Assessment of muscle mass depletion in chronic liver disease: Dual-energy x-ray absorptiometry compared with computed tomography

Abstract Objectives The aim of this study was to perform intermethod comparisons between the following three measures of muscle mass depletion in patients eligible for liver transplantation: 1) fat-free mass index (FFMI) measured by dual-energy x-ray absorptiometry (DXA), 2) appendicular skeletal muscle mass index (ASMI) measured by DXA, and 3) skeletal muscle index (SMI) measured at the third lumbar level by computed tomography (CT). Methods The medical records of patients who received liver transplants between 2009 and 2012 at Karolinska University Hospital were retrospectively reviewed. Adult patients with a chronic liver disease who had both DXA and CT scans performed within a 30-d period during their pretransplant workup were included. Results Appendicular skeletal muscle mass index measured by DXA (ASMI DXA ) and skeletal mass index measured by computed tomography (SMI CT ) provide similar results when assessing the presence of muscle mass depletion in patients with chronic liver diseases and FFMI DXA can be falsely high in patients with ascites. Both ASMI DXA and SMI CT thus appear to be useful methods in the pretransplant evaluation of muscle mass depletion both for patients with and without ascites. Conclusions ASMI measured with DXA is a useful alternative method to SMI measured with CT when a CT scan is not clinically indicated or available.