Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Mar;127(3):228-237.
doi: 10.1007/s11547-022-01450-3. Epub 2022 Jan 18.

Sarcopenia: how to measure, when and why

Alberto Stefano Tagliafico  1   2 , Bianca Bignotti  3   4 , Lorenzo Torri  4 , Federica Rossi  4   5
Affiliations
Review

Sarcopenia: how to measure, when and why

Alberto Stefano Tagliafico et al. Radiol Med. 2022 Mar.

Abstract

Sarcopenia indicates a loss of skeletal muscle mass, a condition that leads to a decline in physical performance. In 2018, the European Working Group on Sarcopenia in Older People met to update the original definition of sarcopenia: New scientific and clinical insights were introduced to emphasize the importance of muscle strength loss as a prime indicator of probable sarcopenia. In addition, the skeletal muscle is not only the organ related to mobility, but it is recognized as a secondary secretory organ too, with endocrine functions influencing several systems and preserving health. In this perspective, radiology could have a major role in early detection of sarcopenia and guarantee improvement in its treatment in clinical practice. We present here an update of clinical knowledge about sarcopenia and advantages and limitations of radiological evaluation of sarcopenia focusing on major body composition imaging modalities such as dual-energy X-ray absorptiometry, CT, and MRI. In addition, we discuss controversial such as the lack of consensus or standardization, different measurement methods, and diagnostic radiological cutoff points. Sarcopenia evaluation with radiological methods could enhance the role of radiologist in performing studies with relevant impact on medical and social outcome, placing radiology at the pinnacle of quality in evidence-based practice with high-level studies.

Keywords: Computed tomography; Imaging; Magnetic resonance; Muscle mass; Radiology; Sarcopenia; Ultrasound.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Proportion of lean body mass versus fat in the thighs of a young versus old woman as normal aging process. See text for detail
Fig. 2
Fig. 2
Muscle as secretory organ. Muscle contraction stimulates the production of different myokines. Myokines act as an endocrine stimulus on distant organs, partly explaining the known association between sedentary life and several chronic diseases
Fig. 3
Fig. 3
Latest data published by the United Nations for life expectancy in 2019
Fig. 4
Fig. 4
a Abdominal CT images at the third lumbar vertebra. Pitfalls are represented by incorrect segmentation of muscular tissue due to the fact that growing algorithms could be unable to distinguish muscular tissue from parts of the bowel and solid abdominal organs (kidney, major vessels and liver). Manual correction is essential. b Classical cross-sectional area evaluation at the L3 level showing muscle area and muscle density in Hounsfield unit. c Whole-body CT images taken with different planes showing some examples to estimate fatty tissue (green), muscular tissue (red), and subcutaneous fat (purple). Note that seeding method has been used; therefore, manual correction by an expert reader is mandatory
Fig. 5
Fig. 5
Vitamin D deficit in patients with selective atrophy of rectus femoris as shown by standard MRI of both thighs of an elderly man with 25-hydroxyvitamin D level of below 12 ng/mL
Fig. 6
Fig. 6
Thoracic CT and MRI images taken at the Lewis angle to estimate muscle mass on pectoralis muscle (arrows). Examples from patent number: 102019000016049
Fig. 7
Fig. 7
Evaluation of the anterior compartment of the thigh could be considered a good anatomical area to take US-derived measurements; in this case, the rectus femoris and the vastus intermedius are shown. Muscular thickness (MT) is measured as a distance between the superficial aponeurosis and femur including the rectus femoris and vastus intermedius muscles. Cross-sectional area of the rectus femoris muscle can be measured from transversal US images drawing a region of interest (ROI) using either a freehand or a polygon tool. ROI should include most of the rectus femoris, excluding the muscle fascia
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Dent E, Morley JE, Cruz-Jentoft AJ, Arai H, Kritchevsky SB, Guralnik J, et al. International clinical practice guidelines for Sarcopenia (ICFSR): screening, diagnosis and management. J Nutr Health Aging. 2018;22(10):1148–1161. doi: 10.1007/s12603-018-1139-9. - DOI - PubMed
    1. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2018;48(1):16–31. doi: 10.1093/ageing/afy169. - DOI - PMC - PubMed
    1. Davydov DM, Boev A, Gorbunov S. Making the choice between bioelectrical impedance measures for body hydration status assessment. Sci Rep. 2021;11(1):7685. doi: 10.1038/s41598-021-87253-4. - DOI - PMC - PubMed
    1. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31. doi: 10.1093/ageing/afy169. - DOI - PMC - PubMed
    1. Chen X, Mao G, Leng SX. Frailty syndrome: an overview. Clin Interv Aging. 2014;9:433–441. doi: 10.2147/cia.S45300. - DOI - PMC - PubMed

LinkOut - more resources