{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:23:10Z","timestamp":1793715790323,"version":"4.6.1"},"reference-count":34,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Persan Farma (Spain)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>(1) Background: The assessment of muscle mass is crucial in the nutritional evaluation of patients with colorectal cancer (CRC), as decreased muscle mass is linked to increased complications and poorer prognosis. This study aims to evaluate the utility of AI-assisted L3 CT for assessing body composition and determining low muscle mass using both the Global Leadership Initiative on Malnutrition (GLIM) criteria for malnutrition and the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria for sarcopenia in CRC patients prior to surgery. Additionally, we aim to establish cutoff points for muscle mass in men and women and propose their application in these diagnostic frameworks. (2) Methods: This retrospective observational study included CRC patients assessed by the Endocrinology and Nutrition services of the Regional University Hospitals of Malaga, Virgen de la Victoria of Malaga, and Vall d\u2019Hebr\u00f3n of Barcelona from October 2018 to July 2023. A morphofunctional assessment, including anthropometry, bioimpedance analysis (BIA), and handgrip strength, was conducted to apply the GLIM criteria for malnutrition and the EWGSOP2 criteria for sarcopenia. Body composition evaluation was performed through AI-assisted analysis of CT images at the L3 level. ROC analysis was used to determine the predictive capacity of variables derived from the CT analysis regarding the diagnosis of low muscle mass and to describe cutoff points. (3) Results: A total of 586 patients were enrolled, with a mean age of 68.4 \u00b1 10.2 years. Using the GLIM criteria, 245 patients (41.8%) were diagnosed with malnutrition. Applying the EWGSOP2 criteria, 56 patients (9.6%) were diagnosed with sarcopenia. ROC curve analysis for the skeletal muscle index (SMI) showed a strong discriminative capacity of muscle area to detect low fat-free mass index (FFMI) (AUC = 0.82, 95% CI 0.77\u20130.87, p &lt; 0.001). The identified SMI cutoff for diagnosing low FFMI was 32.75 cm2\/m2 (Sn 77%, Sp 64.3%; AUC = 0.79, 95% CI 0.70\u20130.87, p &lt; 0.001) in women, and 39.9 cm2\/m2 (Sn 77%, Sp 72.7%; AUC = 0.85, 95% CI 0.80\u20130.90, p &lt; 0.001) in men. Additionally, skeletal muscle area (SMA) showed good discriminative capacity for detecting low appendicular skeletal muscle mass (ASMM) (AUC = 0.71, 95% CI 0.65\u20130.76, p &lt; 0.001). The identified SMA cutoff points for diagnosing low ASMM were 83.2 cm2 (Sn 76.7%, Sp 55.3%; AUC = 0.77, 95% CI 0.69\u20130.84, p &lt; 0.001) in women and 112.6 cm2 (Sn 82.3%, Sp 58.6%; AUC = 0.79, 95% CI 0.74\u20130.85, p &lt; 0.001) in men. (4) Conclusions: AI-assisted body composition assessment using CT is a valuable tool in the morphofunctional evaluation of patients with colorectal cancer prior to surgery. CT provides quantitative data on muscle mass for the application of the GLIM criteria for malnutrition and the EWGSOP2 criteria for sarcopenia, with specific cutoff points established for diagnostic use.<\/jats:p>","DOI":"10.3390\/nu16121869","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T03:52:53Z","timestamp":1718337173000},"page":"1869","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["AI-Assisted Body Composition Assessment Using CT Imaging in Colorectal Cancer Patients: Predictive Capacity for Sarcopenia and Malnutrition Diagnosis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3285-7194","authenticated-orcid":false,"given":"Virginia","family":"Soria-Utrilla","sequence":"first","affiliation":[{"name":"Unidad de Gesti\u00f3n Cl\u00ednica de Endocrinolog\u00eda y Nutrici\u00f3n, Hospital Regional Universitario de M\u00e1laga, 29007 Malaga, Spain"},{"name":"Unidad de Gesti\u00f3n Cl\u00ednica de Endocrinolog\u00eda y Nutrici\u00f3n, Hospital Universitario Virgen de la Victoria de M\u00e1laga, 29010 Malaga, Spain"},{"name":"Department of Medicine and Dermatology, University of M\u00e1laga, 29016 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0739-2567","authenticated-orcid":false,"given":"Francisco Jos\u00e9","family":"S\u00e1nchez-Torralvo","sequence":"additional","affiliation":[{"name":"Unidad de Gesti\u00f3n Cl\u00ednica de Endocrinolog\u00eda y Nutrici\u00f3n, Hospital Regional Universitario de M\u00e1laga, 29007 Malaga, Spain"},{"name":"Unidad de Gesti\u00f3n Cl\u00ednica de Endocrinolog\u00eda y Nutrici\u00f3n, Hospital Universitario Virgen de la Victoria de M\u00e1laga, 29010 Malaga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorella Ximena","family":"Palmas-Candia","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Universitari Vall d\u2019Hebron, 08035 Barcelona, Spain"},{"name":"Diabetes and Metabolism Research Unit, Vall d\u2019Hebron Institut De Recerca (VHIR), 08035 Barcelona, Spain"},{"name":"Department of Medicine, Universitat Aut\u00f2noma de Barcelona, 08193 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7469-5488","authenticated-orcid":false,"given":"Roc\u00edo","family":"Fern\u00e1ndez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Unidad de Gesti\u00f3n Cl\u00ednica de Endocrinolog\u00eda y Nutrici\u00f3n, Hospital Universitario Virgen de la Victoria de M\u00e1laga, 29010 Malaga, Spain"},{"name":"Department of Medicine and Dermatology, University of M\u00e1laga, 29016 Malaga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), 29010 Malaga, Spain"},{"name":"Department of Endocrinology and Nutrition, Quironsalud M\u00e1laga Hospital, 29004 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda","family":"Mucarzel-Suarez-Arana","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Universitari Vall d\u2019Hebron, 08035 Barcelona, Spain"},{"name":"Diabetes and Metabolism Research Unit, Vall d\u2019Hebron Institut De Recerca (VHIR), 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8473-4279","authenticated-orcid":false,"given":"Patricia","family":"Guirado-Pel\u00e1ez","sequence":"additional","affiliation":[{"name":"Unidad de Gesti\u00f3n Cl\u00ednica de Endocrinolog\u00eda y Nutrici\u00f3n, Hospital Universitario Virgen de la Victoria de M\u00e1laga, 29010 Malaga, Spain"},{"name":"Department of Medicine and Dermatology, University of M\u00e1laga, 29016 Malaga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7646-2899","authenticated-orcid":false,"given":"Gabriel","family":"Olveira","sequence":"additional","affiliation":[{"name":"Unidad de Gesti\u00f3n Cl\u00ednica de Endocrinolog\u00eda y Nutrici\u00f3n, Hospital Regional Universitario de M\u00e1laga, 29007 Malaga, Spain"},{"name":"Unidad de Gesti\u00f3n Cl\u00ednica de Endocrinolog\u00eda y Nutrici\u00f3n, Hospital Universitario Virgen de la Victoria de M\u00e1laga, 29010 Malaga, Spain"},{"name":"Department of Medicine and Dermatology, University of M\u00e1laga, 29016 Malaga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8570-184X","authenticated-orcid":false,"given":"Jos\u00e9 Manuel","family":"Garc\u00eda-Almeida","sequence":"additional","affiliation":[{"name":"Unidad de Gesti\u00f3n Cl\u00ednica de Endocrinolog\u00eda y Nutrici\u00f3n, Hospital Universitario Virgen de la Victoria de M\u00e1laga, 29010 Malaga, Spain"},{"name":"Department of Medicine and Dermatology, University of M\u00e1laga, 29016 Malaga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), 29010 Malaga, Spain"},{"name":"Department of Endocrinology and Nutrition, Quironsalud M\u00e1laga Hospital, 29004 Malaga, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de la Fisiopatolog\u00eda de la Obesidad y la Nutrici\u00f3n (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Burgos-Pel\u00e1ez","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Universitari Vall d\u2019Hebron, 08035 Barcelona, Spain"},{"name":"Diabetes and Metabolism Research Unit, Vall d\u2019Hebron Institut De Recerca (VHIR), 08035 Barcelona, Spain"},{"name":"Department of Medicine, Universitat Aut\u00f2noma de Barcelona, 08193 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"89","DOI":"10.5114\/pg.2018.81072","article-title":"Epidemiology of colorectal cancer: Incidence, mortality, survival, and risk factors","volume":"14","author":"Rawla","year":"2019","journal-title":"Gastroenterol. 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