Jose H Trevino1, Krzysztof R Gorny2, Angel Gomez-Cintron3, Chunfeng Zhao4, Hugo Giambini5. 1. Department of Biomedical Engineering, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA. 2. Department of Radiology, Mayo Clinic, Rochester, MN, USA. 3. Department of Radiology, The University of Texas Health Science Center, San Antonio, San Antonio, TX, USA. 4. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA. 5. Department of Biomedical Engineering, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA. hugo.giambini@utsa.edu.
Abstract
OBJECTIVE: The Goutallier classification system is the most commonly used method for grading intramuscular fatty infiltration in rotator cuff tears. This grading system presents low inter-observer reliability and an inability to provide quantitative and repeatable outcomes for intramuscular fat. We determined the correlation and reliability of two methods, the Lava Flex and Ideal IQ MRI techniques, in quantifying volumetric intramuscular fat, while also comparing to the Goutallier method. MATERIALS AND METHODS: The supraspinatus muscles of seventeen cadaveric shoulders were scanned using the Lava Flex and Ideal IQ MRI imaging protocols. Histological analysis was performed on the same muscles. Agreement, reliability, and correlation analyses were performed to compare all outcomes. RESULTS: The Lava Flex protocol took an average of ~ 4 min, while the Ideal IQ required about ~ 11 min to complete. Bland-Altman analysis showed good agreement between the Lava Flex and Ideal IQ [LOA (- 0.10 and 0.05)], and ICC analyses showed excellent reliability (ICC (1,1) 0.948; ICC (2,1) 0.947). There was a 91% correlation between the Lava Flex and Ideal IQ MR protocols. Weighted Kappa analysis between histology and the Goutallier classification showed fair-to-moderate agreement. DISCUSSION: The Lava Flex technique, taking about 30% of the acquisition time, may prevent motion artifacts in outcomes associated with the longer Ideal IQ technique. However, potential magnetic field inhomogeneities should be considered. The Lava Flex technique may be a faster and valid alternative to the Goutallier classification system.
OBJECTIVE: The Goutallier classification system is the most commonly used method for grading intramuscular fatty infiltration in rotator cuff tears. This grading system presents low inter-observer reliability and an inability to provide quantitative and repeatable outcomes for intramuscular fat. We determined the correlation and reliability of two methods, the Lava Flex and Ideal IQ MRI techniques, in quantifying volumetric intramuscular fat, while also comparing to the Goutallier method. MATERIALS AND METHODS: The supraspinatus muscles of seventeen cadaveric shoulders were scanned using the Lava Flex and Ideal IQ MRI imaging protocols. Histological analysis was performed on the same muscles. Agreement, reliability, and correlation analyses were performed to compare all outcomes. RESULTS: The Lava Flex protocol took an average of ~ 4 min, while the Ideal IQ required about ~ 11 min to complete. Bland-Altman analysis showed good agreement between the Lava Flex and Ideal IQ [LOA (- 0.10 and 0.05)], and ICC analyses showed excellent reliability (ICC (1,1) 0.948; ICC (2,1) 0.947). There was a 91% correlation between the Lava Flex and Ideal IQ MR protocols. Weighted Kappa analysis between histology and the Goutallier classification showed fair-to-moderate agreement. DISCUSSION: The Lava Flex technique, taking about 30% of the acquisition time, may prevent motion artifacts in outcomes associated with the longer Ideal IQ technique. However, potential magnetic field inhomogeneities should be considered. The Lava Flex technique may be a faster and valid alternative to the Goutallier classification system.
Authors: Joakim Rydell; Hans Knutsson; Johanna Pettersson; Andreas Johansson; Gunnar Farnebäck; Olof Dahlqvist; Peter Lundberg; Fredrik Nyström; Magnus Borga Journal: Med Image Comput Comput Assist Interv Date: 2007
Authors: Alexandra Grimm; Heiko Meyer; Marcel D Nickel; Mathias Nittka; Esther Raithel; Oliver Chaudry; Andreas Friedberger; Michael Uder; Wolfgang Kemmler; Harald H Quick; Klaus Engelke Journal: Eur J Radiol Date: 2018-04-12 Impact factor: 3.528
Authors: Fabian Gilbert; Dirk Böhm; Lars Eden; Jonas Schmalzl; Rainer H Meffert; Herbert Köstler; Andreas M Weng; Dirk Ziegler Journal: BMC Musculoskelet Disord Date: 2016-08-22 Impact factor: 2.362