PERSONALIZATION OF REHABILITATION MEASURES IN CANCER PATIENTS WITH SARCOPENIA USING RADIATION DIAGNOSTICS METHODS

Sarcopenia is a syndrome characterized by progressive generalized decrease in skeletal muscle mass and functional capacity. Since this syndrome is associated with increased incidence of complications and adverse outcomes in the treatment of other pathologies, including cancer, effective diagnostics of sarcopenia can make a significant contribution to determining the management tactics for each such patient. The aim of this study was to determine the capabilities of 18F-FDG PET/CT in detecting sarcopenia in cancer patients. We retrospectively analyzed the PET/CT results of 29 patients undergoing routine examination for primary staging or monitoring the effectiveness of cancer treatment. Two methods were used to detect sarcopenia: calculation of the musculoskeletal index (SMI) and calculation of the lumbar muscle index, while the SMI calculation method proved to be more sensitive and effective. Patients were divided into two groups: 22 people with sarcopenia and 7 without (control group). When analyzing the levels of 18F-FDG accumulation SUVmax and SUVmean in the lumbar muscles, visceral and subcutaneous fat, bones, no significant difference was found between patients in the two groups. When analyzing the levels of RFP accumulation in the same structures, taking into account the patient's height and weight, the SUV/body mass index (BMI) * 1000 indices were calculated. A statistically significant (p < 0.05) increase in SUVmax / BMI * 1000 in visceral fat was found in patients with sarcopenia compared to the control group, which may correspond to low-intensity inflammation developing in sarcopenia. A statistically significant (p<0.05) increase in SUVmean / BMI * 100 bones was also found in patients with sarcopenia, which requires additional analysis to exclude the effect of bone marrow reactivation due to chemotherapy. The obtained data indicate that PET/CT with 18F-FDG is an effective and promising method for assessing not only the amount of skeletal muscle, but also its functional capacity in patients with malignant tumors, and can also be used to identify additional pathological conditions of the body in sarcopenia, such as low-intensity inflammation, changes in the activity of red bone marrow, etc., without additional studies.