Survival prediction using temporal muscle thickness measurements on cranial magnetic resonance images in patients with newly diagnosed brain metastasesReportar como inadecuado

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European Radiology

, Volume 27, Issue 8, pp 3167–3173

First Online: 03 January 2017Received: 13 September 2016Revised: 20 November 2016Accepted: 15 December 2016


ObjectivesTo evaluate the prognostic relevance of temporal muscle thickness TMT in brain metastasis patients.

MethodsWe retrospectively analysed TMT on magnetic resonance MR images at diagnosis of brain metastasis in two independent cohorts of 188 breast cancer BC and 247 non-small cell lung cancer NSCLC patients overall: 435 patients.

ResultsSurvival analysis using a Cox regression model showed a reduced risk of death by 19% with every additional millimetre of baseline TMT in the BC cohort and by 24% in the NSCLC cohort. Multivariate analysis included TMT and diagnosis-specific graded prognostic assessment DS-GPA as covariates in the BC cohort TMT: HR 0.791-CI 0.703–0.889-p < 0.001; DS-GPA: HR 1.433-CI 1.160–1.771-p = 0.001, and TMT, gender and DS-GPA in the NSCLC cohort TMT: HR 0.710-CI 0.646–0.780-p < 0.001; gender: HR 0.516-CI 0.387–0.687-p < 0.001; DS-GPA: HR 1.205-CI 1.018–1.426-p = 0.030.

ConclusionTMT is easily and reproducibly assessable on routine MR images and is an independent predictor of survival in patients with newly diagnosed brain metastasis from BC and NSCLC. TMT may help to better define frail patient populations and thus facilitate patient selection for therapeutic measures or clinical trials. Further prospective studies are needed to correlate TMT with other clinical frailty parameters of patients.

Key Points• TMT has an independent prognostic relevance in brain metastasis patients.

• It is an easily and reproducibly parameter assessable on routine cranial MRI.

• This parameter may aid in patient selection and stratification in clinical trials.

• TMT may serve as surrogate marker for sarcopenia.

KeywordsBrain metastases Sarcopenia Prognosis Diagnosis-specific graded prognostic assessment Cancer cachexia AbbreviationsBCBreast cancer

BMIBody mass index

CTComputed tomography

DS-GPADiagnosis-specific graded prognostic assessment

ICCIntraclass correlations

MRIMagnetic resonance imaging

NSCLCNon-small cell lung cancer

OSOverall survival

TMTTemporal muscle thickness

Electronic supplementary materialThe online version of this article doi:10.1007-s00330-016-4707-6 contains supplementary material, which is available to authorized users.

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Autor: Julia Furtner - Anna S. Berghoff - Omar M. Albtoush - Ramona Woitek - Ulrika Asenbaum - Daniela Prayer - Georg Widhalm -


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