{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:25:10Z","timestamp":1785432310833,"version":"3.56.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"1111","license":[{"start":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T00:00:00Z","timestamp":1590537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>The measurement of muscle area is routinely utilised in determining sarcopaenia in clinical research. However, this simple measure fails to factor in age-related morphometric changes in muscle quality such as myosteatosis. The aims of this study were to: firstly investigate the relationship between the masseter area (quantity) and density (quality), and secondly compare the prognostic clinical relevance of each parameter.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>Cross-sectional CT head scans were reviewed for patients undergoing carotid endarterectomy. The masseter was manually delineated and the total masseter area (TMA) and the total masseter density (TMD) calculated. Measurements of the TMA were standardised against the cranial circumference. Observer variability in measurements were assessed using Bland\u2013Altman plots. The relationship between TMA and TMD were evaluated using Pearson\u2019s correlation and linear regression analyses. The prognostic value of TMA and TMD were assessed using receiver operator curves and cox-regression analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>In total, 149 patients who had undergone routine CT scans prior to a carotid endarterectomy were included in this study. No significant observer variations were observed in measuring the TMA, TMD and cranium circumference. There was a significant positive correlation between standardised TMA and TMD (Pearson\u2019s correlation 0.426, p &amp;lt; 0.001, adjusted R-squared 17.6%). The area under the curve for standardised TMA in predicting all-cause mortality at 30 days, 1\u2009year and 4 years were higher when compared to TMD. Standardised TMA was only predictive of post-operative overall all-cause mortality (adjusted hazard ratio 0.38, 95%\u2009confidence interval 0.15\u20130.97, p = 0.043).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>We demonstrate a strong relationship between muscle size and density. However, the utilisation of muscle area is likely to be limited in routine clinical care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>Our study supports the utilisation of muscle area in clinical sarcopaenia research. We did not observe any additional prognostic advantage in quantifying muscle density.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20200136","type":"journal-article","created":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T15:40:09Z","timestamp":1589470809000},"source":"Crossref","is-referenced-by-count":5,"title":["Comparison of quantity and quality of muscle as clinical prognostic markers in patients undergoing carotid endarterectomy"],"prefix":"10.1093","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5567-9952","authenticated-orcid":false,"given":"Mohammed Abdul","family":"Waduud","sequence":"first","affiliation":[{"name":"Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street , Leeds, LS1 3EX , United Kingdom"},{"name":"Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way , Leeds, LS2 9JT , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awais","family":"Ul-Hassan","sequence":"additional","affiliation":[{"name":"Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street , Leeds, LS1 3EX , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talha","family":"Naveed","sequence":"additional","affiliation":[{"name":"Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street , Leeds, LS1 3EX , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratik","family":"Adusumilli","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street , Leeds, LS1 3EX , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Alexander","family":"Slater","sequence":"additional","affiliation":[{"name":"Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way , Leeds, LS2 9JT , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Straw","sequence":"additional","affiliation":[{"name":"Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way , Leeds, LS2 9JT , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Hammond","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street , Leeds, LS1 3EX , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Julian","family":"Ashbridge Scott","sequence":"additional","affiliation":[{"name":"Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street , Leeds, LS1 3EX , United Kingdom"},{"name":"Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way , Leeds, LS2 9JT , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,27]]},"reference":[{"key":"2024050215310021500_b1","doi-asserted-by":"crossref","first-page":"2266","DOI":"10.1007\/s00268-017-3999-2","article-title":"Radiologically determined sarcopenia predicts morbidity and mortality following abdominal surgery: a systematic review and meta-analysis","volume":"41","author":"Jones","year":"2017","journal-title":"World J Surg"},{"key":"2024050215310021500_b2","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejvs.2019.09.260","article-title":"Frailty factors and outcomes in vascular surgery patients: a systematic review and meta-analysis","author":"Houghton","year":"2019"},{"key":"2024050215310021500_b3","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejvs.2019.03.020","article-title":"Effect of low skeletal muscle mass on post-operative survival of patients with abdominal aortic aneurysm: a prognostic factor review and meta-analysis of time-to-event data","author":"Antoniou","year":"2019"},{"key":"2024050215310021500_b4","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.surge.2018.03.001","article-title":"The prevalence of sarcopaenia in a vascular surgical patient cohort and its impact on outcome","volume":"16","author":"Heard","year":"2018","journal-title":"The Surgeon"},{"key":"2024050215310021500_b5","first-page":"367","article-title":"Influence of psoas muscle area on mortality following elective abdominal aortic aneurysm repair","author":"Waduud","year":"2019"},{"key":"2024050215310021500_b6","first-page":"53","article-title":"Muscle quality and myosteatosis: novel associations with mortality risk: the Age, Gene\/Environment Susceptibility (AGES)-Reykjavik Study","author":"Reinders","year":"2015"},{"key":"2024050215310021500_b7","article-title":"Sarcopenia is a significant predictor of mortality after abdominal aortic aneurysm repair","volume":"3","author":"Kays","year":"2018","journal-title":"JCSM Clin Rep"},{"key":"2024050215310021500_b8","first-page":"36","article-title":"Image processing with ImageJ","volume":"11","author":"","year":"2004","journal-title":"Biophotonics international"},{"key":"2024050215310021500_b9","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1093\/ajcn\/51.6.953","article-title":"Imaging techniques for measuring adipose-tissue distribution--a comparison between computed tomography and 1.5-T magnetic resonance","volume":"51","author":"Seidell","year":"1990","journal-title":"Am J Clin Nutr"},{"key":"2024050215310021500_b10","doi-asserted-by":"crossref","DOI":"10.1259\/bjr.20160662","article-title":"Validation of a semi-automated technique to accurately measure abdominal fat distribution using CT and MRI for clinical risk stratification","volume":"90","author":"Waduud","year":"2017","journal-title":"Br J Radiol"},{"key":"2024050215310021500_b11","first-page":"331","article-title":"Pre-Operative masseter area is an independent predictor of long-term survival after carotid endarterectomy","author":"Oksala","year":"2019"},{"key":"2024050215310021500_b12","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1007\/s00405-019-05361-4","article-title":"Sarcopenia is a prognostic factor for overall survival in elderly patients with head-and-neck cancer","volume":"276","author":"Chargi","year":"2019","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2024050215310021500_b13","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1001\/jamaoto.2019.1185","article-title":"Association between sarcopenia and mortality in patients undergoing surgical excision of head and neck cancer","volume":"145","author":"Stone","year":"2019","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"2024050215310021500_b14","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0207849","article-title":"High correlation of temporal muscle thickness with lumbar skeletal muscle cross-sectional area in patients with brain metastases","volume":"13","author":"Leitner","year":"2018","journal-title":"PLoS One"},{"key":"2024050215310021500_b15","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/TA.0000000000001297","article-title":"Sarcopenia as a predictor of mortality in elderly blunt trauma patients","volume":"82","author":"Wallace","year":"2017","journal-title":"Journal of Trauma and Acute Care Surgery"},{"key":"2024050215310021500_b16","article-title":"Influences of clinical experience in the quantification of morphometric sarcopaenia: a cohort study","volume":"11","author":"Waduud","year":"2018","journal-title":"Br J Radiol"},{"key":"2024050215310021500_b17","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1007\/s00405-019-05307-w","article-title":"Interobserver agreement of skeletal muscle mass measurement on head and neck CT imaging at the level of the third cervical vertebra","volume":"276","author":"Bril","year":"2019","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2024050215310021500_b18","first-page":"89","article-title":"Use of head circumference as a predictor of height of individual","author":"Mansur","year":"2014"},{"key":"2024050215310021500_b19","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1159\/000321192","article-title":"Association between head circumference and body size","volume":"75","author":"Geraedts","year":"2011","journal-title":"Horm Res Paediatr"}],"container-title":["The British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/93\/1111\/20200136\/57377613\/bjr.20200136.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/93\/1111\/20200136\/57377613\/bjr.20200136.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T16:13:38Z","timestamp":1714666418000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/article\/doi\/10.1259\/bjr.20200136\/7452012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,27]]},"references-count":19,"journal-issue":{"issue":"1111","published-online":{"date-parts":[[2020,5,27]]},"published-print":{"date-parts":[[2020,7,1]]}},"URL":"https:\/\/doi.org\/10.1259\/bjr.20200136","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,7,1]]},"published":{"date-parts":[[2020,5,27]]},"article-number":"20200136"}}