Intramuscular adipose tissue content (IMAC), an indicator of skeletal muscle quality, independently predicted major complications and poor prognosis in patients undergoing pancreatoduodenectomy, providing convenient and highly valuable diagnostic information on body composition.
Key Findings
Results
High IMAC independently predicted major postoperative complications after pancreatoduodenectomy.
Study included 277 patients who underwent PD between January 2013 and December 2022.
Major complications were defined as Clavien-Dindo grade ≥ 3.
High IMAC independently predicted major complications with an odds ratio of 1.776 (P = 0.046).
IMAC was assessed via computed tomography as an indicator of skeletal muscle quality.
Results
High IMAC was independently associated with poor overall survival in pancreatic cancer patients undergoing PD.
Predictive factors for survival were evaluated in 122 pancreatic cancer patients.
High IMAC was associated with poor overall survival with a hazard ratio of 1.694 (P = 0.038).
High IMAC was also independently associated with poor recurrence-free survival (HR 1.582; P = 0.038).
Both OS and RFS analyses were performed in the pancreatic cancer subgroup of 122 patients.
Results
Patients with both high IMAC and C-reactive protein-to-albumin ratio (CAR) ≥ 0.015 had significantly poorer overall survival than those with only one of the factors.
The 5-year survival rate for patients with both high IMAC and CAR ≥ 0.015 was 12.3%.
The 5-year survival rate for patients with only one of the factors was 45.8%.
The difference was statistically significant (P < 0.001).
The combination of IMAC and CAR ≥ 0.015 provided additive prognostic value.
Background
IMAC assessment requires only computed tomography, offering a convenient method for evaluating skeletal muscle quality compared to sarcopenia diagnosis.
Sarcopenia diagnosis requires a combination of motor functional tests and skeletal muscle mass measurements.
IMAC requires only computed tomography, providing convenient diagnostic information regarding body composition.
IMAC serves as an indicator of skeletal muscle quality rather than skeletal muscle mass.
The convenience of CT-based IMAC measurement is contrasted with the more complex sarcopenia diagnostic criteria in the paper's rationale.
Suzuki Y, Yoshida M, Mizuno H, Funakoshi S, Hasui N, Momose H, et al.. (2026). Assessment of Skeletal Muscle Quality via Intramuscular Adipose Tissue Content Predicts Surgical Morbidity and Prognosis After Pancreatoduodenectomy.. Pancreas. https://doi.org/10.1097/MPA.0000000000002609