Opinions

Reply to the Letter to the Editor:”Imaging of sarcopenia: old evidence and new insights”

by Domenico Albano, Carmelo Messina, Jacopo Vitale, Luca Maria Sconfienza (io@lucasconfienza.it)

Imaging of sarcopenia: old evidence and new insights

Dear Editor,

We thank the colleagues Brun-Vergara and Torres-Cortes for their letter regarding our paper entitled “Imaging of sarcopenia: old evidence and new insights” recently published in European Radiology [1].

However, although we really value their comments, we find them not much related to our paper. In detail:

i. they commented on bioelectrical impedance phase angle, which actually is a parameter assessed using bioelectric impedance analysis and not using imaging [2]. This is the reason why this parameter is not included in our review, which is focused on imaging;
ii. authors postulate some thresholds for sarcopenia measurement on ultrasound. As an example, they provide a single paper which reports r = 0.38 correlation and around 70% sensitivity and specificity in respect to bioelectric impedance analysis for the diagnosis of sarcopenia [3]. We think these values seem quite suboptimal to use them in clinical practice and we are still convinced that there is no consensus on the use of ultrasound in the routine evaluation of sarcopenia;
iii. authors report that in our paper we wrote “CT muscle segmentation is not feasible to perform”. We are quite surprised, as we never wrote this sentence. Conversely, in our paper we strongly support the use of computed tomography in the evaluation of sarcopenia. The introduction of artificial intelligence algorithms will be certainly a step forward in this field, however at the time of acceptance of our paper, no strong evidence was published on that. We note that the article indicated in the comment letter [4] is dated April 2020, which is six months later than the acceptance of our paper [1].

Regards,
Domenico Albano, Carmelo Messina, Jacopo Vitale, Luca Maria Sconfienza

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