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Updated: May 12, 2026
3D Ultrasound Imaging: Fast and Cost-effective Morphometry of Musculoskeletal Tissue
Published on: November 27, 2017
Changes in CT-derived muscle mass and density during prehabilitation in patients undergoing NACT ahead of
St-Pierre Jade1, James Tankel2, Lorenzo Ferri2
1Department of Kinesiology and Physical Education, McGill University, 475 Pine Ave. W, Montreal, H2W1S4, Canada; Department of Anesthesia, Montreal General Hospital, 1650 Cedar Ave, Montreal, H3G1B3, Canada.
Introduction:
Esophageal adenocarcinoma (EAC) patients routinely undergo neoadjuvant chemotherapy (NACT) and surgery with known deleterious effects on body composition and functional capacity. Prehabilitation has been postulated as a viable way to combat this decline, however, using CT scans to characterize changes has been scarcely studied. The aims were to a) investigate the impact of prehabilitation among patients treated with NACT using CT-derived measurements of muscle mass and quality as compared to control patients and b) determine their impact on post operative outcomes.
Materials And Methods:
A single-center retrospective cohort study was performed, including 61 patients with EAC, all treated with NACT and surgery between 2019 and 2022 (32 prehabilitation, 29 controls). CT scans at the third lumbar vertebra assessed skeletal muscle index (SMI) and skeletal muscle density (SMD) pre- and post-NACT. Outcome parameters included changes in SMI and SMD, NACT adherence, tumor regression grade, length of stay, and anastomotic leakage. Statistical analyses evaluated differences and correlations between groups.
Results:
Prehabilitation patients showed no significant differences in SMI changes compared to controls. While SMD deterioration was significantly blunted (p < .001), SMI decreased significantly in prehab patients (p = .002). Adherence to protein intake correlated with improved SMD (p = .041) and reduced SMD decline (p = .028). SMD preservation was associated with reduced anastomotic leak rates (p = .001) and low SMD was correlated to impaired 6 Minute Walking distance.
Conclusions:
SMD may serve as a prognostic marker for outcomes, highlighting the importance of individualized prehabilitation programs. Future research should refine patient selection and optimize multimodal interventions to improve outcomes.
