Agreement Between Semi-Automated CT-Based Body Composition Software and Qualitative Muscle Assessment in Sarcopenia:...

To compare quantitative muscle and adipose tissue parameters obtained using two semi-automated CT-based body composition analysis software tools and to evaluate their association with qualitative muscle assessment using the Goutallier classification in patients with abdominal malignancies. This retrospective study included 103 patients with histopathologically confirmed abdominal malignancies who underwent non-contrast abdominopelvic CT examinations. Body composition parameters at the L3 vertebral level, including total abdominal muscle area (TAMA), skeletal muscle index (SMI), psoas muscle area, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT), were independently measured using CoreSlicer version 1.0 and AsanJ-Morphometry. Qualitative muscle assessment was performed using the Goutallier classification. Agreement between the two software tools was evaluated using intraclass correlation coefficient (ICC) and Bland-Altman analysis. Quantitative measurements obtained from both software platforms demonstrated high agreement across all muscle and adipose tissue parameters. Higher Goutallier grades were significantly associated with lower muscle density and reduced muscle area. Semi-automated quantitative measurements also demonstrated strong consistency with qualitative muscle assessment. Semi-automated CT-based body composition analysis software tools provide reliable quantitative measurements and demonstrate high agreement; however, systematic differences exist, and therefore the two software tools should not be considered fully interchangeable for sarcopenia assessment. The combined use of quantitative and qualitative muscle evaluation may improve the clinical assessment of sarcopenia in patients with abdominal malignancies.