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Single-slice CT measurements allow for accurate assessment of sarcopenia and body composition

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript



To evaluate the correlation between simple planimetric measurements in axial computed tomography (CT) slices and measurements of patient body composition and anthropometric data performed with bioelectrical impedance analysis (BIA) and metric clinical assessments.


In this prospective cross-sectional study, we analyzed data of a cohort of 62 consecutive, untreated adult patients with advanced malignant melanoma who underwent concurrent BIA assessments at their radiologic baseline staging by CT between July 2016 and October 2017. To assess muscle and adipose tissue mass, we analyzed the areas of the paraspinal muscles as well as the cross-sectional total patient area in a single CT slice at the height of the third lumbar vertebra. These measurements were subsequently correlated with anthropometric (body weight) and body composition parameters derived from BIA (muscle mass, fat mass, fat-free mass, and visceral fat mass). Linear regression models were built to allow for estimation of each parameter based on CT measurements.


Linear regression models allowed for accurate prediction of patient body weight (adjusted R2 = 0.886), absolute muscle mass (adjusted R2 = 0.866), fat-free mass (adjusted R2 = 0.855), and total as well as visceral fat mass (adjusted R2 = 0.887 and 0.839, respectively).


Our data suggest that patient body composition can accurately and quantitatively be determined by using simple measurements in a single axial CT slice. This could be useful in various medical and scientific settings, where the knowledge of the patient’s anthropometric parameters is not immediately or easily available.

Key Points

Easy to perform measurements on a single CT slice highly correlate with clinically valuable parameters of body composition.

Body composition data were acquired using bioelectrical impedance analysis to correlate CT measurements with a non-imaging-based method, which is frequently lacking in previous studies.

The obtained equations facilitate a quick, opportunistic assessment of relevant parameters of body composition.

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Bioelectrical impedance analysis


Confidence interval


Computed tomography


Dual-energy X-ray absorptiometry


Magnetic resonance imaging


Standard deviation


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This study has received funding from the Koeln Fortune Program/Faculty of Medicine, University of Cologne (Koeln Fortune 339/2018 to N. Große Hokamp), and from the Else Kröner-Fresenius Stiftung (2016-Kolleg-19 to J. Knuever).

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Correspondence to David Zopfs.

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The scientific guarantor of this publication is Daniel Pinto dos Santos.

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The authors declare that they have no conflict of interest.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

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Institutional Review Board approval was obtained.


• prospective

• cross-sectional study

• performed at one institution

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Zopfs, D., Theurich, S., Große Hokamp, N. et al. Single-slice CT measurements allow for accurate assessment of sarcopenia and body composition. Eur Radiol 30, 1701–1708 (2020).

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