Evaluating the Utility of L1 Level Measurement as an Alternative to L3 in Assessing Myosteatosis on Computed Tomography
Abstract
Objectives: Myosteatosis is a pathology characterized by the accumulation of fat within muscle tissue and serves as a significant indicator for monitoring various medical conditions. Computed tomography (CT) is a useful method for objectively assessing myosteatosis, but exploring alternative anatomical levels for evaluation is necessary. The objective of our study is to investigate the possibility of using the lumbar 1 (L1) level as an alternative to lumbar 3 (L3) level for myosteatosis measurements in CT scans.
Materials and Methods: This retrospective study included 135 participants who underwent abdominopelvic CT scans without contrast. CT scans were performed using a Siemens Somatom Force scanner, and myosteatosis was quantified at the L1 and L3 levels. The abdominal skeletal muscles’ cross-sectional area (SMA) and skeletal muscle radiation attenuation (SMRA) values in Hounsfield units (HU) were measured. Statistical analysis included paired t-tests and Pearson correlation coefficients.
Results: SMA at the level of L3 vertebra was statistically significantly higher than that of L1 vertebra (143.5±31.4 cm2; 128.8 cm2±27.7 cm2, respectively, p<0.001) We found a significant correlation between SMA of L3 and L1 (p≤0.001, r=0.93). The difference in SMRA at L3 and L1 vertebras was small but significant (37.6±6.6 HU; 36.5±6.7 HU, respectively, p<0.001) We also found a significant correlation between the SMRA of L3 and L1 (p≤0.001, r=0.85).
Conclusion: This study demonstrates a strong correlation between muscle density and area at the L1 and L3 levels. The results of the study support the use of measurements at the L1 level as an alternative to L3 level measurements for evaluating myosteatosis. Future studies could investigate the variations in CT scanners and techniques and explore the reliability and applicability of the results
Keywords
Myosteatosis, sarcopenia, body composition, computed tomography
Ethical Statement
The study complied with the Declaration of Helsinki, and was approved by the Ethics Committee and the Institutional Review Board of Gazi University Faculty of Medicine (approval no: 548; date: 04.07.2022).
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