ACR Appropriateness Criteria® Diagnosis and Monitoring of Sarcopenia

This article reviews evidence for using various imaging studies related to the diagnosis and monitoring of sarcopenia and other clinical conditions associated with muscle depletion. In this setting, DXA is usually appropriate for the assessment of body composition. Thigh ultrasound, performed in conjunction with clinical history and physical examination, may be useful. There is insufficient evidence to support a stand-alone indication for the use of CT of the abdomen (with or without contrast) or chest (with, without and with, without contrast), but a secondary quantitative analysis of muscle may be appropriate using examinations obtained for another clinical indication. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.