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PubMed1994

Standardized uptake values of FDG: body surface area correction is preferable to body weight correction.

UNLABELLED: Standardized uptake values (SUVs) are widely used to measure 18F-fluorodeoxyglucose (FDG) uptake in various tumors. It has been reported that normalization of FDG uptake for patient body weight (SUVbw) overestimates FDG uptake in heavy patients, as their fraction of body fat (with low FDG uptake) is often increased. The objective of this study was to determine if "normalization of FDG uptake for the body surface area" (SUVbsa) is independent of the patient's body size and is more reliable than SUVbw. METHODS: FDG-PET images were acquired on 44 patients (body weight range: 45-115 kg) with cancer. SUVbw [(mCi/g of tissue)/(mCi injected/patient body weight in g)] and SUVbsa [(mCi/g of tissue)/(mCi injected/patient BSA in m2)] were determined for the liver. Since most observers are accustomed to using the SUVbw, the two values were compared by setting the mean SUVbsa equal to that of SUVbw. RESULTS: SUVbw and SUVbsa were 3.42 +/- 0.85 (mean +/- s.d.) and 3.42 +/- 0.60, respectively. The standard deviation of the SUVbsa was smaller than that of SUVbw. More importantly, there was a strong positive correlation between SUVbw and, not only body weight (r = 0.75) but also BSA (r = 0.68), whereas only a weak correlation between SUVbsa and body weight (r = 0.41) or BSA (r = 0.38) was found with a near flat regression line. CONCLUSION: SUVbw overestimates FDG uptake in large patients. SUVbsa appears preferable to SUVbw, since it is minimally affected by the body size.

Body Surface Area↗
PubMed2003

Human body surface area: a theoretical approach.

Knowledge of the human body surface area has important applications in medical practice, garment design, and other engineering sizing. Therefore, it is not surprising that several expressions correlating body surface area with direct measurements of body mass and length have been reported in the literature. In the present study, based on the assumption that the exterior shape of the human body is the result of convex and concave deformations from a basic cylinder, we derive a theoretical equation minimizing body surface area (BSA) at a fixed volume (V): BSA=(9pi VL)(0.5), where L is the reference length of the body. Assuming a body density value of 1,000 kg.m(-3), the equation becomes BSA=(BM.BH/35.37)(0.5), where BSA is in square meters, BM is the body mass in kilograms, and BH is the body height in meters. BSA values calculated by means of this equation fall within +/-7% of the values obtained by means of the equations available in the literature, in the range of BSA from children to adults. It is also suggested that the above equation, which is obtained by minimizing the outer body surface at a fixed volume, implies a fundamental relation set by the geometrical constraints governing the growth and the development of the human body.

Aging↗
PubMed2004

Prospective evaluation of body surface area as a determinant of paclitaxel pharmacokinetics and pharmacodynamics in women with solid tumors: Cancer and Leukemia Group B Study 9763.

PURPOSE: To study a fixed dose (360 mg) of paclitaxel given i.v. over 3 hours to female patients, and to evaluate prospectively the relationships between the following: body surface area and toxicity; body surface area and pharmacokinetics; and pharmacokinetics and toxicity. EXPERIMENTAL DESIGN: The eligibility criteria included the following: female sex; solid tumors; no more than one prior chemotherapy regimen; no prior paclitaxel; performance status of 0 to 2; and normal organ function. Paclitaxel plasma concentrations were quantified by high-performance liquid chromatography. The area under the curve, total body clearance, and hours above 0.05 micromol/L (T > 0.05) were calculated. RESULTS: Thirty-two patients were enrolled, and 29 patients received the correct dose and regimen. For statistical analyses, 26 patients had complete follow-up blood counts, 23 patients had complete data to correlate blood counts and area under the curve, and 25 patients had data to correlate blood counts and T > 0.05. The main toxicity was neutropenia of grade 3 and 4 severity in 21% and 25% of patients, respectively, in cycle 1. The worst grade of any toxicity, nadir WBC and absolute neutrophil count, and survival fractions were assessed; no significant relationship was found between body surface area and any measure of toxicity. Body surface area correlated inversely with area under the curve (r = -0.67; P < 0.001) and correlated with total body clearance (r = 0.69; P < 0.001), but body surface area did not correlate with T > 0.05. Neither area under the curve nor total body clearance were correlated with nadir absolute neutrophil count or survival fractions, but a significant correlation was found between T > 0.05 and log(nadir absolute neutrophil count; r = -0.41; P = 0.04). CONCLUSIONS: These results suggest that fixed dosing of paclitaxel is feasible in women, which would simplify the administration of this drug.

Adult↗
PubMed1992

Body surface area of the golden Syrian hamster.

The body surface areas (BSAs) of 30 Syrian hamsters were actually measured. From these areas, the Mass Coefficients (K values) for the Dubois and Dubois equation (5.31) and for the Meeh-Rubner equation (11.89), were computed. These values were independent of weight and sex. To verify the applicability of the Mass Coefficients, the BSAs of another 20 animals were calculated and compared with the actually measured BSAs. The difference between measured and calculated BSAs was not significant. Therefore, these values can be used with their respective equations to compute BSA in Golden Syrian hamsters.

Animals↗
PubMedDate not supplied

Relationships between heat production, heat loss, and body temperature for rats with burn injuries between 26% and 63% of the body surface area.

Burn injury in man is characterized by increased body temperature proportional to burn wound size and may represent fever and/or hyperthermia. A nonseptic animal model used to study this phenomena has not been described. To test the hypothesis that large burn injuries in rats would produce increased body temperature, the rectal, skin, and body temperatures were sequentially measured and were calculated for rats in the control group and rats with burn injuries covering 26% to 63% of the body surface area [< or = 35%, 36% to 45%, and > or = 46% body surface area]. The group with burns covering > or = 46% of the body surface area had significantly higher rectal temperatures than did at least one other group on postburn days 7, 9, 11, 13, 18, and 20. On postburn days 7 and 11 this increase was significantly higher than that of all burn and control groups. Animals did not demonstrate any overt evidence of wound infection. These data do not establish a cause for increased body temperature after burn injury but suggest that a reproducible animal model may be possible for the study of the cause of increased body temperature after burn injury.

Animals↗
PubMed2001

Human body surface area: measurement and prediction using three dimensional body scans.

The development of three dimensional laser scanning technology and sophisticated graphics editing software have allowed an alternative and potentially more accurate determination of body surface area (BSA). Raw whole-body scans of 641 adults (395 men and 246 women) were obtained from the anthropometric data base of the Civilian American and European Surface Anthropometry Resource project. Following surface restoration of the scans (i.e. patching and smoothing), BSA was calculated. A representative subset of the entire sample population involving 12 men and 12 women (G24) was selected for detailed measurements of hand surface area (SAhand) and ratios of surface area to volume (SA/VOL) of various body segments. Regression equations involving wrist circumference and arm length were used to predict SAhand of the remaining population. The overall [mean (SD)] of BSA were 2.03 (0.19) and 1.73 (0.19) m2 for men and women, respectively. Various prediction equations were tested and although most predicted the measured BSA reasonably closely, residual analysis revealed an overprediction with increasing body size in most cases. Separate non-linear regressions for each sex yielded the following best-fit equations (with root mean square errors of about 1.3%): BSA (cm2) = 128.1 x m0.44 x h0.60 for men and BSA = 147.4 x m0.47 x h0.55 for women, where m, body mass, is in kilograms and h, height, is in centimetres. The SA/VOL ratios of the various body segments were higher for the women compared to the men of G24, significantly for the head plus neck (by 7%), torso (19%), upper arms (15%), forearms (20%), hands (18%), and feet (11%). The SA/VOL for both sexes ranged from approximately 12.m-1 for the pelvic region to 104-123.m-1 for the hands, and shape differences were a factor for the torso and lower leg.

Adult↗
PubMed1989

Changes in body weight and body surface area in strain 13 guinea pigs infected with Pichinde virus.

In studying pathogenetic mechanisms of Pichinde virus-induced disease in strain 13 guinea pigs, a large decrease of body weight (approximately 28%) observed within 14 days postinoculation raises a question concerning the validity of standardizing body or organ functions in terms of body weight. This study was to examine changes in body weight and body surface area of Pichinde virus-infected strain 13 guinea pigs after various days postinoculation. Control guinea pigs were also subjected to the same experimental procedures and experimental days. While body weights and body surface areas increased progressively in controls, I observed only slight decreases in body surface areas (4-6%) in the infected guinea pigs, despite large decreases of body weights throughout the 14-day experimental period. In conclusion, Pichinde virus-infected strain 13 guinea pigs demonstrated a small reduction of body surface area within 14 days postinoculation, suggesting that body surface area, rather than body weight, should be used for standardizing body or organ functions for comparison with their own baseline values.

Animals↗
PubMed1979

Predictability of peak serum gentamicin concentration with dosage based on body surface area.

We examined gentamicin dosage based on body surface area (60 mg/m2 intravenously every eight hours) as a means of attaining therapeutic but nontoxic serum concentrations in 58 patients ranging in age from 0.7 to 73 years. All but one patient had peak serum levels between 3.4 and 8.0 microgram/ml. The mean serum gentamicin half-life was shorter in patients less than 10 years of age (76 minutes) than in patients aged 10 to 50 years (116 minutes) and in patients aged 50 to 63 years (184 minutes) (all significant at P less than 0.01). We conclude that gentamicin dosage based on body surface area produces uniform peak serum gentamicin concentrations in both children and adults, and that the safety and efficacy of a shorter dosage interval for children deserves investigation.

Adolescent↗
PubMed1995

Fallacy of indexing renal and systemic hemodynamic measurements for body surface area.

Renal plasma flow, glomerular filtration rate, and cardiac output are traditionally indexed for body surface area by expressing these traits as per-surface-area ratios. Indexing is intended to remove interindividual variation attributable to differences in body size. Regression is an alternative method commonly used to adjust other biological traits for the effects of a covariate, such as body surface area. The purpose of this study was to compare the indexing and regression methods of adjusting renal plasma flow, glomerular filtration rate, and cardiac output for interindividual differences in body surface area. We estimated renal plasma flow by the clearance of p-aminohippurate, glomerular filtration rate by clearance of inulin, and cardiac output by thoracic electrical impedance in a sample of 78 unrelated females and 78 unrelated males (ages 20-49.9 yr) from the general population of Rochester, MN. The indexing method created negative dependencies of renal plasma flow and cardiac output on body surface area and failed to eliminate the positive dependency of glomerular filtration rate on body surface area. Moreover, indexing obscured differences in mean renal plasma flow between females and males and created differences in mean cardiac output between the genders. In contrast, the regression method consistently eliminated dependencies of each trait on body surface area and did not lead to inappropriate inferences about mean differences in these traits between females and males. We conclude that the indexing method of adjusting renal plasma flow, glomerular filtration rate, and cardiac output for interindividual differences in body surface area should be abandoned and replaced by use of the regression method.

Adult↗
PubMed2006

Is body surface area still the best way to determine pump flow rate during cardiopulmonary bypass?

For over four decades, pump flow rate during cardiopulmonary bypass (CPB) has been estimated using body surface area (BSA). As patients presenting for heart surgery are increasingly obese, this approach may no longer be appropriate and other estimates of systemic metabolism should be used, such as body mass index and lean body mass. Mixed venous oxygen saturation (SvO2) is a robust and independent estimate of the global efficacy of CPB. The aim of this study was to determine which factors, including body surface area, body mass index and lean body mass, best predict SvO2 during CPB. Forty-eight patients undergoing elective cardiac surgery requiring CPB were studied. Patients' height, weight and skinfold thickness at four sites (biceps, triceps, subscapularis and suprailiac) were measured. Body surface area, lean body mass and body mass index were then calculated. Pump flow rate was maintained at 2.4 L/min/ m2 during CPB as per standard unit protocol. Arterial and mixed venous blood samples were taken during the cooling, stable hypothermia and rewarming phases of CPB. Nasopharyngeal temperatures and flow rates were recorded contemporaneously. The blood samples were analysed for oxygen saturation, haemoglobin concentration and partial pressures of oxygen and carbon dioxide. The values of the three time points were meaned. All potential predictor variables were then univariately correlated with mixed venous oxygen saturation (SvO2). Those correlating significantly (p < 0.1) were entered into a multivariate linear regression model. Nasopharyngeal temperature (beta = 0.615, p < 0.001) and lean body mass (beta = 0.256, p < 0.028) were the only significant predictors of SvO2 (r2 = 0.433, p2 < 0.001). Pump flow rates maintained at 2.4 L/min/m2 throughout CPB results in relative over-perfusion during hypothermia. Lean body mass may be a more sensitive estimate of systemic metabolism and, therefore, may provide a more accurate means of determining pump flow rate than body surface area in patients undergoing heart surgery.

Body Mass Index↗
PubMed1990

Growth of the human heart relative to body surface area.

To determine the growth rate of the human heart in relation to body surface area, normal data obtained by echocardiography and angiocardiography were analyzed with respect to changes in body size occurring between infancy and adulthood. Published data were used to determine the following for 7 theoretical subjects ranging in size from 0.2 m2 (normal newborn) to 2.2 m2 (large adult): average left ventricular (LV) end-diastolic diameter; aortic root diameter; right pulmonary artery diameter; aortic valve area; LV end-diastolic volume; and LV mass. Linear dimensions (LV, aortic and right pulmonary artery diameter) increased as a square root function of surface area and could not be described by a constant "index" of dimension to surface area. Aortic valve area was linearly related to surface area and equalled 3.4 cm2/m2 for subjects of all sizes. LV volume and mass were exponentially related to surface area. This study indicates that intracardiac areas may be indexed for body surface area, but that linear dimensions and volumes have a nonlinear relation to surface area and are more appropriately indexed by surface area to the 0.5 and 1.5 power, respectively.

Angiocardiography↗
PubMed1984

Two methods for estimating body surface area in adult amputees.

Two methods for estimating body surface area (BSA) in adult amputees were developed. BSA in sq m was determined in 42 healthy, nonamputee men and women by summing the surface areas of individual body parts obtained using geometric measurements (BSAmeas) and by an equation using height and weight (BSAcalc). Linear regression analysis was used to determine correlations between BSAmeas and BSAcalc and between BSAmeas and surface-area measurements of individual body parts (SApart). The percentages of total BSA contributed by individual body parts in each subject were determined by the ratio of SApart to BSAmeas, and these percentages were compared with the corresponding percentages for body parts using the "Rule of Nines." BSAcalc and BSAmeas were significantly correlated, as were SApart and BSAmeas. Regression analysis of SApart versus BSAmeas yielded an equation for each measured body part that allowed calculation of SApart without direct measurement. SApart expressed as a percentage of total BSA differed from the percentage of BSA used in the "Rule of Nines" by a mean of 12.4-32% depending on the body part. Two methods of estimating BSA in amputees were proposed based on deduction of the surface area of the amputated part (calculated from the regression equation for SApart or as a percentage of total BSA) from total BSAcalc in adult amputees. The two methods developed in this study for estimating BSA may be useful in determining drug dosages in adult amputees and may provide more accurate information in burn therapy. Further studies are needed to validate the clinical application of these methods.

Adult↗
PubMedDate not supplied

Correlation between the minimal cross-sectional area of the nasal cavity and body surface area: preliminary results in normal patients.

Nasal symptoms often are inconsistent with rhinoscopic findings. However, the proper diagnosis and treatment of nasal pathology requires an objective evaluation of the narrow segments of the anterior part of the nasal cavities (minimal cross-sectional area [MCSA]). The problem is that the value of MCSA is not a unique parameterfor the entire population, but rather it is a distinctive valuefor particular subject (or smaller groups of subjects). Consequently, there is a need for MCSA values to be standardized in a simple way that facilitates the comparison of results and the selection of our treatment regimens. We examined a group of 157 healthy subjects with normal nasal function. A statistically significant correlation was found between the body surface area and MCSA at the level of the nasal isthmus and the head of the inferior turbinate. The age of subjects was not found a statistically significant predictor for the value of MCSA. The results show that the expected value of MCSA can be calculated for every subject based on anthropometric data of height and weight.

Adolescent↗
PubMedDate not supplied

Predictors of body surface area.

STUDY OBJECTIVE: To determine the accuracy of body surface area (BSA) calculations proposed in the literature and their applicability to patient populations such as neonates and parturients. DESIGN: Using 395 actual BSA measurements in the literature, 15 prediction formulas were assessed for accuracy using the root mean squared error (RMSE) method of prediction. Height/weight distributions of infants and parturients, and the relationship of DuBois and DuBois predictions to actual BSA, were compared using scatter plots. Percentage errors across different body sizes were determined. SETTING: Obstetrics clinic and labor and delivery rooms at the University of Chicago Medical Center. PATIENTS: Sixty women (gestational week 34 to 40) and 148 neonates. MEASUREMENTS AND MAIN RESULTS: We measured the height and weight of the neonates and the women. We also used the height, weight, and BSA of 395 subjects reported in the literature. Although the commonly used DuBois and DuBois formula was derived from only 10 subjects, our statistical analysis demonstrates that it can be used over a wide range of measured BSAs (RMSE = 6.3%) and patients, including both infants and pregnant women. As BSA increases, so does the absolute prediction error, but the percentage error is greatest for infants, for whom the formula tends to underestimate BSA. There were no other significant differences in predictive accuracy for gender, age, or body habitus. CONCLUSIONS: Several BSA formulas, including the DuBois and DuBois formulas adequately predict measured BSA over a wide range of patient populations. Although the original subjects studied by Dubois and DuBois excluded extremes of height and weight, their formula appears to be a valid predictor.

Adult↗
PubMed1988

Body surface areas and K values in strain 13 guinea pigs with different body weights and ages.

Body surface areas (BSA) were determined for strain 13 guinea pigs with body weights ranging from 191 to 1011 g. For this determination, the entire skin of each animal was removed immediately after death and flattened on a wax film with a homogeneous paper. The skin outlines on the paper were cut and weighed for determining BSA. The K value was calculated for each guinea pig as the ratio of BSA (cm2)/body weight (g)2/3. Significantly different K values of 11.31 +/- 0.11, 9.66 +/- 0.09, 9.22 +/- 0.05, and 9.17 +/- 0.05 were determined for average body weights of 218 +/- 24, 527 +/- 33, 706 +/- 60, and 943 +/- 30 g, respectively. By plotting these K values on semilog paper and determining the best fit curve of the slope, it was possible to extrapolate exponentially the K values for different body weights. The relationship between age and body weight was also established for guinea pigs, and a series of K values were determined from birth to 35 weeks of life. We conclude that a different K value should be used for calculating BSA for various ages and body weights of strain 13 guinea pigs.

Aging↗
PubMed1981

[Development of body surface area during childhood (author's transl)].

Using the formula of Haycock et al. development of body surface area was calculated in children according to the results of the Dortmund longitudinal growth study. Form birth to the 16th year of life the increase in mean body surface area amounts to 1.49 m2 in boys and 1.39 m2 in girls. Development of body surface area does not follow a Gaussian distribution. The presentation of the development of body surface area as percentiles allow a clearer and an easier application for the clinical use.

Adolescent↗
PubMed1996

Effect of age, race, body surface area, heart weight and atherosclerosis on coronary artery dimensions in young males.

Compensatory arterial enlargement in response to atherosclerosis has been demonstrated for the left main coronary artery. Only limited data is available on the interaction of patient characteristics and atherosclerosis with coronary artery dimensions. The purpose of the present study was to evaluate the influence of age, race, body habitus, heart weight and atherosclerosis on coronary artery dimensions of young males. Hearts from 137 young men (age 32 +/- 8 years; 78 black, 59 white) with unnatural deaths (homicide, suicide, accident, drug overdose) were perfusion-fixed, and histologic sections were obtained from the left main, proximal left anterior descending and left circumflex coronary arteries. Computerized planimetry was performed on Movat stained sections. Multiple regression analysis was used to evaluate the relative contribution of plaque size, age, race, heart weight and body surface area on coronary dimensions and compensatory enlargement in response to atherosclerosis. In the left anterior descending and left main coronary arteries, black race, body surface area and age were independent predictors of increased lumen area. In the left circumflex, age was a predictor of lumen area. Plaque area, black race and body surface area independently predicted increased area enclosed by the internal elastic lamina area. There was compensatory enlargement of internal elastic lamina with increasing plaque size in both races in the three arteries, but the percent luminal stenosis was greater in whites due to smaller artery size. Luminal narrowing did not develop until plaques occupied 30% of internal elastic lamina area. Among a population of young men with non-cardiac deaths, blacks have larger lumen and area enclosed by internal elastic lamina than whites. Age and body surface area are major determinants of lumen areas, and compensatory arterial enlargement was seen in all examined arteries in the present study.

Adolescent↗