title: Survival prediction using temporal muscle thickness measurements on cranial magnetic resonance images in patients with newly diagnosed brain metastases.
abstract: OBJECTIVE
  To evaluate the prognostic relevance of temporal muscle thickness (TMT) in brain metastasis patients.
  
  
  METHODS
  We retrospectively analysed TMT on magnetic resonance (MR) images at diagnosis of brain metastasis in two independent cohorts of 188 breast cancer (BC) and 247 non-small cell lung cancer (NSCLC) patients (overall: 435 patients).
  
  
  RESULTS
  Survival analysis using a Cox regression model showed a reduced risk of death by 19% with every additional millimetre of baseline TMT in the BC cohort and by 24% in the NSCLC cohort. Multivariate analysis included TMT and diagnosis-specific graded prognostic assessment (DS-GPA) as covariates in the BC cohort (TMT: HR 0.791/CI [0.703-0.889]/p < 0.001; DS-GPA: HR 1.433/CI [1.160-1.771]/p = 0.001), and TMT, gender and DS-GPA in the NSCLC cohort (TMT: HR 0.710/CI [0.646-0.780]/p < 0.001; gender: HR 0.516/CI [0.387-0.687]/p < 0.001; DS-GPA: HR 1.205/CI [1.018-1.426]/p = 0.030).
  
  
  CONCLUSIONS
  TMT is easily and reproducibly assessable on routine MR images and is an independent predictor of survival in patients with newly diagnosed brain metastasis from BC and NSCLC. TMT may help to better define frail patient populations and thus facilitate patient selection for therapeutic measures or clinical trials. Further prospective studies are needed to correlate TMT with other clinical frailty parameters of patients.
  
  
  CONCLUSIONS
  • TMT has an independent prognostic relevance in brain metastasis patients. • It is an easily and reproducibly parameter assessable on routine cranial MRI. • This parameter may aid in patient selection and stratification in clinical trials. • TMT may serve as surrogate marker for sarcopenia.
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.|Comprehensive Cancer Center, Central Nervous System Tumor Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Furtner
authors.affiliation: Comprehensive Cancer Center, Central Nervous System Tumor Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.|Department of Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: Anna S
authors.initials: AS
authors.lastname: Berghoff
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.|Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan.
authors.forename: Omar M
authors.initials: OM
authors.lastname: Albtoush
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Ramona
authors.initials: R
authors.lastname: Woitek
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Asenbaum
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.|Comprehensive Cancer Center, Central Nervous System Tumor Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Daniela
authors.initials: D
authors.lastname: Prayer
authors.affiliation: Comprehensive Cancer Center, Central Nervous System Tumor Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.|Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Widhalm
authors.affiliation: Comprehensive Cancer Center, Central Nervous System Tumor Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.|Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Gatterbauer
authors.affiliation: Comprehensive Cancer Center, Central Nervous System Tumor Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.|Department of Radiotherapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Karin
authors.initials: K
authors.lastname: Dieckmann
authors.affiliation: Comprehensive Cancer Center, Central Nervous System Tumor Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.|Department of Medicine I, Medical University of Vienna, Vienna, Austria.|Department of Pathology, Medical University of Vienna, Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Birner
authors.affiliation: Pharmacy Department, General Hospital Vienna, Vienna, Austria.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Aretin
authors.affiliation: Comprehensive Cancer Center, Central Nervous System Tumor Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Rupert
authors.initials: R
authors.lastname: Bartsch
authors.affiliation: Comprehensive Cancer Center, Central Nervous System Tumor Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.|Department of Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: Christoph C
authors.initials: CC
authors.lastname: Zielinski
authors.affiliation: Institute of Psychology, University of Graz, Graz, Austria.|BioTechMed, Graz, Austria.
authors.forename: Veronika
authors.initials: V
authors.lastname: Schöpf
authors.affiliation: Comprehensive Cancer Center, Central Nervous System Tumor Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria. matthias.preusser@meduniwien.ac.at.|Department of Medicine I, Medical University of Vienna, Vienna, Austria. matthias.preusser@meduniwien.ac.at.
authors.forename: Matthias
authors.initials: M
authors.lastname: Preusser
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000556:secondary; D001943:Breast Neoplasms / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013703:Temporal Muscle / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: Brain metastases; Cancer cachexia; Diagnosis-specific graded prognostic assessment; Prognosis; Sarcopenia