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The feasibility of using CT scans to detect changes in body composition over time in colon cancer survivors enrolled in a physical activity intervention Meyers, Logan


Computed tomography (CT) imaging presents an accurate and readily available method to quantify changes in body composition within colon cancer patients. Unwanted changes in body composition is one pathway in which cancer outcomes, particularly survival, may be altered in this population. Sarcopenic cancer patients consistently exhibit poorer overall survival compared to non-sacropenic cancer patients. Physical activity is associated with favourable changes in body composition, namely through promoting reductions in visceral adipose tissue and increases in muscle mass. The purpose of this feasibility study is to evaluate the practicality of using CT scans to quantify changes in body composition over time between colon cancer patients who had completed primary cancer treatment randomized to a physical activity intervention (intervention group) or usual care (control group). Eighteen participants who had completed a minimum of 12 months of the CO.21 Trial from the Vancouver CO.21 Trial center were included. Body composition outcomes were measured at baseline, 6 months and 12 months using CT scans taken as part of routine practice. Manual image analysis time took on average longer (17min:20sec) then automated analysis (57sec). Image retention rate was high (97.9%), and only a small proportion of images were deemed as having major quality issues (5.9%). All but one quantified body composition outcome had excellent measured inter- and intra-rater reliability (ICC >0.9). There were no significant time and group effect (p<0.05) across 12 months between the intervention group and control group for any of the measured body composition outcomes. CT automated analysis of body composition may be preferable and more feasible for future use in research or clinical settings compared to manual analysis. In a sub-sample of the CO.21Trial, we found no evidence that trial participants randomized to an aerobic physical activity intervention demonstrate favourable improvements in body composition after 12 months compared to usual care.

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