High inter-rater reliability of manual segmentation and volume-based tractography in healthy and dystrophic human calf muscle
Forsting, Johannes; Rohm, Marlena; Froeling, Martijn; Güttsches, Anne Katrin; Vorgerd, Matthias; Schlaffke, Lara; Rehmann, Robert
(2021) Diagnostics, volume 11, issue 9, pp. 1 - 13
(Article)
Abstract
Background: Muscle diffusion tensor imaging (mDTI) is a promising surrogate biomarker in the evaluation of muscular injuries and neuromuscular diseases. Since mDTI metrics are known to vary between different muscles, separation of different muscles is essential to achieve musclespecific diffusion parameters. The commonly used technique to assess DTI metrics is
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parameter maps based on manual segmentation (MSB). Other techniques comprise tract-based approaches, which can be performed in a previously defined volume. This so-called volume-based tractography (VBT) may offer a more robust assessment of diffusion metrics and additional information about muscle architecture through tract properties. The purpose of this study was to assess DTI metrics of human calf muscles calculated with two segmentation techniques—MSB and VBT—regarding their inter-rater reliability in healthy and dystrophic calf muscles. Methods: 20 healthy controls and 18 individuals with different neuromuscular diseases underwent an MRI examination in a 3T scanner using a 16-channel Torso XL coil. DTI metrics were assessed in seven calf muscles using MSB and VBT. Coefficients of variation (CV) were calculated for both techniques. MSB and VBT were performed by two independent raters to assess inter-rater reliability by ICC analysis and Bland-Altman plots. Next to analysis of DTI metrics, the same assessments were also performed for tract properties extracted with VBT. Results: For both techniques, low CV were found for healthy controls (≤13%) and neuromuscular diseases (≤17%). Significant differences between methods were found for all diffusion metrics except for λ1 . High inter-rater reliability was found for both MSB and VBT (ICC ≥ 0.972). Assessment of tract properties revealed high inter-rater reliability (ICC ≥ 0.974). Conclusions: Both segmentation techniques can be used in the evaluation of DTI metrics in healthy controls and different NMD with low rater dependency and high precision but differ significantly from each other. Our findings underline that the same segmentation protocol must be used to ensure comparability of mDTI data.
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Keywords: Calf musculature, Diffusion tensor imaging, Muscle MRI, Neuromuscular diseases, Quantitative MRI, Tractography, tractography, muscle MRI, calf musculature, quantitative MRI, diffusion tensor imaging, neuromuscular diseases, Clinical Biochemistry, Journal Article
ISSN: 2075-4418
Publisher: MDPI AG
Note: Funding Information: Funding: Lara Schlaffke received funding from the DFG (Project number: 122679504, SFB874; TP-A5). Marlena Rohm, Johannes Forsting, and Anne-Katrin Güttsches received grants from the FoRUM-program of the Ruhr-University Bochum (M.R.: F960R-2020; J.F.: K139-20; A.G.: K-139-44). Marlena Rohm and Matthias Vorgerd are funded by the Heimer Institute. Lara Schlaffke and Robert Rehmann received funding from Sanofi Genzyme (Project number: SGZ-2019-12541). Funding Information: Lara Schlaffke received funding from the DFG (Project number: 122679504, SFB874; TP-A5). Marlena Rohm, Johannes Forsting, and Anne-Katrin G?ttsches received grants from the FoRUMprogram of the Ruhr-University Bochum (M.R.: F960R-2020; J.F.: K139-20; A.G.: K-139-44). Marlena Rohm and Matthias Vorgerd are funded by the Heimer Institute. Lara Schlaffke and Robert Rehmann received funding from Sanofi Genzyme (Project number: SGZ-2019-12541).We thank Philips Germany for continuous scientific support and, specifically, Burkhard M?dler for valuable discussion. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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