Masticatory Muscle Index for Indicating Skeletal Muscle Mass in Patients with Head and Neck Cancer

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2021 May 10

PMID 33970954

Citations 11

Authors

Sheng-Wei Chang

Yuan-Hsiung Tsai

Cheng-Ming Hsu

Ethan I Huang

Geng-He Chang

Ming-Shao Tsai

Yao-Te Tsai

Affiliations

Soon will be listed here.

Abstract

Background: A typical assessment for sarcopenia involves the use of abdominal computed tomography (CT) for calculating the skeletal muscle index (SMI) at the level of the third lumbar vertebra (L3). However, abdominal CT is not regularly performed on patients with head and neck cancer (HNC). We investigated whether masticatory SMI (M-SMI) measurements based on head and neck CT scans can be used to conduct sarcopenia assessments by evaluating whether M-SMI is correlated with L3-SMI.

Methods: Abdominal and head and neck CT images of patients with trauma (n = 50) and HNC (n = 52) were analyzed retrospectively. Both manual delineation and threshold selection methods were used to measure cross-sectional areas of masticatory muscles and those of muscles at the L3 level on CT images. Muscle cross-sectional areas were normalized to height squared to calculate SMI, and a multivariate linear regression model was established to evaluate the correlation between the M-SMI and L3-SMI. Receiver operating characteristic curve analysis was used to assess the ability of the M-SMI to identify sarcopenia, and Cox logistic regression was used to identify predictors of sarcopenia.

Results: Patients with HNC had significantly lower M-SMI and L3-SMI than did patients with trauma (p = 0.011 and 0.03, respectively). M-SMI and L3-SMI were strongly correlated (r = 0.901, p < 0.001); in the multivariate model that included sex, the correlation was stronger (r = 0.913, p < 0.001). The associations of sarcopenia with a lower M-SMI (p < 0.001), male sex (p = 0.028), and advanced age (p = 0.011) were significant, and multivariate logistic analysis demonstrated that an M-SMI of <5.5 was an independent predictor of sarcopenia (hazard ratio = 5.37, p < 0.001).

Conclusions: M-SMI assessment in routine head and neck CT scans is feasible and can be an alternative for detecting sarcopenia in patients with HNC.

Citing Articles

Intravoxel incoherent motion (IVIM) MRI-derived masseter muscle characteristics: a new diagnostic marker in head and neck cancer?.

Cheng K, Lu H, Shen C, Lin C, Wang H, Chou Y BMC Cancer. 2025; 25(1):184.

PMID: 39891104 PMC: 11786376. DOI: 10.1186/s12885-025-13569-3.

Unveiling the relation between swallowing muscle mass and skeletal muscle mass in head and neck cancer patients.

Hurtado-Oliva J, Nunez-Miranda L, Zwart A, Vister J, Plaat B, Steenbakkers R Eur Arch Otorhinolaryngol. 2025; .

PMID: 39863816 DOI: 10.1007/s00405-025-09207-0.

Correction: Masticatory muscle index for indicating skeletal muscle mass in patients with head and neck cancer.

Chang S, Tsai Y, Hsu C, Huang E, Chang G, Tsai M PLoS One. 2024; 19(5):e0304880.

PMID: 38820312 PMC: 11142516. DOI: 10.1371/journal.pone.0304880.

Masseter muscle thickness is predictive of cancer cachexia in patients with head and neck cancer.

Balanta-Melo J, Jones A, Novinger L, Moore M, Bonetto A Head Neck. 2024; 46(11):2678-2686.

PMID: 38661244 PMC: 11473234. DOI: 10.1002/hed.27789.

Feasibility of using cross-sectional area of masticatory muscles to predict sarcopenia in healthy aging subjects.

Janovic A, Milicic B, Antic S, Bracanovic D, Markovic-Vasiljkovic B Sci Rep. 2024; 14(1):2079.

PMID: 38267441 PMC: 10808244. DOI: 10.1038/s41598-024-51589-4.

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