| Abstract [eng] |
Sarcopenia is a progressive and generalized skeletal muscle disorder associated with an increased risk of falls, fractures, physical disability, poor treatment outcomes, and mortality. Imaging methods play an important role in the diagnosis of sarcopenia, as they allow objective assessment of muscle quantity and, in some cases, muscle quality. The aim of this study was to systematically analyze and compare the main radiological methods used for assessing sarcopenia, discuss their technical principles, diagnostic accuracy, advantages, limitations, and potential clinical applications. A literature review was conducted, covering publications from 2016 to 2026. The literature search was performed in the following databases: PubMed/MEDLINE, Scopus, Web of Science Core Collection, Embase, and Google Scholar. The review included studies evaluating sarcopenia or muscle quantity and quality using dual-energy X-ray absorptiometry (DXA/DEXA), computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography (US). DXA remains the most practical method in routine clinical practice due to its wide availability, low radiation exposure and the ability to assess body composition and bone mineral density simultaneously. However, DXA mainly reflects muscle quantity rather than muscle quality. CT and MRI are the most informative imaging modalities because they enable assessment not only of muscle mass but also of qualitative changes, including myosteatosis. Nevertheless, their use is limited by, higher cost, lower availability, and lack of methodological standardization and ionizing radiation in the case of CT. Ultrasonography is a promising, mobile, and safe method, particularly suitable for bedside assessment and follow-up, but its broader implementation is limited by strong operator dependence and heterogeneous measurement protocols. In conclusion, no single imaging modality can currently be considered universally appropriate for all clinical situations. The major unresolved issue is the lack of unified diagnostic criteria and universal cut-off values, therefore, further standardization of imaging methods and development of population-specific reference values are needed. |
