Thickness of Biceps and Quadriceps Femoris Muscle Measured Using Point-of-Care Ultrasound as a Representation of Total Skeletal Muscle Mass

Rianne N M Hogenbirk; Alain R Viddeleer; Judith E K R Hentzen; Willemijn Y van der Plas; Cees P van der Schans; Geertruida H de Bock; Schelto Kruijff; Joost M Klaase

doi:10.3390/jcm11226606

Thickness of Biceps and Quadriceps Femoris Muscle Measured Using Point-of-Care Ultrasound as a Representation of Total Skeletal Muscle Mass

J Clin Med. 2022 Nov 8;11(22):6606. doi: 10.3390/jcm11226606.

Authors

Rianne N M Hogenbirk¹, Alain R Viddeleer², Judith E K R Hentzen¹, Willemijn Y van der Plas^{1

3}, Cees P van der Schans^{4

5}, Geertruida H de Bock⁶, Schelto Kruijff¹, Joost M Klaase¹

Affiliations

¹ Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
² Department of Radiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
³ Department of Surgery, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands.
⁴ Department of Rehabilitation, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
⁵ Research Group Healthy Ageing, Allied Health Care and Nursing, Center of Expertise Healthy Ageing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands.
⁶ Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.

Abstract

Generalized loss of muscle mass is associated with increased morbidity and mortality in patients with cancer. The gold standard to measure muscle mass is by using computed tomography (CT). However, the aim of this prospective observational cohort study was to determine whether point-of-care ultrasound (POCUS) could be an easy-to-use, bedside measurement alternative to evaluate muscle status. Patients scheduled for major abdominal cancer surgery with a recent preoperative CT scan available were included. POCUS was used to measure the muscle thickness of mm. biceps brachii, mm. recti femoris, and mm. vasti intermedius 1 day prior to surgery. The total skeletal muscle index (SMI) was derived from patients’ abdominal CT scan at the third lumbar level. Muscle force of the upper and lower extremities was measured using a handheld dynamometer. A total of 165 patients were included (55% male; 65 ± 12 years). All POCUS measurements of muscle thickness had a statistically significant correlation with CT-derived SMI (r ≥ 0.48; p < 0.001). The strongest correlation between POCUS muscle measurements and SMI was observed when all POCUS muscle groups were added together (r = 0.73; p < 0.001). Muscle strength had a stronger correlation with POCUS-measured muscle thickness than with CT-derived SMI. To conclude, this study indicated a strong correlation between combined muscle thickness measurements performed by POCUS- and CT-derived SMI and measurements of muscle strength. These results suggest that handheld ultrasound is a valid tool for the assessment of skeletal muscle status.

Keywords: POCUS; muscle force; muscle status; sarcopenia; skeletal muscle index.

Grants and funding

This work was supported by a grant from the University Medical Center Groningen Cancer Research Foundation (Institutional Foundation for Cancer Research and Development).