Evaluation of the reliability of measuring lower back muscles cross-sectional area based on manual segmentation within multi-level MRI images

IF 2.5 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiography Pub Date : 2024-10-01 DOI:10.1016/j.radi.2024.10.002

A.A. Alhulail , M.S. Alshuhri , D.F. AL-jolifiy , M.N. AL-nuwaybit , A.S. AL-tamimi , N.M. AL-qahtani , R.A. AL-hakami , M.A. Almanaa , A.M. Jabour

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引用次数: 0

Abstract

Introduction

Manual segmentation of paraspinal muscle cross-sectional area (CSA) is widely used to assess related health disorders. This study aimed to evaluate the reliability of this segmentation process for each paraspinal region of interest across the three intervertebral levels commonly used for segmentation (L3/4, L4/5, and L5/S1).

Methods

Axial-T2-weighted MRI images for 238 patients were divided among five raters (47 ± 1 cases each). To conduct the intra-rater reliability study, the CSA of each paraspinal lumber muscle (psoas major (PM), multifidus (MF), and erector spinae (ES)) and the intervertebral disc (ID) were manually segmented twice on all targeted levels before being assessed for each region per rater. The Inter-rater reliability was determined by comparing the results of different readers who segmented the same dataset. The Intraclass Correlation (ICC) and Coefficient-of-Variation percentage (CV%) were reported for each analysis.

Results

Low intra- and inter-rater variability (CV%<11) was found for each reader in each region and intervertebral level. The inter-rater reliability was excellent (ICC>0.9) for the PM, ID, and ES at L3/4. However, it was very good for MF at all levels and ES at L4/5, L5/S1 (ICC range: 0.82–0.88) affected by the fat-infiltration nature of the ES and MF muscles, their proximity to each other, and their smaller size (correlation between muscle size and ICC = 0.6, P < 0.01). The ID segmentation has the lowest CV (<3 %) and excellent ICC (>0.93).

Conclusion

Manual paraspinal muscle segmentation using axial-T2-weighted MRI is reliable at all commonly segmented intervertebral levels. However, the reliability level can be degraded by the presence of high-fat infiltrate, unclear muscle boundaries, and muscle size.

Implications for practice

Following consistent guidelines can help improve segmentation results. The IDs can be used as reliable internal references.

查看原文本刊更多论文

基于多层次核磁共振成像图像的手动分割测量下背部肌肉横截面积的可靠性评估。

简介人工分割脊柱旁肌肉横截面积（CSA）被广泛用于评估相关的健康疾病。本研究旨在评估这一分割过程在常用于分割的三个椎间水平（L3/4、L4/5 和 L5/S1）的每个脊柱旁相关区域的可靠性：将 238 名患者的轴向-T2 加权 MRI 图像分给五名评分者（每人 47 ± 1 例）。为了进行评分者内部信度研究，在对每个评分者的每个区域进行评估之前，先对所有目标水平的每块腰椎旁肌肉（腰大肌（PM）、多裂肌（MF）和竖脊肌（ES））和椎间盘（ID）的CSA进行两次手动分割。评分者之间的可靠性是通过比较不同评分者对同一数据集的评分结果来确定的。每次分析都报告了类内相关性（ICC）和差异系数百分比（CV%）：L3/4的PM、ID和ES的评分者内和评分者间变异性较低（CV%0.9）。然而，由于 ES 和 MF 肌肉的脂肪浸润性、相互邻近性和较小的尺寸（肌肉尺寸与 ICC 之间的相关性 = 0.6，P 0.93），所有级别的 MF 和 L4/5、L5/S1 的 ES 的评定结果非常好（ICC 范围：0.82-0.88）：结论：使用轴向-T2加权磁共振成像进行人工脊柱旁肌肉分割在所有常见的椎间水平上都是可靠的。结论：使用轴向-T2 加权磁共振成像对所有常见的椎间水平进行人工脊柱旁肌肉分割都是可靠的，但可靠性水平会因存在高脂肪浸润、肌肉边界不清和肌肉大小而降低：实践意义：遵循一致的指导原则有助于改善分割结果。ID 可用作可靠的内部参考。

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

Radiography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.70

自引率

34.60%

发文量

169

审稿时长

63 days

期刊介绍： Radiography is an International, English language, peer-reviewed journal of diagnostic imaging and radiation therapy. Radiography is the official professional journal of the College of Radiographers and is published quarterly. Radiography aims to publish the highest quality material, both clinical and scientific, on all aspects of diagnostic imaging and radiation therapy and oncology.