title: 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.
  
  
  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 mm(2) (95% CI 16.97-32.04) and 78.89 mm(2) (95% CI 60.36-113.92), respectively.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada. karampatos@hhsc.ca.|Juravinski Research Centre, Geriatric Education and Research in the Aging Sciences (GERAS) Centre, 88 Maplewood Avenue, Hamilton, ON, L8M 1W9, Canada. karampatos@hhsc.ca.|Department of Rehabilitation Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada. karampatos@hhsc.ca.
authors.forename: Sarah
authors.initials: S
authors.lastname: Karampatos
authors.affiliation: Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.|Juravinski Research Centre, Geriatric Education and Research in the Aging Sciences (GERAS) Centre, 88 Maplewood Avenue, Hamilton, ON, L8M 1W9, Canada.|Department of Biostatistics and Epidemiology, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Papaioannou
authors.affiliation: Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Beattie
authors.affiliation: Department of Rehabilitation Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
authors.forename: Monica R
authors.initials: MR
authors.lastname: Maly
authors.affiliation: Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
authors.forename: Adrian
authors.initials: A
authors.lastname: Chan
authors.affiliation: Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Adachi
authors.affiliation: Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.|Juravinski Research Centre, Geriatric Education and Research in the Aging Sciences (GERAS) Centre, 88 Maplewood Avenue, Hamilton, ON, L8M 1W9, Canada.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Pritchard
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000473:pathology; D050154:Adiposity; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003238:Connective Tissue / Q000000981:diagnostic imaging / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007866:Leg / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging* / Q000473:pathology; D015588:Observer Variation; D010363:Pattern Recognition, Automated / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Intermuscular adipose tissue; Intramuscular adipose tissue; Magnetic resonance imaging (MRI); Reliability; Segmentation