P1.153. Dietitian-Led Integration of CT Body Composition Analysis in Oesophagogastric Cancer Care

Abstract

Abstract Topic Esophageal Cancer: Other Background Malnutrition and poor muscle health are prevalent in patients with oesophagogastric cancer and are associated with poor outcomes. However, body composition assessment is not routinely implemented in clinical practice. This project aimed to assess the feasibility of incorporating body composition analysis for patients undergoing curative-intent oesophagogastric cancer surgery. Methods A prospective quality improvement project was conducted. All adult patients who underwent curative-intent treatment for oesophagogastric cancer at a single centre tertiary hospital were included with data collected as part of routine clinical practice. A literature review was conducted to scope the optimal body composition assessment methods for use in clinical practice. Stakeholder engagement included radiologists, surgeons, oncologists, dietitians, nurses, and consumers. Diagnostic and restaging CT images were utilised to assess skeletal muscle quantity (cross-sectional area) and quality (muscle attenuation) to incorporate into the malnutrition diagnosis. Feasibility outcomes included workforce capability, and integration into clinical workflows. Results Dietitians were deemed by stakeholders the most suitable health professionals to complete the CT body composition assessment, as software was well integrated within dietitian workflows and supported by adequate resource allocation. Two dietitians were trained in CT body composition analysis utilising manual and automated segmentation software. Both demonstrated competency in performing accurate image segmentation, applying standardised protocols, and interpreting skeletal muscle mass and quality from routine CT imaging. An automated segmentation software was deemed more efficient and appropriate for use within clinical practice to optimise workforce capability. Dietitians were able to independently complete CT body composition assessments within clinical workflows. Conclusion A dietitian-led nutrition care pathway, integrating CT body composition analysis into the management of oesophagogastric cancer is feasible. Key components of the pathway include successful training of dietitians using body composition analysis software. Further evaluation of this project will include validation of automated CT analysis against manual segmentation, which is required to support broader adoption in clinical care pathways and scalability to other cancer cohorts.