Abstract
Purpose: Based on conventional and quantitative magnetic resonance imaging (MRI), texture analysis (TA) has shown encouraging results as a biomarker for tissue structure. Chemical shift encoding-based water–fat MRI (CSE-MRI)-derived proton density fat fraction (PDFF) of thigh muscles has been associated with musculoskeletal, metabolic, and neuromuscular disorders and was demonstrated to predict muscle strength. The purpose of this study was to investigate PDFF-based TA of thigh muscles as a predictor of thigh muscle strength in comparison to mean PDFF. Methods: 30 healthy subjects (age = 30 ± 6 years; 15 females) underwent CSE-MRI of the lumbar spine at 3T, using a six-echo 3D spoiled gradient echo sequence. Quadriceps (EXT) and ischiocrural (FLEX) muscles were segmented to extract mean PDFF and texture features. Muscle flexion and extension strength were measured with an isokinetic dynamometer. Results: Of the eleven extracted texture features, Variance(global) showed the highest significant correlation with extension strength (p < 0.001, R2adj = 0.712), and Correlation showed the highest significant correlation with flexion strength (p = 0.016, R2adj = 0.658). Multivariate linear regression models identified Variance(global) and sex, but not PDFF, as significant predictors of extension strength (R2adj = 0.709; p < 0.001), while mean PDFF, sex, and BMI, but none of the texture features, were identified as significant predictors of flexion strength (R2adj = 0.674; p < 0.001). Conclusions: Prediction of quadriceps muscle strength can be improved beyond mean PDFF by means of TA, indicating the capability to quantify muscular fat infiltration patterns.
Highlights
Thigh muscle composition and volume have been demonstrated to be affected by age, exercise, and a multitude of diseases, including musculoskeletal disorders, metabolic disorders, sarcopenia, and neuromuscular diseases [1,2,3,4,5,6,7,8,9,10,11,12,13]
Based on the hypothesis that muscle structure is a significant determinator of muscle function, the aim of our study was to investigate whether texture analysis (TA) of thigh muscles improves the prediction of muscle strength beyond mean proton density fat fraction (PDFF)
We showed that thigh muscle texture features, extracted from CSE-MRIderived PDFF maps, significantly correlated with strength measurements of quadriceps and ischiocrural muscles
Summary
Thigh muscle composition and volume have been demonstrated to be affected by age, exercise, and a multitude of diseases, including musculoskeletal disorders, metabolic disorders, sarcopenia, and neuromuscular diseases [1,2,3,4,5,6,7,8,9,10,11,12,13]. Magnetic resonance imaging (MRI), in particular quantitative MRI (qMRI), offers a non-invasive, radiation-free technique for the assessment of muscle tissue It has been utilized for the evaluation of various properties, including cross-sectional area (CSA), fatty infiltration, inflammation, and structure. The proton density fat fraction (PDFF), measured by chemical shift encoding-based water–fat MRI (CSE-MRI) and validated by magnetic resonance spectroscopy (MRS) [14] and histology [15], has been established as a robust and reliable biomarker for muscle fat infiltration (MFI). In this context, mean PDFF values are commonly used
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