Poster Presentation ESA-SRB-ANZOS 2025 in conjunction with ENSA

Measuring Sarcopenia Via Psoas Muscle Volume Changes In Patients With Thyroid Cancer Receiving Lenvatinib (127876)

Eleanor White 1 2 3 , Matti Gild 1 2 3 , John Makeham 1 , Rory Clifton-Bligh 1 2 3 , Anthony Glover 2 3 , James Elliott 2 3
  1. Royal North Shore Hospital, St Leonards, NSW, Australia
  2. University of Sydney, Sydney, NSW, Australia
  3. Kolling Institute, St Leonards, NSW, Australia

Background: Lenvatinib is a multikinase inhibitor used for patients with advanced thyroid cancer. Sarcopenia is common in patients receiving Lenvatinib despite reasonable baseline performance status. We utilised a deep learning artificial intelligence tool, the TotalSegmentator which employs an automatic convolutional neural network (CNN) to analyse computed tomography (CT) scans of psoas muscles in people with thyroid cancer receiving Lenvatinib.

Aims: To assess if there is a reduction in muscle volume after administration of Lenvatinib treatment in patients treated for thyroid cancer.

Methods: Patients with advanced thyroid cancer who received Lenvatinib through our centre between 2008 – 2023 were identified. Baseline CT scans and repeat staging scans were analysed before and after commencing Lenvatinib. CT scans were converted to DICOM images and analysed through the Total Segmentator software.

Results: 21 patients were identified, 12 excluded and 9 included (5 female, 4 male).  Median age was 56 years (range 38-76). Starting dose Lenvatinib was 24mg in eight patients and 20mg in one patient. Median observation period was 16.9 months (range 3.8 – 27.1). Median baseline psoas muscle volume prior to commencing Lenvatinib was 488585.78 mm3 and at first follow-up imaging was 452975.82mm3 with median time to first follow up imaging 3.05 months (2 – 6.3). Median psoas muscle volume at end of Lenvatinib administration period was 468902.84mm3, representing a mean -8.8% loss of psoas muscle volume (p= 0.01). 

Conclusion: We have validated a novel analysis pipeline to quantify sarcopenia on Lenvatinib therapy for patients with thyroid cancer, using the TotalSegmentator software. Patients who received Lenvatinib for thyroid cancer demonstrated reduction in psoas muscle volume during the treatment period. Limitations of this study are the retrospective nature and small sample size. Larger prospective studies are required with a control group to help quantify sarcopenia in patients receiving Lenvatinib and to investigate potential mechanisms.