Muscle analysis using pQCT, DXA and MRI

Skeletal muscle is one of the larger organs of the body and is integrally involved in metabolic processes in both health and disease. The ability to accurately and precisely measure skeletal muscle structure is essential for understanding the changes that occur naturally over the lifespan as well as those observed in chronic disease, and in response to targeted interventions. Musculoskeletal imaging allows for the quantification of skeletal muscle mass and select modalities are also able to determine muscle quality. The purpose of this paper is to review peripheral quantitative computed tomography (pQCT), dual X-ray energy absorptiometry (DXA) and magnetic resonance imaging (MRI) techniques used to assess skeletal muscle size and quality in-vivo. Each modality is briefly described and the strengths and limitations are provided. No single imaging technique will be able to best address every clinical and research question of interest. Selecting the most appropriate imaging device for measuring skeletal muscle depends on access to technology, availability of expertise required for image acquisition and analysis, characteristics of the population, anatomical site of interest, and the level of structural detail required.