Rebecca Abbott1, Anneli Peolsson2, Janne West3, James M Elliott4, Ulrika Åslund2, Anette Karlsson5, Olof Dahlqvist Leinhard6. 1. Department of Physical Therapy and Human Movement Sciences, NU-PTHMS, Feinberg School of Medicine, Northwestern University, 645 North Michigan Ave, Suite 1100, Chicago, IL, 60611 USA. 2. Department of Medical and Health Sciences, Physiotherapy, IMH kansli, Sandbäcksgatan 7, 3 tr, Campus US, Linköping University, 58183 Linköping, Sweden. 3. Department of Medical and Health Sciences, and Center for Medical Image Science and Visualization (CMIV)/Division of Radiological Sciences, IMH, Linköping University, SE-581 85 Linköping, Sweden. 4. Department of Physical Therapy and Human Movement Sciences, NU-PTHMS, Feinberg School of Medicine, Northwestern University, 645 North Michigan Ave, Suite 1100, Chicago, IL, 60611 USA; School of Health and Rehabilitation Sciences, The University of Queensland, Australia; Zürich University of Applied Sciences, Gertrudstrasse 15, 8400 Winterthur, Switzerland. 5. Center for Medical Image Science and Visualization (CMIV)/Department of Biomedical Engineering, Linköping University, SE 58183 Linköping, Sweden. 6. Department of Medical and Health Sciences, and Center for Medical Image Science and Visualization (CMIV)/Division of Radiological Sciences, IMH, Linköping University, SE-581 85 Linköping, Sweden. Electronic address: olof.dahlqvist.leinhard@liu.se.
Abstract
BACKGROUND CONTEXT: The development of muscle fat infiltration (MFI) in the neck muscles is associated with poor functional recovery following whiplash injury. Custom software and time-consuming manual segmentation of magnetic resonance imaging (MRI) is required for quantitative analysis and presents as a barrier for clinical translation. PURPOSE: The purpose of this work was to establish a qualitative MRI measure for MFI and evaluate its ability to differentiate between individuals with severe whiplash-associated disorder (WAD), mild or moderate WAD, and healthy controls. STUDY DESIGN/ SETTING: This is a cross-sectional study. PATIENT SAMPLE: Thirty-one subjects with WAD and 31 age- and sex-matched controls were recruited from an ongoing randomized controlled trial. OUTCOME MEASURES: The cervical multifidus was visually identified and segmented into eighths in the axial fat/water images (C4-C7). Muscle fat infiltration was assessed on a visual scale: 0 for no or marginal MFI, 1 for light MFI, and 2 for distinct MFI. The participants with WAD were divided in two groups: mild or moderate and severe based on Neck Disability Index % scores. METHODS: The mean regional MFI was compared between the healthy controls and each of the WAD groups using the Mann-Whitney U test. Receiver operator characteristic (ROC) analyses were carried out to evaluate the validity of the qualitative method. RESULTS: Twenty (65%) patients had mild or moderate disability and 11 (35%) were considered severe. Inter- and intra-rater reliability was excellent when grading was averaged by level or when frequency of grade II was considered. Statistically significant differences (p<.05) in regional MFI were particularly notable between the severe WAD group and healthy controls. The ROC curve, based on detection of distinct MFI, showed an area-under-the curve of 0.768 (95% confidence interval 0.59-0.94) for discrimination of WAD participants. CONCLUSIONS: These preliminary results suggest a qualitative MRI measure for MFI is reliable and valid, and may prove useful toward the classification of WAD in radiology practice.
BACKGROUND CONTEXT: The development of muscle fat infiltration (MFI) in the neck muscles is associated with poor functional recovery following whiplash injury. Custom software and time-consuming manual segmentation of magnetic resonance imaging (MRI) is required for quantitative analysis and presents as a barrier for clinical translation. PURPOSE: The purpose of this work was to establish a qualitative MRI measure for MFI and evaluate its ability to differentiate between individuals with severe whiplash-associated disorder (WAD), mild or moderate WAD, and healthy controls. STUDY DESIGN/ SETTING: This is a cross-sectional study. PATIENT SAMPLE: Thirty-one subjects with WAD and 31 age- and sex-matched controls were recruited from an ongoing randomized controlled trial. OUTCOME MEASURES: The cervical multifidus was visually identified and segmented into eighths in the axial fat/water images (C4-C7). Muscle fat infiltration was assessed on a visual scale: 0 for no or marginal MFI, 1 for light MFI, and 2 for distinct MFI. The participants with WAD were divided in two groups: mild or moderate and severe based on Neck Disability Index % scores. METHODS: The mean regional MFI was compared between the healthy controls and each of the WAD groups using the Mann-Whitney U test. Receiver operator characteristic (ROC) analyses were carried out to evaluate the validity of the qualitative method. RESULTS: Twenty (65%) patients had mild or moderate disability and 11 (35%) were considered severe. Inter- and intra-rater reliability was excellent when grading was averaged by level or when frequency of grade II was considered. Statistically significant differences (p<.05) in regional MFI were particularly notable between the severe WAD group and healthy controls. The ROC curve, based on detection of distinct MFI, showed an area-under-the curve of 0.768 (95% confidence interval 0.59-0.94) for discrimination of WAD participants. CONCLUSIONS: These preliminary results suggest a qualitative MRI measure for MFI is reliable and valid, and may prove useful toward the classification of WAD in radiology practice.
Authors: James M Elliott; D Mark Courtney; Alfred Rademaker; Daniel Pinto; Michele M Sterling; Todd B Parrish Journal: Spine (Phila Pa 1976) Date: 2015-06-15 Impact factor: 3.468
Authors: Ashley Craig; Yvonne Tran; Rebecca Guest; Bamini Gopinath; Jagnoor Jagnoor; Richard A Bryant; Alex Collie; Robyn Tate; Justin Kenardy; James W Middleton; Ian Cameron Journal: BMJ Open Date: 2016-09-08 Impact factor: 2.692
Authors: D Stone; H Bogaardt; S D Linnstaedt; B Martin-Harris; A C Smith; D M Walton; E Ward; J M Elliott Journal: Dysphagia Date: 2019-08-03 Impact factor: 3.438
Authors: Kenneth A Weber; Andrew C Smith; Marie Wasielewski; Kamran Eghtesad; Pranav A Upadhyayula; Max Wintermark; Trevor J Hastie; Todd B Parrish; Sean Mackey; James M Elliott Journal: Sci Rep Date: 2019-05-28 Impact factor: 4.379
Authors: James M Elliott; Brad E Heinrichs; David M Walton; Todd B Parrish; D Mark Courtney; Andrew C Smith; Jasmine Hunt; Mary J Kwasny; Marie Wasielewski; Gunter P Siegmund Journal: PLoS One Date: 2019-12-04 Impact factor: 3.240
Authors: Andrew C Smith; Stephanie R Albin; Rebecca Abbott; Rebecca J Crawford; Mark A Hoggarth; Marie Wasielewski; James M Elliott Journal: Sci Rep Date: 2020-07-10 Impact factor: 4.379