Ultrasound attenuation imaging as a strategy for evaluation of early and late ambulatory functions in Duchenne muscular dystrophy

IF 3.2 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Medical physics Pub Date : 2024-09-05 DOI:10.1002/mp.17389

Dong Yan, Qiang Li, Ya-Wen Chuang, Chun-Hao Lu, Ai-Ping Yang, Chia-Wei Lin, Jeng-Yi Shieh, Wen-Chin Weng, Po-Hsiang Tsui

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引用次数: 0

Abstract

Background

Duchenne muscular dystrophy (DMD) is a genetic neuromuscular disorder that leads to mobility loss and life-threatening cardiac or respiratory complications. Quantitative ultrasound (QUS) envelope statistics imaging, which characterizes fat infiltration and fibrosis in muscles, has been extensively used for DMD evaluations.

Purpose

Notably, changes in muscle microstructures also result in acoustic attenuation, potentially serving as another crucial imaging biomarker for DMD. Expanding upon the reference frequency method (RFM), this study contributes to the field by introducing the robust RFM (RRFM) as a novel approach for ultrasound attenuation imaging in DMD.

Methods

The RRFM algorithm was developed using an iterative reweighted least squares technique. We conducted standard phantom measurements with a clinical ultrasound system equipped with a linear array transducer to assess the improvement in attenuation estimation bias by RRFM. Additionally, 161 DMD patients, included in both a validation dataset (n = 130) and a testing dataset (n = 31), underwent ultrasound scanning of the gastrocnemius for RRFM-based attenuation imaging. The diagnostic performances for ambulatory functions and discrimination between early and late ambulatory stages were evaluated and compared with those of QUS envelope statistics imaging (involving Nakagami distribution, homodyned K distribution, and entropy values) using the area under the receiver operating characteristic curve (AUROC).

Results

The results indicated that the RRFM method more closely matched the actual attenuation properties of the phantom, reducing measurement bias by 50% compared to conventional RFM. The AUROCs for RRFM-based attenuation imaging, used to discriminate between early and late ambulatory stages, were 0.88 and 0.92 for the validation and testing datasets, respectively. These performances significantly surpassed those of QUS envelope statistics imaging (p < 0.05).

Conclusions

Ultrasound attenuation imaging employing RRFM may serve as a sensitive tool for evaluating the progression of ambulatory function deterioration, offering substantial potential for the health management and follow-up care of DMD patients.

查看原文本刊更多论文

超声衰减成像是评估杜氏肌营养不良症早期和晚期活动功能的一种策略。

背景：杜氏肌营养不良症（DMD）是一种遗传性神经肌肉疾病，会导致行动不便和危及生命的心脏或呼吸系统并发症。目的：值得注意的是，肌肉微结构的变化也会导致声衰减，可能成为 DMD 的另一个重要成像生物标志物。在参考频率法（RFM）的基础上，本研究引入了鲁棒RFM（RRFM）作为DMD超声衰减成像的新方法，为该领域做出了贡献：方法：RRFM 算法采用迭代再加权最小二乘法技术开发而成。我们使用配备线性阵列换能器的临床超声系统进行了标准模型测量，以评估 RRFM 对衰减估计偏差的改善情况。此外，161 名 DMD 患者（包括验证数据集（n = 130）和测试数据集（n = 31））接受了基于 RRFM 的衰减成像的腓肠肌超声扫描。使用接收器工作特征曲线下面积（AUROC）评估并比较了 QUS 包膜统计成像（包括中神分布、同调 K 分布和熵值）对卧位功能的诊断性能以及卧位早期和晚期的分辨能力：结果表明，RRFM 方法更接近模型的实际衰减特性，与传统的 RFM 相比，测量偏差减少了 50%。基于 RRFM 的衰减成像用于区分早期和晚期非卧床阶段，验证数据集和测试数据集的 AUROC 分别为 0.88 和 0.92。这些性能大大超过了 QUS 包膜统计成像（p 结论：RRFM 超声波衰减成像是一种新型的超声波成像技术：采用 RRFM 的超声衰减成像可作为一种灵敏的工具，用于评估活动功能衰退的进展情况，为 DMD 患者的健康管理和后续护理提供了巨大的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical physics 医学-核医学

CiteScore

6.80

自引率

15.80%

发文量

660

审稿时长

1.7 months

期刊介绍： Medical Physics publishes original, high impact physics, imaging science, and engineering research that advances patient diagnosis and therapy through contributions in 1) Basic science developments with high potential for clinical translation 2) Clinical applications of cutting edge engineering and physics innovations 3) Broadly applicable and innovative clinical physics developments Medical Physics is a journal of global scope and reach. By publishing in Medical Physics your research will reach an international, multidisciplinary audience including practicing medical physicists as well as physics- and engineering based translational scientists. We work closely with authors of promising articles to improve their quality.