Researchers at the State University of Campinas (UNICAMP) in Brazil have identified a new biomarker, the Visceral-Muscular Density (VMD) index, that significantly improves prognosis prediction for gastric cancer patients. By analyzing radiodensity patterns in CT scans—a standard diagnostic tool—the team discovered that VMD can distinguish between high-risk and low-risk disease progression, potentially allowing for more personalized treatment plans that account for a patient’s unique metabolic and inflammatory state.
How does the VMD index work?
The VMD index functions by mathematically combining the radiodensity of visceral fat and muscle tissue found in routine computed tomography (CT) scans. According to the study published in Clinical Nutrition Espen, this method captures an integrated patient phenotype that traditional tumor-centric staging often misses. Radiodensity, which measures how tissue attenuates X-rays, serves as a proxy for the body’s inflammatory and metabolic condition. Jun Takahashi, a professor at the Gleb Wataghin Institute of Physics at UNICAMP, notes that the research team used machine learning to analyze 461 patient cases to identify the specific formula that best correlates with clinical outcomes.
The researchers utilized the difference between fat and muscle radiodensity to “cancel out” technical calibration variations between different CT scanner models, ensuring the VMD marker remains accurate across various medical facilities.
Why does body composition change patient prognosis?
Prognosis appears to be heavily influenced by how cancer affects the body’s systemic health. Maria Carolina Santos Mendes, a nutritionist and co-advisor on the study, explains that the two tissues react differently to the disease. In adipose tissue, higher radiodensity often signals inflammation, which correlates with a worse prognosis. Conversely, lower radiodensity in muscle tissue—often a sign of muscle quality degradation—is also linked to poorer outcomes. Patients identified by the VMD index as being in the high-risk group showed a median survival of 13.8 months, significantly lower than the 58.5-month median survival observed in the low-risk group.
Can this biomarker replace traditional cancer staging?
The VMD index is intended to complement, not replace, traditional tumor-staging protocols. Currently, clinical oncology relies on tumor size and the presence of metastases to guide treatment. However, José Barreto Campello Carvalheira, a professor of clinical oncology at UNICAMP, suggests that VMD provides the missing “patient-centric” data. By incorporating metabolic and inflammatory markers, physicians may eventually be able to identify which patients require aggressive chemotherapy and which might safely avoid the toxicity of such treatments following surgery.
While VMD shows high potential for precision medicine, researchers emphasize that the current study is retrospective. Future prospective, multicenter trials are required to validate these findings across broader, more diverse patient populations before the marker enters standard clinical practice.
Frequently Asked Questions
- What is the VMD index? It is a new biomarker developed at UNICAMP that combines fat and muscle radiodensity from CT scans to predict gastric cancer outcomes.
- Does this require new medical tests? No. The VMD index uses data from routine CT scans that are already standard in the care of gastric cancer patients.
- Can patients change their VMD profile? Researchers are currently investigating whether nutritional therapy or other interventions can modify these body composition markers, though this remains an open question.
- Is this being used for other cancers? Yes, the UNICAMP team has begun testing the VMD approach on other types of cancer, with early results showing similar promise.
The research was supported by the São Paulo Research Foundation (FAPESP) under projects 21/10265-8, 22/06239-4, and 23/13749-1. For more updates on oncology breakthroughs and precision medicine, subscribe to our weekly newsletter or join the conversation in the comments below.
