Integrating Imaging and Nutrition: Chest CT Muscle Analysis in Adults with Cystic Fibrosis

Abstract

Background: Computed Tomography (CT) is considered a highly accurate tool for assessing body composition. The aim of this study is to assess the usefulness of chest CT for malnutrition diagnosis in people with cystic fibrosis (PwCF), compared with other body composition techniques, as well as to assess possible associations with nutritional and respiratory status. Methods: A cross-sectional study was carried out in clinically stable adult PwCF. Subjects who had undergone a CT including the twelfth thoracic vertebra (T12) during the 6 months prior to or after our assessment were included and body composition was assessed using FocusedON-BC. The results were compared with anthropometry, bioelectrical impedance analysis (BIA), muscle ultrasonography, and handgrip strength (HGS). Respiratory parameters were collected, and nutritional status was assessed using Global Leadership Initiative on Malnutrition (GLIM) criteria. Results: A total of 55 PwCF were included. Muscle area assessed by CT correlated significantly with fat-free mass determined by BIA (r = 0.725) and anthropometry (r = 0.645), muscle mass evaluated by ultrasonography (r = 0.657), HGS (r = 0.593), Bhalla score (r = 0.403), and FEV1 (r = 0.488). Differences were observed when comparing muscle area in CT based on the Bhalla score (94.6 ± 21.1 cm2 in normal/mild involvement vs. 79.3 ± 20.9 cm2 in moderate/severe involvement; p = 0.009) and on nutritional status (96.3 ± 17.9 cm2 in normo-nourished vs. 75.9 ± 22.1 cm2 in malnourished; p < 0.001). Conclusions: In adult PwCF, measurements obtained from CT image analysis correlate adequately with anthropometry, BIA, muscle ultrasound, and HGS. Muscle area in CT is related to nutritional and respiratory status.