title: Multi-parametric MR imaging of quadriceps musculature in the setting of clinical frailty syndrome.
abstract: OBJECTIVE
  Frailty is a common geriatric syndrome associated with loss of skeletal muscle mass (sarcopenia) conferring an increased risk of rapid decline in health and function with increased vulnerability to adverse outcomes. The purpose of this study was to investigate the correlation between diffusion tensor, T2 and intramuscular fat content values of the quadriceps muscle group and clinical frailty status using diffusion tensor MR imaging.
  
  
  METHODS
  Subjects were recruited from the Arizona Frailty cohort composed of all females with frailty status based on the Fried criteria, including 6 non-frail and 10 pre-frail/frail adults, as well as a community sample of 11 young, healthy controls. Axial images of both thighs were obtained on a 3-T magnet with T1, T2 and diffusion tensor imaging as well as intramuscular fat analysis. Diffusion tensor and T2 values were determined by region-of-interest measurements at the proximal, mid and distal thirds of both thighs. Data were evaluated to determine differences between measured values and frailty status.
  
  
  RESULTS
  The mean fractional anisotropy (FA) values in the bilateral quadriceps muscles demonstrated significant differences (F = 7.558, p = 0.0030) between the control and pre-frail/frail and non-frail and pre-frail/frail groups. There was a significant difference in mean T2 (F = 21.675, p < 0.0001) and lipid content (F = 19.266, p < 0.0001) among all three groups in the total quadriceps muscle group.
  
  
  CONCLUSIONS
  The quadriceps musculature of pre-frail/frail adults demonstrated increased FA compared to young controls and non-frail adults with increasing T2 and intramuscular fat among the control, non-frail and pre-frail/frail categories.
authors.affiliation: Department of Medical Imaging, University of Arizona College of Medicine, 1501 N. Campbell Ave., P.O. Box 245067, Tucson, AZ, 85724, USA. dmelville@radiology.arizona.edu.
authors.forename: David M
authors.initials: DM
authors.lastname: Melville
authors.affiliation: Arizona Center on Aging, University of Arizona College of Medicine, 1821 E. Elm Street, Tucson, AZ, 85719, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Mohler
authors.affiliation: Arizona Center on Aging, University of Arizona College of Medicine, 1821 E. Elm Street, Tucson, AZ, 85719, USA.
authors.forename: Mindy
authors.initials: M
authors.lastname: Fain
authors.affiliation: Arizona Center on Aging, University of Arizona College of Medicine, 1821 E. Elm Street, Tucson, AZ, 85719, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Muchna
authors.affiliation: Department of Medical Imaging, University of Arizona College of Medicine, 1501 N. Campbell Ave., P.O. Box 245067, Tucson, AZ, 85724, USA.|Department of Radiology & Imaging Services, Emory University, 1364 Clifton Rd NE, Atlanta, GA, 30322, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Krupinski
authors.affiliation: Department of Medical Imaging, University of Arizona College of Medicine, 1501 N. Campbell Ave., P.O. Box 245067, Tucson, AZ, 85724, USA.
authors.forename: Puneet
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Department of Medical Imaging, University of Arizona College of Medicine, 1501 N. Campbell Ave., P.O. Box 245067, Tucson, AZ, 85724, USA.
authors.forename: Mihra S
authors.initials: MS
authors.lastname: Taljanovic
mesh_terms: D000368:Aged; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D018908:Muscle Weakness / Q000000981:diagnostic imaging* / Q000473:pathology; D052097:Quadriceps Muscle / Q000000981:diagnostic imaging* / Q000473:pathology; D015203:Reproducibility of Results; D055948:Sarcopenia / Q000000981:diagnostic imaging* / Q000473:pathology; D012680:Sensitivity and Specificity
keywords: Diffusion tensor imaging; Frailty; MRI; Muscle; Sarcopenia