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Published in: BMC Medical Imaging 1/2010

Open Access 01-12-2010 | Research article

Reliability of computed tomography measurements in assessment of thigh muscle cross-sectional area and attenuation

Authors: Sören Strandberg, Marie-Louise Wretling, Torsten Wredmark, Adel Shalabi

Published in: BMC Medical Imaging | Issue 1/2010

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Abstract

Background

Advancement in technology of computer tomography (CT) and introduction of new medical imaging softwares enables easy and rapid assessment of muscle cross-sectional area (CSA) and attenuation. Before using these techniques in clinical studies there is a need for evaluation of the reliability of the measurements. The purpose of the study was to evaluate the inter- and intra-observer reliability of ImageJ in measuring thigh muscles CSA and attenuation in patients with anterior cruciate ligament (ACL) injury by computer tomography.

Methods

31 patients from an ongoing study of rehabilitation and muscle atrophy after ACL reconstruction were included in the study. Axial CT images with slice thickness of 10 mm at the level of 150 mm above the knee joint were analyzed by two investigators independently at two times with a minimum of 3 weeks between the two readings using NIH ImageJ. CSA and the mean attenuation of individual thigh muscles were analyzed for both legs.

Results

Mean CSA and mean attenuation values were in good agreement both when comparing the two observers and the two replicates. The inter- and intraclass correlation (ICC) was generally very high with values from 0.98 to 1.00 for all comparisons except for the area of semimembranosus. All the ICC values were significant (p < 0,001). Pearson correlation coefficients were also generally very high with values from 0.98 to 1.00 for all comparisons except for the area of semimembranosus (0.95 for intraobserver and 0.92 for interobserver).

Conclusion

This study has presented ImageJ as a method to monitor and evaluate CSA and attenuation of different muscles in the thigh using CT-imaging. The method shows an overall excellent reliability with respect to both observer and replicate.
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Literature
1.
go back to reference Eriksson KO: On the semitendinosus tendon in anterior cruciate ligament reconstructive surgery. PhD thesis. 2001, Karolinska Institutet, Stockholm Eriksson KO: On the semitendinosus tendon in anterior cruciate ligament reconstructive surgery. PhD thesis. 2001, Karolinska Institutet, Stockholm
2.
go back to reference Marrale J, Morrissey M, Haddad F: A literature review of autograft and allograft anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2007, 15: 690-704. 10.1007/s00167-006-0236-1.CrossRefPubMed Marrale J, Morrissey M, Haddad F: A literature review of autograft and allograft anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2007, 15: 690-704. 10.1007/s00167-006-0236-1.CrossRefPubMed
3.
go back to reference Hurd W, Axe M, Snyder-Mackler L: Management of the athlete with acute anterior cruciate ligament deficiency. Sports Health: A Multidisciplinary Approach. 2009, 1: 39-46. 10.1177/1941738108326977.CrossRef Hurd W, Axe M, Snyder-Mackler L: Management of the athlete with acute anterior cruciate ligament deficiency. Sports Health: A Multidisciplinary Approach. 2009, 1: 39-46. 10.1177/1941738108326977.CrossRef
4.
go back to reference Aglietti P, Giron F, Losco M, Cuomo P, Ciardullo A, Mondanelli N: Comparison between single-and double-bundle anterior cruciate ligament reconstruction: A prospective, randomized, single-blinded clinical trial. Am J Sports Med. 2010, 38: 25-34. 10.1177/0363546509347096.CrossRefPubMed Aglietti P, Giron F, Losco M, Cuomo P, Ciardullo A, Mondanelli N: Comparison between single-and double-bundle anterior cruciate ligament reconstruction: A prospective, randomized, single-blinded clinical trial. Am J Sports Med. 2010, 38: 25-34. 10.1177/0363546509347096.CrossRefPubMed
5.
go back to reference Mattsson S, Thomas BJ: Development of methods for body composition studies. Phys Med Biol. 2006, 51: 203-228. 10.1088/0031-9155/51/13/R13.CrossRef Mattsson S, Thomas BJ: Development of methods for body composition studies. Phys Med Biol. 2006, 51: 203-228. 10.1088/0031-9155/51/13/R13.CrossRef
6.
go back to reference Beneke R, Neuerburg J, Bohndorf K: Muscle cross-section measurement by magnetic resonance imaging. Eur J Appl Physiol. 1991, 63: 424-429. 10.1007/BF00868073.CrossRef Beneke R, Neuerburg J, Bohndorf K: Muscle cross-section measurement by magnetic resonance imaging. Eur J Appl Physiol. 1991, 63: 424-429. 10.1007/BF00868073.CrossRef
7.
go back to reference Engstrom CM, Loeb GE, Reid JG, Forrest WJ, Avruch L: Morphometry of the human thigh muscles. A comparison between anatomical sections and computer tomographic and magnetic resonance images. J Anat. 1991, 176: 139-156.PubMedPubMedCentral Engstrom CM, Loeb GE, Reid JG, Forrest WJ, Avruch L: Morphometry of the human thigh muscles. A comparison between anatomical sections and computer tomographic and magnetic resonance images. J Anat. 1991, 176: 139-156.PubMedPubMedCentral
8.
go back to reference Mitsiopoulos N, Baumgartner RN, Heymsfield SB, Lyons W, Gallagher D, Ross R: Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol. 1998, 85 (1): 115-122.PubMed Mitsiopoulos N, Baumgartner RN, Heymsfield SB, Lyons W, Gallagher D, Ross R: Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol. 1998, 85 (1): 115-122.PubMed
9.
go back to reference Steiger P, Block JE, Friedlander A, Genant HK: Precise determination of paraspinous musculature by quantitative CT. J Comput Assist Tomogr. 1988, 12: 616-620. 10.1097/00004728-198807000-00015.CrossRefPubMed Steiger P, Block JE, Friedlander A, Genant HK: Precise determination of paraspinous musculature by quantitative CT. J Comput Assist Tomogr. 1988, 12: 616-620. 10.1097/00004728-198807000-00015.CrossRefPubMed
10.
go back to reference Lemieux S, Lesage M, Bergeron J, Prud'Homme D, Després JP: Comparison of two techniques for measurement of visceral adipose tissue cross-sectional areas by computed tomography. Am J Hum Biol. 1999, 11: 61-68. 10.1002/(SICI)1520-6300(1999)11:1<61::AID-AJHB6>3.0.CO;2-3.CrossRefPubMed Lemieux S, Lesage M, Bergeron J, Prud'Homme D, Després JP: Comparison of two techniques for measurement of visceral adipose tissue cross-sectional areas by computed tomography. Am J Hum Biol. 1999, 11: 61-68. 10.1002/(SICI)1520-6300(1999)11:1<61::AID-AJHB6>3.0.CO;2-3.CrossRefPubMed
11.
go back to reference Engstrom CM, Loeb GE, Reid JG, Forrest WJ, Avruch L: Morphometry of the human thigh muscles. A comparison between anatomical sections and computer tomographic and magnetic resonance images. J Anat. 1991, 176: 139-156.PubMedPubMedCentral Engstrom CM, Loeb GE, Reid JG, Forrest WJ, Avruch L: Morphometry of the human thigh muscles. A comparison between anatomical sections and computer tomographic and magnetic resonance images. J Anat. 1991, 176: 139-156.PubMedPubMedCentral
12.
go back to reference Bland J, Altman D: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986, 1: 307-310.CrossRefPubMed Bland J, Altman D: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986, 1: 307-310.CrossRefPubMed
13.
go back to reference Bland J, Altman D: Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat. 2007, 17: 571-582. 10.1080/10543400701329422.CrossRefPubMed Bland J, Altman D: Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat. 2007, 17: 571-582. 10.1080/10543400701329422.CrossRefPubMed
14.
go back to reference Chowdhury B, Sjöström L, Alpsten M, Kostanty J, Kvist H, Löfgren R: A multicompartment body composition technique based on computerized tomography. Int J Obes Metab Disord. 1994, 18 (4): 219-234. Chowdhury B, Sjöström L, Alpsten M, Kostanty J, Kvist H, Löfgren R: A multicompartment body composition technique based on computerized tomography. Int J Obes Metab Disord. 1994, 18 (4): 219-234.
15.
go back to reference Irving BA, Weltman JY, Brock DW, Davis CK, Gaesser GA, Weltman A: NIH ImageJ and Slice-o-matic computed tomography imaging software to quantify soft tissue. Obesity. 2007, 15: 370-376. 10.1038/oby.2007.573.CrossRefPubMed Irving BA, Weltman JY, Brock DW, Davis CK, Gaesser GA, Weltman A: NIH ImageJ and Slice-o-matic computed tomography imaging software to quantify soft tissue. Obesity. 2007, 15: 370-376. 10.1038/oby.2007.573.CrossRefPubMed
16.
go back to reference Kelley DE, Slasky BS, Janosky J: Skeletal muscle density: effects of obesity and non-insulin-dependent diabetes mellitus. Am J Clin Nut. 1991, 54: 509-515. Kelley DE, Slasky BS, Janosky J: Skeletal muscle density: effects of obesity and non-insulin-dependent diabetes mellitus. Am J Clin Nut. 1991, 54: 509-515.
17.
go back to reference Goodpaster BH, Kelley DE, Wing RR, Meier A, Thaete FL: Effects of weight loss on regional fat distribution and insulin sensitivity in obesity. Diabetes. 1999, 48 (4): 839-847. 10.2337/diabetes.48.4.839.CrossRefPubMed Goodpaster BH, Kelley DE, Wing RR, Meier A, Thaete FL: Effects of weight loss on regional fat distribution and insulin sensitivity in obesity. Diabetes. 1999, 48 (4): 839-847. 10.2337/diabetes.48.4.839.CrossRefPubMed
18.
go back to reference Goodpaster BH, Thaete FL, Kelley DE: Thigh adipose tissue distribution is associated with insulin resistance in obesity and in type 2 diabetes mellitus. Am J Clin Nutr. 2000, 71 (4): 885-892.PubMed Goodpaster BH, Thaete FL, Kelley DE: Thigh adipose tissue distribution is associated with insulin resistance in obesity and in type 2 diabetes mellitus. Am J Clin Nutr. 2000, 71 (4): 885-892.PubMed
19.
go back to reference Goodpaster BH, Thaete FL, Kelley DE: Composition of skeletal muscle evaluated with computed tomography. Ann N Y Acad Sci. 2000, 904: 18-24. 10.1111/j.1749-6632.2000.tb06416.x.CrossRefPubMed Goodpaster BH, Thaete FL, Kelley DE: Composition of skeletal muscle evaluated with computed tomography. Ann N Y Acad Sci. 2000, 904: 18-24. 10.1111/j.1749-6632.2000.tb06416.x.CrossRefPubMed
20.
go back to reference Goodpaster BH, Kelley DE, Thaete FL, He J, Ross R: Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content. J Appl Physiol. 2000, 89 (1): 104-110.PubMed Goodpaster BH, Kelley DE, Thaete FL, He J, Ross R: Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content. J Appl Physiol. 2000, 89 (1): 104-110.PubMed
21.
go back to reference Van de Sande MA, Stoel BC, Obermann WR, Tjong a Lieng JG, Rozing PM: Quantitative assessment of fatty degeneration in rotator cuff muscles determined with computed tomography. Invest Radiol. 2005, 40 (5): 313-319. 10.1097/01.rli.0000160014.16577.86.CrossRefPubMed Van de Sande MA, Stoel BC, Obermann WR, Tjong a Lieng JG, Rozing PM: Quantitative assessment of fatty degeneration in rotator cuff muscles determined with computed tomography. Invest Radiol. 2005, 40 (5): 313-319. 10.1097/01.rli.0000160014.16577.86.CrossRefPubMed
22.
go back to reference Rasch A, Byström AH, Dalen N, Berg HE: Reduced muscle radiological density, cross-sectional area, and strength of major hip and knee muscles in 22 patients with hip osteoarthritis. Acta Orthop. 2007, 78 (4): 505-510. 10.1080/17453670710014158.CrossRefPubMed Rasch A, Byström AH, Dalen N, Berg HE: Reduced muscle radiological density, cross-sectional area, and strength of major hip and knee muscles in 22 patients with hip osteoarthritis. Acta Orthop. 2007, 78 (4): 505-510. 10.1080/17453670710014158.CrossRefPubMed
23.
go back to reference Berg HE, Tedner B, Tesch PA: Changes in lower limb muscle cross-sectional area and tissue fluid volume after transition from standing to supine. Acta Physiol Scand. 1993, 148 (4): 379-385. 10.1111/j.1748-1716.1993.tb09573.x.CrossRefPubMed Berg HE, Tedner B, Tesch PA: Changes in lower limb muscle cross-sectional area and tissue fluid volume after transition from standing to supine. Acta Physiol Scand. 1993, 148 (4): 379-385. 10.1111/j.1748-1716.1993.tb09573.x.CrossRefPubMed
24.
go back to reference Cerniglia LM, Delmonico MJ, Lindle R, Hurley BF, Rogers MA: Effects of acute supine rest on mid-thigh cross-sectional area as measured by computed tomography. Clin Physiol Funct Imaging. 2007, 27 (4): 249-253. 10.1111/j.1475-097X.2007.00742.x.CrossRefPubMed Cerniglia LM, Delmonico MJ, Lindle R, Hurley BF, Rogers MA: Effects of acute supine rest on mid-thigh cross-sectional area as measured by computed tomography. Clin Physiol Funct Imaging. 2007, 27 (4): 249-253. 10.1111/j.1475-097X.2007.00742.x.CrossRefPubMed
Metadata
Title
Reliability of computed tomography measurements in assessment of thigh muscle cross-sectional area and attenuation
Authors
Sören Strandberg
Marie-Louise Wretling
Torsten Wredmark
Adel Shalabi
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Medical Imaging / Issue 1/2010
Electronic ISSN: 1471-2342
DOI
https://doi.org/10.1186/1471-2342-10-18

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