BackgroundMeasuring the swallowing muscle mass with volume measurements is complex and time intensive; therefore, it is not used in clinical practice. However, it can be clinically relevant, for instance, in the case of sarcopenic dysphagia. The aim of the study was to develop a feasible and clinically applicable method to measure swallowing muscle mass.MethodsData from 10 head and neck cancer patients were collected from the Oncological Life Study data‐biobank of the University Medical Center Groningen. The pharyngeal constrictor, genioglossus, mylohyoid and geniohyoid complex muscles, as well as the tongue complex muscles, were delineated manually on routinely performed head and neck computed tomography scans. Axial and sagittal planes were used for volume and area measurements, respectively. Muscle density measurements were performed with and without Hounsfield unit thresholding. Correlations were assessed by Pearson correlation coefficients, and interobserver reliability was measured using intra‐class correlation coefficients (ICCs).ResultsSignificant differences were observed between sagittal area measurements with and without Hounsfield unit thresholds for pharyngeal constrictor, tongue complex and the sum of the swallowing muscles (t > 6; P‐value < 0.001). Stronger correlations emerged without Hounsfield unit thresholding. Strong positive and significant correlations were found between the total swallowing muscle mass volume and the sagittal area of the tongue complex muscles (r = 0.87, P‐value < 0.05) and the sum of the sagittal areas of the pharyngeal constrictor and tongue complex muscles (r = 0.85, P‐value < 0.05). The use of the Hounsfield unit threshold weakened correlations. Interobserver reliability was assessed and found to be fair to good for the pharyngeal constrictor muscle (ICC = 0.68, P‐value < 0.05), excellent for the tongue complex muscles (ICC = 0.98, P‐value < 0.05) and excellent for the total swallowing muscle area (ICC = 0.96, P‐value < 0.05).ConclusionsSingle‐slice delineation of the sagittal area of tongue complex muscle and pharyngeal constrictor muscle is a promising, fast, simple and clinically applicable method for measuring the total volume of the swallowing muscle mass in head and neck cancer patients without Hounsfield unit thresholding. These advancements and findings would help in the early and accurate diagnosis of definitive sarcopenic dysphagia.

中文翻译：

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一种基于计算机断层扫描的新方法，通过测量单切片中的舌头肌肉面积来量化吞咽肌肉体积


背景通过体积测量来测量吞咽肌肉质量是复杂且耗时的；因此，它并未用于临床实践。然而，它可能具有临床相关性，例如，在肌肉减少性吞咽困难的情况下。本研究的目的是开发一种可行且临床适用的方法来测量吞咽肌质量。方法从格罗宁根大学医学中心的肿瘤生命研究数据生物库中收集了 10 名头颈癌患者的数据。在常规进行的头颈部计算机断层扫描中手动描绘咽缩肌、颏舌肌、下颌舌骨肌和颏舌骨复合体肌肉以及舌复合体肌肉。轴向和矢状面分别用于体积和面积测量。在使用和不使用亨斯菲尔德单位阈值的情况下进行肌肉密度测量。通过皮尔逊相关系数评估相关性，并使用组内相关系数（ICC）测量观察者间的可靠性。结果在有和没有亨斯菲尔德单位阈值的咽缩肌、舌复合体和吞咽肌总和的矢状面积测量之间观察到显着差异( t > 6；磷‐值 < 0.001)。在没有亨斯菲尔德单位阈值的情况下出现了更强的相关性。总吞咽肌质量体积与舌复合肌矢状面积之间存在强正相关和显着相关性（ r = 0.87,磷‐值 < 0.05）以及咽缩肌和舌复合体肌肉矢状面积的总和（ r = 0.85,磷‐值 < 0.05）。 亨斯菲尔德单位阈值的使用削弱了相关性。评估了观察者间的可靠性，发现咽缩肌的可信度为一般到良好（ICC = 0.68，磷‐值 < 0.05），对于舌头复合体肌肉非常有效（ICC = 0.98，磷‐值 < 0.05）并且对于总吞咽肌面积而言非常出色（ICC = 0.96，磷‐值 < 0.05）。结论 单层勾画舌复合肌和咽缩肌矢状区是一种有前途、快速、简单且临床适用的方法，用于测量头颈癌患者吞咽肌质量的总体积，无需亨斯菲尔德单位阈值。这些进展和发现将有助于对明确的肌肉减少性吞咽困难进行早期和准确的诊断。