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31/03/25 - General information

Magnetic Resonance Imaging, a Potential Tool for Diagnosing Sarcopenia in Patients with Bronchiectasis

A study by the Hospital del Mar Research Institute and the Pneumology and Radiology Services of Hospital del Mar, published in Archivos de Bronconeumología, shows a strong correlation between the results of this imaging diagnostic test and those of current diagnostic tools based on observation and physical performance tests.

People with bronchiectasis, a chronic airway disease characterized by the accumulation of secretions in the bronchi leading to recurrent lung infections, are at high risk of experiencing a decline in muscle mass and function, known as sarcopenia. Having tools to diagnose their condition is vital to slowing its progression and avoiding a point of no return. For this reason, the Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group of the Hospital del Mar Research Institute, together with the Pneumology and Radiology Services of Hospital del Mar and part of the dibi network, have conducted a study to validate the use of magnetic resonance imaging (MRI) to assess the muscular condition of these patients. The study is published in Archivos de Bronconeumología and also includes researchers from the CIBER Respiratory Diseases area (CIBERES).

Patients with bronchiectasis experience a significant decline in quality of life due to the deterioration of their muscular capacity. The muscle continues to deteriorate until a point is reached where neither physical training nor nutritional interventions have any positive effect. Current diagnostic tools, including observational assessments, performance tests, and muscle biopsies, are effective, but having a non-invasive tool would facilitate the work of professionals monitoring these patients. This was the goal of the study, which validated the results of MRI and ultrasound in 20 people with bronchiectasis, alongside a control group of ten healthy individuals.

Greater Fat Infiltration

The correlation of the results highlighted the ability of MRI to assess muscle condition. Notably, there was a significant presence of fat and collagen fibers in cases of advanced sarcopenia. "This explains why it is so difficult to restore muscle once sarcopenia has progressed-the muscle no longer has muscle fibers, it cannot respond," explains Dr. Esther Barreiro, researcher at the Hospital del Mar Research Institute and assistant physician in the Pneumology Service. "The results obtained with MRI directly correlate with the clinical condition of the patients. The more fat infiltration, the worse the muscle condition and the higher the risk of advanced sarcopenia," she adds.

"MRI imaging, combined with segmentation and spectral analysis techniques for quantifying fat infiltration and edema, has allowed us to obtain quantitative information on the composition and structural integrity of the muscle. This helps assess the disease's impact on the individual's functional status," notes Dr. Josep Maria Maiques, Head of the Radiology Service at Hospital del Mar and researcher at its research institute. The study is now continuing to evaluate new imaging diagnostic tools and the genetic basis of sarcopenia.

These tools could help diagnose patients who, despite having their underlying condition under control, show signs of advanced muscle loss-likely caused by the chronic inflammatory state induced by bronchiectasis itself.

Bronchiectasis

This is a chronic airway disease that can originate from a prior lung infection (such as viral pneumonia, tuberculosis, or COVID-19). It causes bronchial changes-ectasis-that promote the accumulation of secretions, leading to inflammation and creating a favorable environment for germs to proliferate and cause new infections. It leads to persistent expectoration, sometimes with blood. It affects women more than men and has no curative treatment, only symptom management.

Reference Article

Alvarado-Miranda M, Solano A, Marsico S, Núñez-Robainas A, Cumpli-Gargallo MC, Sáinz M, Maiques JM, Barreiro E. Clinical Implications of Functional Imaging in the Assessment of Bronchiectasis-Associated Sarcopenia. Arch Bronconeumol. 2024 Dec 4:S0300-2896(24)00453-8. English, Spanish. doi: 10.1016/j.arbres.2024.11.015. Epub ahead of print. PMID: 39706732.

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