Table 3.
Evidence for the prognostic value of different body composition measures and proposed research directions.
| Modality | Measures | Cut-Offs/ Evidence |
Proposed Research |
|---|---|---|---|
| CT | L3-SMI Myosteatosis VSR |
Yes/high Yes/medium No/low |
Stratification and differentiation of cut-offs Validation, stratification, and differentiation of cut-offs Establishment of cut-offs Automated reporting and implementation in advanced models for risk prediction |
| DXA | ASMI or ALM Arm lean mass Fat mass |
Yes/low Yes/medium No/low |
Validation, stratification, and differentiation of cut-offs Validation, stratification, and differentiation of cut-offs Establishment of prognostic value and cut-offs Intervention studies with repeated assessments |
| BIA | ASMI or ALM Arm lean mass Fat mass Phase angle |
Yes/low Yes/medium No/low Yes/medium |
Validation, stratification, and differentiation of cut-offs Validation, stratification, and differentiation of cut-offs Establishment of prognostic value and cut-offs Validation, stratification, and differentiation of cut-offs Intervention studies with repeated assessments |
| MRI | L3-SMI Myosteatosis VSR |
Yes/medium No/medium No/low |
Validation, stratification, and differentiation of cut-offs Establishment and validation of cut-offs Establishment and validation of cut-offs Pathophysiology of body composition changes in liver disease Automated reporting and AI analysis to improve risk prediction |
| US | Muscle thickness, CSA, and volume, Pennation angle, Echo intensity, Feather index, Shear wave velocity |
No/low | Standardization and reliability studies Establishment of prognostic values and cut-offs Intervention studies with repeated assessments |
CT: Computed Tomography, DXA: Dual-energy X-ray Absorptiometry, BIA: Bioelectrical Impedance Analysis, MRI: Magnetic Resonance Imaging, US: Ultrasonography, L3-SMI: skeletal muscle index at the L3 level. VSR: visceral-to-subcutaneous fat ratio. ASMI: appendicular skeletal muscle index. ALM: appendicular lean mass. Validation, i.e., establishment of cut-offs or testing the ability of established cut-offs to predict morbidity and mortality. Stratification and differentiation, i.e., establishment of cut-offs for different severity categories of sarcopenia, different etiologies of liver disease, or according to gender.