VIENNA -- Low-dose CT data from routine PET/CT scans provide a reliable, opportunistic tool for assessing sarcopenia in oncology patients, according to a study presented on 4 March at ECR 2026 in Vienna.
Dr. Ashraf Ahmed Basheer Ahmed, a senior consultant at Elite Scans in Chennai, India, and colleagues conducted a prospective trial in patients and suggest the approach can add valuable prognostic information in oncology.
“We advocate for standardized sarcopenia screening as part of every oncologic PET/CT read -- enabling timely nutritional intervention, personalized treatment planning, and improved patient outcomes,” Ahmed said.
Dr. Ashraf Ahmed Basheer Ahmed, a senior consultant radiologist from Chennai, India, presented a study on opportunistic PET/CT imaging on 4 March in Vienna.
Sarcopenia is the progressive loss of skeletal muscle mass and function in oncologic patients. It is associated with increased treatment toxicity, reduced response to therapy, prolonged hospitalization, and diminished overall survival. However, it remains systematically underdiagnosed in routine clinical workflows, Ahmed noted.
Oncology patients already undergo F-18 FDG-PET/CT scans for staging and response assessment, and these scans inherently contain low-dose CT (LDCT) data from which sarcopenia metrics can be extracted as a zero-cost add-on to standard care, he added. Hence, the group aimed to evaluate the feasibility of assessing sarcopenia and body composition using LDCT data from routine F-18 FDG-PET/CT scans. They further correlated these measurements with clinical parameters and treatment outcomes in patients.
Out of 70 oncology patients who underwent whole-body F-18 FDG-PET/CT, the researchers identified sarcopenia in 32 patients (45.7%), predominantly among older individuals and those with low body mass index -- “a striking prevalence in a routine oncology cohort,” Ahmed said.
In addition, patients with sarcopenia exhibited a significantly higher burden of treatment-related toxicity, including hematologic, gastrointestinal, and infectious complications, compared with nonsarcopenia participants. Finally, LDCT-based measurements were reproducible, with excellent interobserver agreement (intraclass correlation coefficient = 0.92), while the radiation dose for patients from LDCT did not exceed 2.5 mSv per scan, Ahmed reported.
“Since this CT is inherently part of the attenuation correction and anatomical localization required for PET interpretation, body composition analysis adds zero incremental radiation burden to the patient,” Ahmed said.
Steps forward include validating the approach in larger, multicenter cohorts and developing an AI-assisted automated L3 segmentation model for scalability and to reduce any additional work burden on radiologists, Ahmed noted.
“Incorporating body composition analysis into routine PET/CT reporting is a pragmatic, high-yield step toward precision oncology,” he concluded.
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