The purpose of this study is to evaluate respiratory muscles, which are considered indicators of respiratory sarcopenia, using chest CT imaging and verifying inter-rater reliability.
Five patients who had undergone lung cancer surgery at this hospital between July and August 2023 were selected. Four physical therapists with no experience in measuring muscle mass using chest CT images received a lecture on the measurement method from a radiology technician beforehand. Respiratory muscle area (intercostal muscles, pectoralis muscles, and latissimus muscles) were measured using an image analysis system from the preoperative chest CT images. Measurements were taken four times each on different days. Intraclass correlation coefficients (ICC) (1, k) and ICC (2, k) were used to verify intra- and inter-rater reliability, respectively; ICC≥0.75 was considered excellent reliability.
Participants were median age of 75.0 (72.0-79.0) years, 7 (70%) male, median body mass index of 23.0 (23.0-24.0), and 4 (80%) with tumor stage I. Excellent intra-assessor reliability was demonstrated for all respiratory muscles {intercostal muscles (ICC: 0.941 to 0.985), pectoralis muscle group (ICC: 0.908 to 0.996) and latissimus (ICC: 0.885 to 0.984)}. Excellent inter-rater reliability was demonstrated for the intercostal muscles (ICC: 0.914, 95%CI: 0.533 to 0.99) and the pectoralis muscle group (ICC: 0.986, 95%CI: 0.945 to 0.98).
This study demonstrated excellent inter-rater reliability in measuring intercostal muscles and pectoral muscles by physical therapists with no experience in measuring respiratory muscle mass by chest CT images.
This finding may be important for future physiotherapy practice for respiratory sarcopenia, encouraging the establishment of respiratory muscle mass assessment by chest CT images.
Computed Tomography
Respiratory Muscles
