The reliability of a segmentation methodology for assessing intramuscular adipose tissue and other soft-tissue compartments of lower leg MRI images

Abstract

Objective: Determine the reliability of a magnetic resonance (MR) image segmentation protocol for quantifying intramuscular adipose tissue (IntraMAT), subcutaneous adipose tissue, total muscle and intermuscular adipose tissue (InterMAT) of the lower leg. Materials and methods: Ten axial lower leg MRI slices were obtained from 21 postmenopausal women using a 1 Tesla peripheral MRI system. Images were analyzed using sliceOmatic™ software. The average cross-sectional areas of the tissues were computed for the ten slices. Intra-rater and inter-rater reliability were determined and expressed as the standard error of measurement (SEM) (absolute reliability) and intraclass coefficient (ICC) (relative reliability). Results: Intra-rater and inter-rater reliability for IntraMAT were 0.991 (95 % confidence interval [CI] 0.978–0.996, p < 0.05) and 0.983 (95 % CI 0.958–9.993, p < 0.05), respectively. For the other soft tissue compartments, the ICCs were all >0.90 (p < 0.05). The absolute intra-rater and inter-rater reliability (expressed as SEM) for segmenting IntraMAT were 22.19 mm2 (95 % CI 16.97–32.04) and 78.89 mm2 (95 % CI 60.36–113.92), respectively. Conclusion: This is a reliable segmentation protocol for quantifying IntraMAT and other soft-tissue compartments of the lower leg. A standard operating procedure manual is provided to assist users, and SEM values can be used to estimate sample size and determine confidence in repeated measurements in future research.