1.
Longitudinal Body Composition Changes and the Importance of Fat-Free Mass Index in Locally Advanced Nasopharyngeal Carcinoma Patients Undergoing Concurrent Chemoradiotherapy.
Ding, H, Dou, S, Ling, Y, Zhu, G, Wang, Q, Wu, Y, Qian, Y
Integrative cancer therapies. 2018;(4):1125-1131
Abstract
AIM: This was a prospective investigation of longitudinal body composition changes in patients with nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy (CCRT) and a comparison of the Patient-Generated Subjective Global Assessment (PG-SGA) and the ESPEN (European Society for Clinical Nutrition and Metabolism) diagnostic criteria (EDC) as evaluation methods. METHODS All patients received standard CCRT according to 2 centers' current practices. Body composition parameters were determined by bioelectrical impedance analysis and obtained weekly from baseline until the end of treatment. The nutritional status of all patients was evaluated by the PG-SGA and EDC. RESULTS Forty-eight patients were eligible for analysis. Most body composition parameters, including body cell mass, fat mass, fat-free mass, and skeletal mass, as well as body weight, body mass index, and PG-SGA score, significantly decreased during CCRT ( P = .00). The PG-SGA was shown to have better sensitivity than the EDC; however, the 2 different evaluation methods were found to have a perfect concordance at Week 4 and Week 6 (κ = 0.91 and 0.96, P = .00 and .00, respectively). Pearson correlation analyses showed that fat-free mass index and body weight were positively correlated with global quality of life score ( r = 0.81, P = .00; r = 0.78, P = .00, respectively). CONCLUSIONS This study has shown that body composition parameters, especially fat-free mass index, are valuable for diagnosing malnutrition in patients with nasopharyngeal carcinoma receiving CCRT. We recommend that these bioelectrical impedance analysis techniques should be increasingly implemented in nutritional assessments.
2.
Interexamination repeatability and spatial heterogeneity of liver iron and fat quantification using MRI-based multistep adaptive fitting algorithm.
Sofue, K, Mileto, A, Dale, BM, Zhong, X, Bashir, MR
Journal of magnetic resonance imaging : JMRI. 2015;(5):1281-90
Abstract
PURPOSE To assess the interexamination repeatability and spatial heterogeneity of liver iron and fat measurements using a magnetic resonance imaging (MRI)-based multistep adaptive fitting algorithm. MATERIALS AND METHODS This prospective observational study was Institutional Review Board-approved and Health Insurance Portability and Accountability Act-compliant. Written informed consent was waived. In all, 150 subjects were imaged on 3T MRI systems. A whole-liver volume acquisition was performed twice using a six-echo 3D spoiled gradient echo sequence during two immediately adjacent examinations. Colocalized regions of interest (ROIs) in three different hepatic segments were placed for R2 * and proton density fat fraction (PDFF) measurements by two readers independently. Mean R2 * and PDFF values between readers and acquisitions were compared using the Wilcoxon signed-rank test, intraclass correlation coefficients (ICCs), linear regression, Bland-Altman analysis, and analysis of variance (ANOVA). RESULTS The mean R2 * and PDFF values across all ROIs and measurements were 51.2 ± 25.2 s(-1) and 6.9 ± 6.4%, respectively. Mean R2 * and PDFF values showed no significant differences between the two acquisitions (P = 0.05-0.87). Between the two acquisitions, R2 * and PDFF values demonstrated almost perfect agreement (ICCs = 0.979-0.994) and excellent correlation (R(2) = 0.958-0.989). Bland-Altman analysis also demonstrated excellent agreement. In the ANOVA, the individual patient and ROI location were significant effects for both R2 * and PDFF values (P < 0.05). CONCLUSION MRI-based R2 * and PDFF measurements are repeatable between examinations. Between-measurement changes in R2 * of more than 10.1 s(-1) and in PDFF of more than 1.7% are likely due to actual tissue changes. Liver iron and fat content are variable between hepatic segments.