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The association of paraspinous muscle size and density and T12 vertebral bone mineral density and mortality in adults age 60-69

Principal Investigator
Name
Leon Lenchik
Degrees
MD
Institution
Wake Forest University Health Sciences
Position Title
Professor of Radiology
Email
About this CDAS Project
Study
NLST (Learn more about this study)
Project ID
NLST-428
Initial CDAS Request Approval
Jul 16, 2018
Title
The association of paraspinous muscle size and density and T12 vertebral bone mineral density and mortality in adults age 60-69
Summary
We have previously evaluated sarcopenia and osteopenia on the low-dose CT scans of National Lung Screening Trial participants who were age 70-74 at the time of registration. We have developed an Automated Muscle Analysis Tool to facilitate measurements of muscle attenuation and cross-sectional area for a large scale application. In our analyses, we have observed associations of paraspinal muscle attenuation with health-related quality of life and with all-cause mortality. We have also found an association of bone attenuation with all-cause mortality. These findings have been reported at multiple radiology conferences, including the Radiological Society of North America, the Society of Skeletal Radiology, and the National Cancer Institute Workshop on “Understanding the role of muscle and body composition in studies of cancer risk and prognosis in cancer survivors.” We plan to extend this analysis to the cohort of NLST participants who were age 60-69 at the time of registration.
The archived cases from the National Lung Screening Trial includes low-dose CT scans from approximately 8,170 participants, age 60-64, and 4,756 participants age 65-69. This large cohort of 12,926 participants will allow us to investigate both cross sectional and longitudinal muscle and bone metrics and to determine if these metrics can be used to predict mortality in this age group.
Aims

Hypothesis Aim 1: Baseline CT measurement of muscle size is associated with mortality.
Approach Aim 1: We will measure paraspinous muscle size on baseline CT images at the level of T12 vertebra and determine the association with mortality. Secondary analysis will examine the impact of covariates such as self-reported activity level.
Hypothesis Aim 2: Baseline CT measurement of muscle density is associated with mortality.
Approach Aim 2: We will measure paraspinous muscle density on baseline CT images at the level of T12 vertebra and determine the association with mortality. Secondary analysis will examine the impact of covariates such as self-reported activity level.
Hypothesis Aim 3: Baseline CT measurement of BMD is associated with mortality.
Approach Aim 3: We will measure volumetric trabecular BMD on baseline CT images at the level of T12 vertebra and determine the association with mortality. Secondary analysis will examine the impact of covariates such as self-reported activity level.
Hypothesis Aim 4: Change in muscle size, muscle density, and BMD is associated with mortality.
Approach Aim 4: We will measure muscle size, muscle density, and BMD at the level of T12 vertebra on T2 CT exams. We will determine the association of the change in the muscle and bone measures from baseline with mortality.

Collaborators

Caroline Chiles, MD., Wake Forest School of Medicine
Ashley Weaver, Ph.D., Wake Forest School of Medicine
Haiying Chen Ph.D., Wake Forest School of Medicine
Robert Boutin, MD., University of California, Davis
Ryan Barnard, MS, Wake Forest School of Medicine
Josh Tan, MS, Wake Forest School of Medicine

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