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Automated evaluation of masseter muscle volume: deep learning prognostic approach in oral cancer
BMC Cancer volume 24, Article number: 128 (2024)
Abstract
Background
Sarcopenia has been identified as a potential negative prognostic factor in cancer patients. In this study, our objective was to investigate the relationship between the assessment method for sarcopenia using the masseter muscle volume measured on computed tomography (CT) images and the life expectancy of patients with oral cancer. We also developed a learning model using deep learning to automatically extract the masseter muscle volume and investigated its association with the life expectancy of oral cancer patients.
Methods
To develop the learning model for masseter muscle volume, we used manually extracted data from CT images of 277 patients. We established the association between manually extracted masseter muscle volume and the life expectancy of oral cancer patients. Additionally, we compared the correlation between the groups of manual and automatic extraction in the masseter muscle volume learning model.
Results
Our findings revealed a significant association between manually extracted masseter muscle volume on CT images and the life expectancy of patients with oral cancer. Notably, the manual and automatic extraction groups in the masseter muscle volume learning model showed a high correlation. Furthermore, the masseter muscle volume automatically extracted using the developed learning model exhibited a strong association with life expectancy.
Conclusions
The sarcopenia assessment method is useful for predicting the life expectancy of patients with oral cancer. In the future, it is crucial to validate and analyze various factors within the oral surgery field, extending beyond cancer patients.
Background
Despite the advancements in the treatment that have improved the survival rates, oral cancer has the highest mortality rate among all types of head and neck cancers [1]. A total of 377,713 new cases and 177,757 deaths due to oral cancer were reported in 2020, making it the 18th most commonly diagnosed cancer worldwide [2]. In Japan, the number of oral cancer cases is increasing as the population ages, accounting for approximately 40% of all head and neck cancer cases. The male-to-female ratio is 3:2, with men outnumbering women; the majority of patients with oral cancer are in their 60s [3]. Recently, sarcopenia, characterized by the loss of muscle strength and mass, may be a poor prognostic factor in patients with cancer [4]. Patients with head and neck cancer and upper gastrointestinal cancer have a significantly higher risk of developing sarcopenia compared with patients with other cancer types, owing to severe nutritional disorders [5]. Patients with oral cancer may already have sarcopenia prior to the diagnosis of cancer due to undernutrition and weight loss caused by difficulty with oral intake. However, only a few studies have reported the occurrence of sarcopenia in patients diagnosed with oral cancer; therefore, the actual incidence of sarcopenia remains unclear.
The Asian Working Group for Sarcopenia (AWGS) [6] diagnostic criteria include the skeletal muscle index (SMI) determined by bioelectrical impedance analysis (BIA) to assess the limb skeletal muscle mass. Recently, a sarcopenia assessment method using the area [7] and volume [8] of the psoas major muscle measured at the level of the third lumbar vertebra (L3) on computed tomography (CT) images in patients with gastroin-testinal cancer has been reported and is associated with life expectancy. However, assessing the psoas major muscle at the L3 level is difficult as abdominal CT imaging is not routinely performed in patients with oral cancer. Wallace et al. [9] reported that the cross-sectional area of the masseter muscle correlates with the L3-level psoas major cross-sectional area on CT images in older patients with trauma. Yoshimura et al. re-ported that cervical (C3) skeletal muscle mass measured on CT may be associated with the favorable prognosis in patients with oral squamous cell carcinoma [10](1). The masseter muscle plays an important role in performing masticatory movements. The masseter muscle cross-sectional area directly correlates with bite force [11], and the maximum bite force is associated with mortality [12].
In recent years, artificial intelligence (AI) has been rapidly implemented in society with advancements in hardware, such as graphic processing units, faster Internet speeds, and the widespread use of cloud storage. Using deep learning, the methods used for automatically detecting polyps on colonoscopy images [13], the methods for classifying lung cancer using cytological diagnosis images [14], and research and development applying deep learning technology in the medical field are rapidly advancing.
This study aimed to investigate the association between a decrease in masseter muscle volume (MMV) on CT images and life expectancy in patients with oral cancer. In addition, to eliminate the bias caused by the evaluator’s manual extraction of the MMV data, we developed a learning model that automatically extracts the MMV data using deep learning and examined its clinical usefulness.
Methods
Patients
We included 348 patients (177 men and 171 women) admitted in the Department of Oral Surgery, Osaka University Dental Hospital (our department) and scheduled for surgery under general anesthesia between January 2017 and December 2020 (Table 1).
We used the data of these patient groups to determine the cutoff values. Head and neck CT and Body composition analysis by BIA were performed on all patients prior to treatment. We excluded patients aged < 20 years, those with infections that might affect nutrition-related factors, and those with a history of syndromes involving head and neck dysplasia.
We included 308 patients (176 men and 132 women) with oral cancer who received primary treatment at our department between January 2006 and December 2020 (Table 2).
The data of these patient groups were used for validation. CT imaging of the head and neck was performed in all patients prior to treatment. Exclusion criteria included patients with direct tumor invasion of the masseter muscle, previous surgical or nonsurgical treatment for oral cancer, and patients younger than 20 years of age who were still growing, in order to ensure that the masseter volume measurements were not directly influenced by the presence of a tumor.
This study was approved by the Ethical Review Committee of Osaka University Graduate School of Dentistry and Dental Hospital (approval no. H29-E19).
Methods of measuring skeletal muscle index and masseter muscle volume
SMI was measured at the time of admission using the BIA method with InBody 570TM (InBody Japan). MMV was measured on the head and neck CT images obtained within 6 months prior to the initiation of treatment. Contrast or non-contrast CT imaging was performed using the following parameters: 2.5–5.0-mm slice thickness, 120 kVp, and 200–330 mA. The images acquired were converted from DICOM format to NIFTY format. Volume values were calculated by manually extracting both sides of the masseter muscle from the head and neck CT images using a three-dimensional slicer (version 4.11.0, www.slicer.org). The accuracy of the manual extraction of the masseter muscle was con-firmed by a specialist in our department (certified by the Japanese Society for Oral and Maxillofacial Radiology).
Analysis factors
We collected the data on age, sex, stage (Union for International Cancer Control 8th edition [15]), and nutrition-related factors as analytic factors. Meanwhile, the following nutrition-related factors were obtained: C-reactive protein (CRP) (mg/dL), albumin (Alb) (g/dL), Alb/globulin (A/G) ratio, total cholesterol (T-cho) (mg/dL), body mass index (BMI) (kg/m2), CRP/Alb ratio (CAR) [16], neutrophil/lymphocyte ratio (NLR) [17], plate-let/lymphocyte ratio (PLR) [18], prognostic nutrition index (PNI) [19], modified Glasgow prognostic score (mGPS) [20], and controlling nutritional status (CONUT) score [21, 22]. CAR, NLR, PLR, and PNI were calculated as follows: CAR = CRP (mg/dL)/Alb (g/dL), NLR = neutrophil count/lymphocyte count, PLR = platelet count/lymphocyte count, and PNI = 10 × Alb (g/dL) + 0.005 × lymphocyte count. The mGPS was scored by combining CRP (mg/dL) and Alb (g/dL), while CONUT was scored by combining Alb (g/dL), total lymphocyte count, and T-cho (mg/dL). CAR, NLR, PLR, PNI, mGPS, and CONUT score were reported as prognostic predictors in patients with gastrointestinal cancer [16,17,18,19,20,21,22]. Among the data used for setting the cutoff values (Table 1), the cutoff values for age- and nutrition-related factors were set using the cutoff values for SMI in accordance with the AWGS [6] diagnostic criteria and using the receiver operating characteristic (ROC) curve.
Development of the masseter muscle volume learning model
Clara Train SDK from NVIDIA Clara Imaging (Clara) (https://developer.nvidia.com/clara-medical-imaging) was used to develop the MMV learning model. Clara is a platform for medical imaging that has AI capabilities, such as medical image reconstruction, annotation, and segmentation using deep learning. Clara Train SDK is a Python-based application. Models can be trained by AI-assisted annotation of NVIDIA’s pretrained models, transfer learning using the individual institution’s own data, and automatic machine learning. In the 277 patients, after excluding the data of patients with oral cancer from those used for setting cutoff values (Table 1), the MMV manual extraction data and original CT image data were used as training data. We developed the MMV learning model by transferring a pretrained spleen volume model (https://catalog.ngc.nvidia.com/orgs/nvidia/teams/med/models/clara_pt_spleen_ct_annotation) based on SegResNet [23], which is included in the Clara Train SDK (Fig. 1).
In the validation data (Table 2), artificial intelligence masseter muscle volume (AIMMV) was defined as the automatically extracted masseter muscle volume.
Items for investigation
Setting of cutoff values for masseter muscle volume
The MMV cutoff values for men and women were set using the cutoff values for SMI according to the AWGS [6] diagnostic criteria (men, < 7.0 kg/m2; women, < 5.7 kg/m2) and using the ROC curve. The patient data for setting cutoff values (Table 1) were used to set the cutoff values.
Evaluation of manually extracted masseter muscle volume
We evaluated the correlation between MMV and SMI using Pearson’s correlation coefficient. In the validation data (Table 2), the overall survival (OS) of the low MMV group was evaluated using the log-rank test. Moreover, a univariate analysis of the OS was performed using Fisher’s exact test after adjusting for age, sex, stage, nutrition-related factors, and low MMV, while a multivariate analysis of the factors that were significantly different was performed using the Cox proportional hazards regression model.
Evaluation of masseter muscle volume automatically extracted by the masseter muscle volume learning model
In the validation data (Table 2), we evaluated the correlation between manually extracted MMV and automatically extracted AIMMV using Pearson’s correlation coefficient. Then, we evaluated the OS of the low AIMMV group using the log-rank test. In addition, a univariate analysis of the OS was performed using Fisher’s exact test after adjusting for age, sex, stage, nutrition-related factors, and low AIMMV, while a multivariate analysis of the factors that were significantly different was performed using the Cox proportional hazards regression model.
Statistical analyses
All statistical analyses were performed using EZR version 1.40, with a statistical significance level set at a p-value of < 0.05. Descriptive statistics for normally distributed continuous variables were presented as mean and standard deviation. Normality was investigated using the Kolmogorov–Smirnov test. Categorical variables were expressed as frequency (n) and ratio (%).
OS was measured from the date of primary treatment initiation to the date of death or final follow-up. Pearson’s correlation coefficient was used to analyze the correlation between MMV and SMI and between the manually extracted MMV and AIMMV auto-matically extracted by the MMV learning model. For comparative analysis of OS in the low and normal muscle mass groups, the log-rank test was used and visualized using Kaplan–Meier curves.
Fisher’s exact test and the Cox proportional hazards regression model were used for the univariate and multivariate analyses of OS after the adjusting for age, sex, stage, nutrition-related factors, and low muscle mass. The covariates used in the multivariate analysis were selected from the factors that were significantly different in the univariate analysis.
Results
Setting of cutoff values for masseter muscle volume
The MMV cutoff values were calculated as follows: MMV (men, 45.030 cm3/area under the curve [AUC] = 0.690; women, 31.752 cm3/AUC = 0.625). We divided the patients into two groups (low and normal MMV groups/low and normal AIMMV groups) based on these cutoff values.
Evaluation of manually extracted masseter muscle volume
MMV and SMI showed a moderate positive correlation in both men and women (men: correlation coefficient [r] = 0.37, p < 0.001; women: r = 0.36, p < 0.001). The OS rate in the low MMV group was significantly lower than that in the normal MMV group for both men and women (men: hazard ratio [HR] = 0.598; 95% confidence interval [CI], 0.438–0.726, p < 0.001; women: HR = 0.616; 95% CI, 0.433–0.755; p < 0.001) (Fig. 2).
In the univariate analysis, stage, CRP, Alb, A/G ratio, mGPS, CONUT score, NLR, PNI, BMI, and low MMV were significantly associated with OS. In the multivariate analysis, low MMV was an independent poor prognostic factor (HR, 4.325; 95% CI, 2.082–8.981; p < 0.001) (Table 3).
Evaluation of the masseter muscle volume automatically extracted by the masseter muscle volume learning model
A comparison of the MMV extracted manually and the AIMMV extracted automatically by the MMV learning model is shown in Fig. 3.
MMV and AIMMV showed a high positive correlation in both men and women (men: r = 0.972, p < 0.001; women: r = 0.965, p < 0.001). The OS rate in the low AIMMV group was significantly lower than that in the normal AIMMV group for both men and women (men: HR = 0.690; 95% CI, 0.547–0.795; p < 0.001; women: HR = 0.746; 95% CI, 0.611–0.840; p = 0.013) (Fig. 4).
In the univariate analysis, stage, CRP, Alb, A/G ratio, mGPS, CONUT score, NLR, PNI, BMI, and low AIMMV were significantly associated with OS. In the multivariate analysis, low AIMMV was an independent poor prognostic factor (HR, 2.231; 95% CI, 1.055–4.719; p = 0.036) (Table 4).
Discussion
In recent years, nutritional disorders and sarcopenia have been associated with postoperative complications and life expectancy in patients with various cancers. Several methods for assessing sarcopenia have been reported using the L3-level psoas muscle cross-sectional area on abdominal CT images in patients with gastrointestinal cancer [24,25,26]. However, abdominal CT is not routinely performed in patients with oral cancer. Swartz et al. [27] reported a sarcopenia assessment method using sternocleidomastoid and paravertebral muscle cross-sectional areas at the level of the third cervical vertebra on head and neck CT images. In 2017, Wallace et al. [9] reported a sarcopenia assessment method using the masseter muscle cross-sectional area on head CT images. Owing to the advancements in diagnostic imaging, volume, rather than cross-sectional area, has be-come an important parameter in assessing sarcopenia in various clinical settings [28, 29]. This study showed a correlation between SMI as defined in the AWGS [6] diagnostic criteria and MMV on CT images. Furthermore, a decrease in MMV on CT images was an independent poor prognostic factor in patients with oral cancer. This study is the first to report a significant association between MMV measured on head and neck CT images and life expectancy of patients with oral cancer. The cross-sectional area and density of the masseter muscle decrease with aging, and these changes are consistent with the general age-related changes in muscle tissue throughout the body [30, 31]. The masseter muscle thickness measured by ultrasound may be related to the risk of malnutrition in older adult patients requiring care [10]. Masseter muscle thickness measured by ultrasound in elderly patients with hip fractures may also be associated with the risk of dysphagia [32]. Masseter muscle atrophy occurs with aging through the activation of the autophagy–lysosome pathway [33]. Hwang et al. demonstrated a significant correlation between the mass of the masseter muscle and that of the L3 psoas major. This finding implies that the masseter muscle mass could be indicative of general muscular mass and nutritional status, considering the pivotal role of the L3 psoas major in the evaluation of sarcopenia [34]. Additionally, various preoperative nutritional indicators in patients with advanced oral cancer have been linked to both the occurrence of Surgical Site Infections and life expectancy [35]. These observations suggest that the Masseter Muscle Volume (MMV) might serve as a valuable prognostic tool in oral cancer cases. On the other hand, it has been reported that patients with oral cancer often experience a decline in oral function and nutritional status due to the effects of the cancer before treatment [36]. Clinically, it is anticipated that the more advanced the cancer stage, the more pronounced these effects become. Therefore, particularly in cases of advanced lower gingival carcinoma, direct invasion of the masseter muscle may be affected, suggesting that our findings may not be applicable in such situations.
These studies suggested that the sarcopenia assessment method using MMV measured on the head and neck CT images may be useful for predicting the life expectancy of patients with oral cancer.
Currently, the extraction of MMV from CT images is performed by manual manipulation, which is cumbersome and may lead to bias. To address this issue, we developed a learning model for the automatic extraction of the MMV using deep learning. The Clara Train SDK used in this study included NVIDIA’s pretrained models (Medical Model Archive [MMAR]). New models can be developed with high accuracy using MMAR for transfer learning. In this study, a high correlation was observed between the MMV in the manual and automatic extraction groups. Furthermore, a decrease in MMV, automatically extracted from the MMV learning model, was an independent poor prognostic factor. Therefore, it is possible to quickly, simply, and objectively predict the prognosis of patients with oral cancer. However, the MMV values automatically extracted by the MMV learning model tended to be relatively lower than those of the manual extraction group. To improve its accuracy, the number of training data should be increased, and the training parameters should be standardized.
This study has some limitations. It is a single-center retrospective study. Due to the relatively small number of patients and unequal proportion of men and women, selection bias cannot be excluded. In addition, the definition of sarcopenia based on muscle mass measured on CT images has not been established, and the specific cutoff values have not been determined [37]. In this study, the target patients were Japanese, and the cutoff values were set using the AWGS [6] diagnostic criteria based on the Asian epidemiological data. Therefore, large prospective studies are required to validate the usefulness of MMV in patients with oral cancer. As this study focused only on patients with oral cancer, further studies will be conducted to validate and analyze the association of various factors in other patient groups.
Conclusions
This study showed that assessing sarcopenia using MMV measured on CT images is associated with life expectancy in patients with oral cancer. Furthermore, the method for assessing sarcopenia using the MMV learning model developed utilizing deep learning has also been associated with life expectancy. Therefore, this study suggests that the sarcopenia assessment method using MMV measured on CT images and the MMV learning model may be useful for predicting the life expectancy in patients with oral cancer.
Data availability
The datasets generated and/or analyzed during the current study are not publicly available due to ethical concerns regarding patient’s confidentiality but are available from the corresponding author on reasonable request.
Abbreviations
- A/G:
-
Alb/globulin
- AI:
-
Artificial intelligence
- AIMMV:
-
Artificial intelligence masseter muscle volume
- Alb:
-
Albumin
- AWGS:
-
Asian Working Group for Sarcopenia
- BIA:
-
Bioelectrical impedance analysis
- BMI:
-
Body mass index
- CAR:
-
CRP/Alb ratio [16]
- C3:
-
Cervical
- Clara:
-
Clara Train SDK from NVIDIA Clara Imaging
- CONUT:
-
And controlling nutritional status
- CRP:
-
C-reactive protein
- CT:
-
Computed tomography
- HR:
-
Hazard ratio
- L3:
-
Third lumbar vertebra
- mGPS:
-
Modified Glasgow prognostic score
- MMAR:
-
Medical Model Archive
- MMV:
-
Masseter muscle volume
- NLR:
-
Neutrophil/lymphocyte ratio
- OS:
-
Overall survival
- PLR:
-
Plate-let/lymphocyte ratio
- PNI:
-
Prognostic nutrition index
- ROC:
-
Receiver operating characteristic
- SD:
-
Standard deviation
- SMI:
-
Skeletal muscle index
- SMI:
-
Skeletal muscle index
- T-cho:
-
Total cholesterol
References
Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA Cancer J Clin. 2021;71:7–33. https://doi.org/10.3322/caac.21654
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49. https://doi.org/10.3322/caac.21660
Committee, J.S.f.H.a.N.C.C.R. Report of head and neck cancer registry of Japan clinical statistics of registered patients. Jpn J Head Neck Cancer. 2002;32:1–98.
Bozzetti F. Forcing the vicious circle: Sarcopenia increases toxicity, decreases response to chemotherapy and worsens with chemotherapy. Ann Oncol. 2017;28:2107–18. https://doi.org/10.1093/annonc/mdx271
Pressoir M, Desné S, Berchery D, Rossignol G, Poiree B, Meslier M, et al. Prevalence, risk factors and clinical implications of malnutrition in French comprehensive cancer centres. Br J Cancer. 2010;102:966–71. https://doi.org/10.1038/sj.bjc.6605578
Chen L-K, Woo J, Assantachai P, Auyeung T-W, Chou M-Y, Iijima K, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21:300–307e2. https://doi.org/10.1016/j.jamda.2019.12.012
Pecorelli N, Carrara G, De Cobelli F, Cristel G, Damascelli A, Balzano G, et al. Effect of sarcopenia and visceral obesity on mortality and pancreatic fistula following pancreatic cancer surgery. Br J Surg. 2016;103:434–42. https://doi.org/10.1002/bjs.10063
Amini N, Spolverato G, Gupta R, Margonis GA, Kim Y, Wagner D, et al. Impact total psoas volume on short- and long-term outcomes in patients undergoing curative resection for pancreatic adenocarcinoma: a new tool to assess sarcopenia. J Gastrointest Surg. 2015;19:1593–602. https://doi.org/10.1007/s11605-015-2835-y
Wallace JD, Calvo RY, Lewis PR, Brill JB, Shackford SR, Sise MJ, et al. Sarcopenia as a predictor of mortality in elderly blunt trauma patients: comparing the masseter to the psoas using computed tomography. J Trauma Acute Care Surg. 2017;82:65–72. https://doi.org/10.1097/TA.0000000000001297
Yoshimura T, Suzuki H, Takayama H, Higashi S, Hirano Y, Tezuka M, et al. Prognostic role of preoperative sarcopenia evaluation of cervical muscles with long-term outcomes of patients with oral squamous cell carcinoma. Cancers (Basel). 2021;13(18):4725. https://doi.org/10.3390/cancers13184725
Van Spronsen PH, Weijs WA, Valk J, Prahl-Andersen B, van Ginkel FC. Comparison of jaw-muscle bite-force cross-sections obtained by means of magnetic resonance imaging and high-resolution CT scanning. J Dent Res. 1989;68:1765–70. https://doi.org/10.1177/00220345890680120901
Iwasaki M, Yoshihara A, Sato N, Sato M, Taylor GW, Ansai T, et al. Maximum bite force at age 70 years predicts all-cause mortality during the following 13 years in Japanese men. J Oral Rehabil. 2016;43:565–74. https://doi.org/10.1111/joor.12401
Yu L, Chen H, Dou Q, Qin J, Heng PA. Integrating online and offline three-dimensional deep learning for automated polyp detection in colonoscopy videos. IEEE J Biomed Health Inform. 2017;21:65–75. https://doi.org/10.1109/JBHI.2016.2637004
Teramoto A, Tsukamoto T, Kiriyama Y, Fujita H. Automated classification of lung cancer types from cyto-logical images using deep convolutional neural networks. BioMed Res Int. 2017;2017:4067832. https://doi.org/10.1155/2017/4067832
Bertero L, Massa F, Metovic J, Zanetti R, Castellano I, Ricardi U, et al. Eighth edition of the UICC classification of malignant tumours: an overview of the changes in the pathological TNM classi-fication criteria-what has changed and why? Virchows Arch 8th Edition. 2018;472:519–31. https://doi.org/10.1007/s00428-017-2276-y
Ishizuka M, Nagata H, Takagi K, Iwasaki Y, Shibuya N, Kubota K. Clinical significance of the C-reactive protein to albumin ratio for survival after surgery for colorectal cancer. Ann Surg Oncol. 2016;23:900–7. https://doi.org/10.1245/s10434-015-4948-7
Chiang S-F, Hung H-Y, Tang R, Changchien CR, Chen J-S, You Y-T, et al. Can neutrophil-to-lymphocyte ratio predict the survival of colorectal cancer patients who have received curative surgery electively? Int J Colorectal Dis. 2012;27:1347–57. https://doi.org/10.1007/s00384-012-1459-x
Messager M, Neofytou K, Chaudry MA, Allum WH. Prognostic impact of preoperative platelets to lym-phocytes ratio (PLR) on survival for oesophageal and junctional carcinoma treated with neoadjuvant chemo-therapy: a retrospective monocentric study on 153 patients. Eur J Surg Oncol. 2015;41:1316–23. https://doi.org/10.1016/j.ejso.2015.06.007
Kanda M, Mizuno A, Tanaka C, Kobayashi D, Fujiwara M, Iwata N, et al. Nutritional predictors for postoperative short-term and long-term outcomes of patients with gastric cancer. Med (Baltim). 2016;95:e3781. https://doi.org/10.1097/MD.0000000000003781
Toiyama Y, Miki C, Inoue Y, Tanaka K, Mohri Y, Kusunoki M. Evaluation of an inflammation-based prognostic score for the identification of patients requiring postoperative adjuvant chemotherapy for stage II colorectal cancer. Exp Ther Med. 2011;2:95–101. https://doi.org/10.3892/etm.2010.175
Iseki Y, Shibutani M, Maeda K, Nagahara H, Ohtani H, Sugano K, et al. Impact of the preoperative controlling nutritional status (CONUT) score on the survival after curative surgery for colorectal cancer. PLoS ONE. 2015;10:e0132488. https://doi.org/10.1371/journal.pone.0132488
Toyokawa T, Kubo N, Tamura T, Sakurai K, Amano R, Tanaka H, et al. The pretreatment controlling nutritional status (CONUT) score is an independent prognostic factor in patients with resectable thoracic esophageal squamous cell carcinoma: results from a retrospective study. BMC Cancer. 2016;16:722. https://doi.org/10.1186/s12885-016-2696-0
Myronenko A. 3D MRI brain tumor segmentation using autoencoder regularization. Brainlesion: Glioma, multiple sclerosis, stroke and traumatic brain injuries. Cham: Springer International Publishing; 2019. pp. 311–20. https://doi.org/10.1007/978-3-030-11726-9_28
Peng P, Hyder O, Firoozmand A, Kneuertz P, Schulick RD, Huang D, et al. Impact of sarcopenia on outcomes following resection of pancreatic adenocarcinoma. J Gastrointest Surg. 2012;16:1478–86. https://doi.org/10.1007/s11605-012-1923-5
Zhuang C-L, Huang D-D, Pang W-Y, Zhou CJ, Wang S-L, Lou N, et al. Sarcopenia is an independent predictor of severe postoperative complications and long-term survival after radical gastrectomy for gastric cancer: analysis from a large-scale cohort. Med (Baltim). 2016;95:e3164. https://doi.org/10.1097/MD.0000000000003164
Malietzis G, Currie AC, Athanasiou T, Johns N, Anyamene N, Glynne-Jones R, et al. Influence of body composition profile on outcomes following colorectal cancer surgery. Br J Surg. 2016;103:572–80. https://doi.org/10.1002/bjs.10075
Swartz JE, Pothen AJ, Wegner I, Smid EJ, Swart KMA, de Bree R, et al. Feasibility of using head and neck CT imaging to assess skeletal muscle mass in head and neck cancer patients. Oral Oncol. 2016;62:28–33. https://doi.org/10.1016/j.oraloncology.2016.09.006
Prasad SR, Jhaveri KS, Saini S, Hahn PF, Halpern EF, Sumner JE. CT tumor measurement for therapeutic response assessment: comparison of unidimensional, bidimensional, and volumetric techniques initial observations. Radiology. 2002;225:416–9. https://doi.org/10.1148/radiol.2252011604
Mozley PD, Schwartz LH, Bendtsen C, Zhao B, Petrick N, Buckler AJ. Change in lung tumor volume as a biomarker of treatment response: a critical review of the evidence. Ann Oncol. 2010;21:1751–5. https://doi.org/10.1093/annonc/mdq051
Newton JP, Yemm R, Abel RW, Menhinick S. Changes in human jaw muscles with age and dental state. Gerodontology. 1993;10:16–22. https://doi.org/10.1111/j.1741-2358.1993.tb00074.x
Raadsheer MC, van Eijden TMGJ, van Ginkel FC, Prahl-Andersen B. Human jaw muscle strength and size in relation to limb muscle strength and size. Eur J Oral Sci. 2004;112:398–405. https://doi.org/10.1111/j.1600-0722.2004.00154.x
Sanz-Paris A, González-Fernandez M, Hueso-Del RÃo LE, Ferrer-Lahuerta E, Monge-Vazquez A, Losfablos-Callau F, et al. Muscle thickness and echogenicity measured by ultrasound could detect local sarcopenia and malnutrition in older patients hospitalized for hip fracture. Nutrients. 2021;13:2401. https://doi.org/10.3390/nu13072401
Iida R-H, Kanko S, Suga T, Morito M, Yamane A. Autophagic-lysosomal pathway functions in the masseter and tongue muscles in the klotho mouse, a mouse model for aging. Mol Cell Biochem. 2011;348:89–98. https://doi.org/10.1007/s11010-010-0642-z
Hwang Y, Lee YH, Cho DH, Kim M, Lee DS, Cho HJ. Applicability of the masseter muscle as a nutritional biomarker. Med (Baltim). 2020;99(6):e19069. https://doi.org/10.1097/md.0000000000019069
Hiraoka SI, Shimada Y, Kawasaki Y, Akutagawa M, Tanaka S. Preoperative nutritional evaluation, surgical site infection, and prognosis in patients with oral cancer. Oral surgery, oral medicine, oral pathology and oral radiology. 2022;134(2):168–75. https://doi.org/10.1016/j.oooo.2022.01.009
Matsuda Y, Okui T, Tatsumi H, Okuma S, Kato A, Morioka R, et al. Oral dysfunction in patients with oral cancer could occur before treatment and require early nutritional improvement: a cross-sectional study. Dysphagia. 2023;38(4):1096–105. https://doi.org/10.1007/s00455-022-10531-4
Kurumisawa S, Kawahito K. The psoas muscle index as a predictor of long-term survival after cardiac surgery for hemodialysis-dependent patients. J Artif Organs. 2019;22:214–21. https://doi.org/10.1007/s10047-019-01108-4
Acknowledgements
The authors would like to thank the members of the Oral Cancer Team of the First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University. We would like to thank Editage (www.editage.jp) for English language editing.
Funding
This study was supported by Japan Society for the Promotion of Science Grants-in-Aid for Scientific Research program (grant number: JP20K10115).
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Conceptualization, S.H.; Methodology, P.R. and C.L.; Validation, K.S., K.K., S.U., R.A., K.I., S.T., and S.H.; Investigation, K.S. and S.H.; Data curation, S.K.; Writing—original draft preparation, K.S. and S.H.; Writing—review and editing, S.H.; Supervision, S.H.; Project administration, S.H; Funding acquisition, S.H. All authors have read and agreed to the published version of the manuscript.
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The study was conducted in accordance with the Declaration of Helsinki and was approved by the ethical committee of the Osaka University Dental Hospital (approval no. H29-E19). The need for informed consent was waived by the ethics committee of the Osaka University Dental Hospital, because of the retrospective nature of the study.
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Not applicable as no personal data were included in the study.
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The authors declare no competing interests.
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Sakamoto, K., Hiraoka, Si., Kawamura, K. et al. Automated evaluation of masseter muscle volume: deep learning prognostic approach in oral cancer. BMC Cancer 24, 128 (2024). https://doi.org/10.1186/s12885-024-11873-y
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DOI: https://doi.org/10.1186/s12885-024-11873-y