Automated analysis of quantitative muscle MRI and its reliability in patients with Duchenne muscular dystrophy.

IF 3.2 4区 医学 Q2 CLINICAL NEUROLOGY
Sara Nagy, Olga Kubassova, Patricia Hafner, Sabine Schädelin, Simone Schmidt, Michael Sinnreich, Jonas Schröder, Oliver Bieri, Mikael Boesen, Dirk Fischer
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Abstract

Background: Quantitative muscle MRI is one of the most promising biomarkers to detect subclinical disease progression in patients with neuromuscular disorders, including Duchenne muscular dystrophy (DMD). However, its clinical application has been limited partly due to the time-intensive process of manual segmentation.

Objective: We present a simple and fast automated approach to obtain quantitative measurement of thigh muscle fat fraction and investigate its reliability in patients with DMD.

Methods: Clinical and radiological baseline and 6-month follow-up data of 41 ambulant patients with DMD were analysed retrospectively. Axial 2-point Dixon MR images of all thigh muscles were used to quantify mean fat fraction, while clinical outcomes were measured by the Motor Function Measure (MFM) and its D1 domain. Data obtained by automated segmentation were compared to manual segmentation and correlated with clinical outcomes. Results were also used to compare the statistical power when using automated or manual segmentation.

Results: A mean increase of 3.55% in thigh muscle fat fraction at 6-month follow-up could be detected by both methods without any significant difference between them (p=0.437). The automated muscle segmentation method demonstrated a strong correlation with manually segmented data (Pearson's ρ = 0.97). Additionally, there was no statistically significant difference between the automated and manual segmentation methods in their association with clinical progression, as measured by the total MFM score and its D1 domain (p = 0.235 and p = 0.425, respectively).

Conclusions: The presented automated segmentation technique is a fast and reliable tool for assessing disease progression, particularly in the early stages of DMD. It is one of the few studies validated using manual segmentation, and with further refinement, it has the potential to become a good surrogate marker for disease progression in various neuromuscular disorders.

背景:定量肌肉磁共振成像是检测包括杜氏肌营养不良症(DMD)在内的神经肌肉疾病患者亚临床疾病进展的最有前途的生物标志物之一。然而,其临床应用一直受到限制,部分原因是人工分割过程耗时耗力:我们提出了一种简单、快速的自动方法来定量测量大腿肌肉脂肪率,并研究其在 DMD 患者中的可靠性:方法:回顾性分析了 41 名行走不便的 DMD 患者的临床和放射学基线数据以及 6 个月的随访数据。所有大腿肌肉的轴向两点 Dixon MR 图像用于量化平均脂肪率,而临床结果则通过运动功能测量(MFM)及其 D1 域进行测量。通过自动分割获得的数据与手动分割进行了比较,并与临床结果进行了关联。结果还用于比较使用自动或手动分割时的统计能力:结果:两种方法都能检测到随访6个月时大腿肌肉脂肪率平均增加了3.55%,但两者之间没有显著差异(P=0.437)。自动肌肉分割方法与人工分割数据具有很强的相关性(Pearson's ρ = 0.97)。此外,根据 MFM 总分及其 D1 域(分别为 p = 0.235 和 p = 0.425),自动和手动分割方法与临床进展的相关性在统计学上没有显著差异:本文介绍的自动分割技术是一种快速、可靠的疾病进展评估工具,尤其适用于 DMD 的早期阶段。它是为数不多的使用人工分割技术进行验证的研究之一,经过进一步改进,它有可能成为各种神经肌肉疾病疾病进展的良好替代标志物。
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来源期刊
Journal of neuromuscular diseases
Journal of neuromuscular diseases Medicine-Neurology (clinical)
CiteScore
5.10
自引率
6.10%
发文量
102
期刊介绍: The Journal of Neuromuscular Diseases aims to facilitate progress in understanding the molecular genetics/correlates, pathogenesis, pharmacology, diagnosis and treatment of acquired and genetic neuromuscular diseases (including muscular dystrophy, myasthenia gravis, spinal muscular atrophy, neuropathies, myopathies, myotonias and myositis). The journal publishes research reports, reviews, short communications, letters-to-the-editor, and will consider research that has negative findings. The journal is dedicated to providing an open forum for original research in basic science, translational and clinical research that will improve our fundamental understanding and lead to effective treatments of neuromuscular diseases.
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