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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Understanding Muscle Before it's Gone: Multi-Parametric Characterization of Skeletal Muscle Biomarkers Derived From DXA and MRI in a Frail Population / Imaging Frailty and it's Skeletal Muscle Biomarkers

Grala, Konrad 11 1900 (has links)
Approximately 23% of Canadians over the age of 65 are considered frail, with that number predicted to increase up to 40% for the population over the age of 85. Frailty is a geriatric syndrome defined by the natural decline in muscle mass and function caused by the natural aging process. When developing to an excessive degree, frailty may present as a disease state, which is recognized as sarcopenia. The exact definition of sarcopenia relies on the presence of low muscle mass, strength, and/or function, but quantitative cut-off values are still a topic of debate. Understanding how biomarkers measured via diagnostic imaging such as magnetic resonance imaging (MRI) and dual-energy x-ray absorptiometry (DXA) describe skeletal muscle can allow doctors to develop a profile of sarcopenia and define predictors to aide in preventative therapy. 4 male and 9 female (mean age = 78 ± 6.5 years) participants from a frailty study underwent full-body DXA and had their dominant thigh scanned using a 3.0T MRI. DXA-derived appendicular lean mass (ALM) and MRI-derived cross-sectional area (CSA), fat fraction (FF), T2 relaxation (T2), magnetization transfer ratio (MTR), fractional anisotropy (FA) and mean diffusivity (MD) from 4 muscle groups at the mid-thigh were defined as muscle biomarkers. Pearson's correlation was calculated to identify relationships between biomarkers and a Wilcoxon rank-sum test was performed to assess the agreement of low-muscle mass characterization between ALM normalized by height (ALMI), ALM normalized by BMI (ALM/BMI), and the gold standard MRI cross-sectional area. Strong positive correlations between muscle quantity biomarkers such as ALMI and CSA were recognized within the quadriceps (p=0.0095), adductors (p=0.035), and sartorius (p=0.00065) muscles while muscle quality biomarkers such as FF and T2 showed significant positive correlation within the quadriceps (p=3.58*10^-5) and the hamstring (p=0.0042) muscles. Finally, ALM/BMI displayed a much stronger agreement in muscle mass quantification with the gold-standard of MRI-CSA over the more commonly researched ALMI from DXA. The main purpose of this study was to collate a vast array of skeletal muscle biomarkers obtained using DXA and MRI on a frail population, and show that significant correlations can be recognized from a single MRI-slice located at the mid-thigh. Additionally, this study recognized the potential of ALM/BMI as the DXA-derived biomarker of choice in muscle mass assessment of frailty. / Thesis / Master of Applied Science (MASc) / A person is diagnosed with sarcopenia when they present symptoms of low muscle mass, strength, and/or function. Defining these three criteria with objective measures has been long debated by researchers and clinicians alike. By understanding how different properties, or biomarkers, of skeletal muscle relate to one another and change as a person becomes more frail, we hope to better understand sarcopenia and identify the best measures to classify someone as sarcopenic. Being able to accurately diagnose someone as sarcopenic early allows for more effective treatment of this muscle disease. In this study, non-invasive magnetic resonance imaging (MRI) and dual energy x-ray absorptiometry (DXA) were used to measure many different biomarkers of skeletal muscle at the mid-thigh. Through characterizing these measures of muscle quality and quantity between different imaging techniques this study aimed to recognize which imaging techniques, and more specifically biomarkers, can best distinguish between a person who is sarcopenic and one who is non-sarcopenic.

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