Value of ultrasound assessment of sarcopenia in patients with diffuse large B-cell lymphoma: A prospective study

Abstract

Background. This study investigates the clinical utility of ultrasound in diagnosing sarcopenia in patients with diffuse large B-cell lymphoma (DLBCL), focusing on muscle mass, strength, and physical fitness.

Patients and methods. A prospective analysis was conducted on 167 patients with DLBCL (88 with sarcopenia and 79 without). Muscle thickness (MT), cross-sectional area (CSA), and subcutaneous fat thickness (SFT) were measured using ultrasound at various anatomical sites. Diagnostic efficacy of muscle indices for sarcopenia was assessed using receiver operating characteristic (ROC) curves.

Results. Patients with sarcopenia exhibited significant reductions in MT and CSA across multiple muscle groups, including biceps brachii (BB), vastus intermedius (VI), and rectus femoris (RF) (all p ≤ 0.001). ROC analysis identified RF-CSA as the most effective indicator of sarcopenia, with an area under the curve (AUC) of 0.87, a sensitivity of 86%, and a specificity of 83% at a critical value of 7.08 cm². Multivariate analysis revealed that reduced MT and CSA significantly increased the risk of sarcopenia after adjusting for age, gender, and physical performance.

Conclusions. Ultrasound is a cost-effective and accessible diagnostic tool for identifying sarcopenia in DLBCL patients. Early detection through ultrasound can guide timely interventions and improve clinical outcomes.