortality risks.” Farhad to cook, MD, MPH, postdoctoral researcher in Russell H. Morgan’s department of radiology and radiological sciences at Johns Hopkins University School of Medicine, and his colleagues wrote.

Lungs
Source: Adobe Stock.

The researchers performed a secondary analysis of 2,994 participants (mean age, 69 years) from the Multi-Ethnic Atherosclerosis Study (MESA) with available chest CT scans from 2010 to 2012. The researchers analyzed the CT scans to determine tissue subcutaneous adipose, intermuscular adipose tissue and pectoralis muscle areas and spirometry assessments to establish the diagnosis of COPD. The aim of the researchers was to evaluate the associations between soft tissue markers of chest CT and mortality in those with COPD.

Overall, 265 participants had COPD (mean age, 72 years; 162 men) and 18% of these participants died during follow-up.

The markers had moderate to excellent intrarelectoral and interlector reliability (intraclass correlation coefficient, 0.88-0.99), the researchers reported.

Among all participants, the rates of subcutaneous adipose tissue (0.8; 95% CI, 0.78-0.81) and intermuscular adipose tissue (0.37; 95% CI, 0.34-0, 41) correlated with fat mass index (Pg <.001 for both). Among participants with COPD, those with a higher subcutaneous adipose tissue index had a lower risk of mortality (HR = 0.2; 95% CI, 0.1–0.4; Pg <.001), while those with a higher intermuscular adipose tissue index had a higher risk of mortality (HR = 1.4; 95% CI, 1–1.9; Pg = .04).

“These markers of body composition derived from chest CT may have added predictive value for adverse clinical outcomes, such as all-cause mortality in patients with COPD,” the researchers wrote. “While we were able to show the associations between soft tissue markers and mortality in COPD, future studies with larger samples are needed to confirm these results.”

Nicola Sverzellati, MD, PhD, professor of diagnostic imaging and president of the radiology unit of the department of medicine and surgery and main radiology for the image of thoracic disorders at the University of Parma, Italy, and Philip Cademartiri, MD, PhD, chairman of the radiology department at the NHS Hospital in Urbino and senior research consultant at the Scientific Institute of Naples, Italy, discussed the findings in a related editorial.

“The study by Pishgar et al encourages assessment of body composition of other chronic complex disorders in which alterations in muscle or adipose tissue may be associated with lung disease,” they wrote. “… Chest CT has the potential to become a powerful tool in the search for personalized drugs in COPD. Whether it is incorporated into routine assessment for patients with COPD will ultimately depend on our ability to demonstrate that this information changes treatment and improves outcomes. ”

Reference:

Sverzellati N, et al. Radiology. 2021; doi: 10.1148 / radiol.2021204737.


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