Reliability and agreement of lumbar multifidus volume and fat fraction quantification using magnetic resonance imaging — The International Society for the Study of the Lumbar Spine
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Reliability and agreement of lumbar multifidus volume and fat fraction quantification using magnetic resonance imaging (#1044)

Sofie Rummens 1 2 , Saskia Bosch 1 , Sofie Dierckx 3 , Anna Vanmechelen 3 , Ronald Peeters 4 , Simon Brumagne 3 , Kaat Desloovere 3 , Koen Peers 1 2
  1. Department of Physical Medicine & Rehabilitation, University Hospitals Leuven, Leuven, Belgium
  2. Department of Development & Regeneration, KU Leuven - University of Leuven, Leuven, Belgium
  3. Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
  4. Department of Radiology, University Hospitals Leuven, Leuven, Belgium

Introduction 

Magnetic resonance imaging (MRI) is the standard to quantify size and structure of lumbar muscles. Three-dimensional volumetric measures are expected to be more closely related to muscle function than two-dimensional measures such as cross-sectional area. Reliability and agreement of a standardized method should be established to enable the use of MRI to assess lumbar muscle characteristics. This study investigates the intra- and inter-processor reliability for the quantification of (1) muscle volume and (2) fat fraction based on chemical shift MRI images using axial 3D-volume measurements of the lumbar multifidus in patients with low back pain.  

Methods 

Two processor manually segmented the lumbar multifidus on the MRI scans of 18 patients with low back pain using Mevislab software. (See Figure 1) Fat fraction of the segmented volume was calculated. Reliability and agreement were determined using intra-class correlation coefficients (ICC), and calculation of the standard error of measurement (SEM). 

Results 

Excellent ICCs were found for both intra-processor as well as inter-processor analysis of lumbar multifidus volume measurement, with slightly better results for the intra-processor reliability. The SEMs for volume were lower than 4.05 cm³. Excellent reliability and agreement were also found for fat fraction measures, with ICCs of 0.985 – 0.998 and SEMs below 0.946%. 

Discussion 

The proposed method to quantify muscle volume and fat fraction of the lumbar multifidus on MRI was highly reliable. Future studies could use this method to obtain more in-depth insight into the three-dimensional structural properties of the lumbar multifidus.  

 618e6df7da3f6-Figure+-+segmentation+of+lumbar+multifidus+MRI.jpg

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