Fast and Smart Segmentation of Paraspinal Muscles in Magnetic Resonance Imaging with CleverSeg

Abstract Background Vertebral augmentation (VA) techniques are used to treat acute osteoporotic vertebral compression fractures (OVCFs). However, the incidence of recurrent vertebral fractures after VA is controversial. Various factors have been discussed in the literature, but no convincing study on the quality of paraspinal muscles has been reported. The purposes of this study were to evaluate the changes in paraspinal muscles and discuss the relationship between paraspinal muscle degeneration and vertebral refractures after percutaneous kyphoplasty (PKP). Methods This retrospective study was conducted in patients who underwent PKP for an initial OVCF between July 2017 and August 2018. Patients were followed up and categorized in the refractured or non-refractured group. A final magnetic resonance imaging (MRI) scan and a preoperative MRI scan were used to determine the measurements. The paraspinal muscles at the mid-height level of the initial fractured vertebral body were measured using regions of interest (ROIs), including the cross-sectional area (CSA) and signal intensity (SI). The changes in the observed data were compared between the groups using rank-sum tests. Results Overall, 92 patients were enrolled in the study; 33 of them sustained vertebral refractures during the follow-up and the other 59 patients did not. There were no significant differences in terms of sex, age, preoperative bone mineral density, and body mass index between the groups (all, P > 0.05). The refractured group had a significantly higher decrease in the ROI-CSA and CSA/SI, and a higher increase in ROI-SI, compared with the preoperative data (all, P < 0.05). Conclusions The quality of paraspinal muscles significantly decreased in patients with new OVCFs after PKP. This brings a new perspective to the study of postoperative recurrent fractures; patients and physicians need to pay more attention to the efficacy of bed rest and bracing.

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A Deep-Learning–Based, Fully Automated Program to Segment and Quantify Major Spinal Components on Axial Lumbar Spine Magnetic Resonance Imaging

Physical Therapy ◽

10.1093/ptj/pzab041 ◽

2021 ◽

Author(s):

Haotian Shen ◽

Jiawei Huang ◽

Qiangqiang Zheng ◽

Zhiwei Zhu ◽

Xiaoqiang Lv ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Deep Learning ◽

Lumbar Spine ◽

Magnetic Resonance ◽

Spinal Canal ◽

Erector Spinae ◽

Paraspinal Muscle ◽

Resonance Imaging ◽

Paraspinal Muscles ◽

Quantitative Measurements

Abstract Objective The paraspinal muscles have been extensively studied on axial lumbar magnetic resonance imaging (MRIs) for better understanding of back pain; however, the acquisition of measurements mainly relies on manual segmentation, which is time consuming. The study objective was to develop and validate a deep-learning–based program for automated acquisition of quantitative measurements for major lumbar spine components on axial lumbar MRIs, the paraspinal muscles in particular. Methods This study used a cross-sectional observational design. From the Hangzhou Lumbar Spine Study, T2-weighted axial MRIs at the L4–5 disk level of 120 participants (aged 54.8 y [SD = 15.0]) were selected to develop the deep-learning–based program Spine Explorer (Tulong). Another 30 axial lumbar MRIs were automatically measured by Spine Explorer and then manually measured using ImageJ to acquire quantitative size and compositional measurements for bilateral multifidus, erector spinae, and psoas muscles; the disk; and the spinal canal. Intersection-over-union and Dice score were used to evaluate the performance of automated segmentation. Intraclass coefficients (ICCs) and Bland–Altman plots were used to examine intersoftware agreements for various measurements. Results After training, Spine Explorer (Tulong) measures an axial lumbar MRI in 1 second. The intersections-over-union were 83.3% to 88.4% for the paraspinal muscles, 92.2% and 82.1% for the disk and spinal canal, respectively. For various size and compositional measurements of paraspinal muscles, Spine Explorer (Tulong) was in good agreement with ImageJ (ICC = 0.85 ~ 0.99). Impact Spine Explorer (Tulong) is automated, efficient, and reliable in acquiring quantitative measurements for the paraspinal muscles, the disk, and the canal, and various size and compositional measurements were simultaneously obtained for the lumbar paraspinal muscles. Such an automated program might encourage further epidemiological studies of the lumbar paraspinal muscle degeneration and enhance paraspinal muscle assessment in clinical practice.

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Cross-sectional area of human trunk paraspinal muscles before and after posterior lumbar surgery using magnetic resonance imaging

European Spine Journal ◽

10.1007/s00586-015-4014-y ◽

2015 ◽

Vol 25 (3) ◽

pp. 774-782 ◽

Cited By ~ 15

Author(s):

Mohammad S. Ghiasi ◽

Navid Arjmand ◽

Aboulfazl Shirazi-Adl ◽

Farzam Farahmand ◽

Hassan Hashemi ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Cross Sectional Area ◽

Lumbar Surgery ◽

Sectional Area ◽

Resonance Imaging ◽

Paraspinal Muscles ◽

Cross Sectional ◽

Before And After

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A Comparison of Magnetic Resonance Imaging Muscle Fat Content in the Lumbar Paraspinal Muscles with Patient-Reported Outcome Measures in Patients with Lumbar Degenerative Disk Disease and Focal Disk Prolapse

Global Spine Journal ◽

10.1055/s-0036-1583290 ◽

2016 ◽

Vol 6 (4) ◽

pp. 401-410 ◽

Cited By ~ 8

Author(s):

Ashwin Bhadresha ◽

Owen John Lawrence ◽

Michael J. H. McCarthy

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Resonance Imaging ◽

Paraspinal Muscles ◽

Degenerative Disk Disease ◽

Patient Reported ◽

Disk Prolapse ◽

Lumbar Paraspinal Muscles

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Inter-rater reliability between two examiners with different professional roles in the evaluation of fat infiltration in the lumbar paraspinal muscles using magnetic resonance imaging

Journal of Physical Therapy Science ◽

10.1589/jpts.33.591 ◽

2021 ◽

Vol 33 (8) ◽

pp. 591-595

Author(s):

Kenta Suzuki ◽

Yuki Hasebe ◽

Mitsuru Yamamoto ◽

Kazuo Saita ◽

Satoshi Ogihara

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Professional Roles ◽

Resonance Imaging ◽

Paraspinal Muscles ◽

Rater Reliability ◽

Fat Infiltration ◽

Lumbar Paraspinal Muscles

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Can Paraspinal Muscle Degeneration Be a Reason for Refractures After Percutaneous Kyphoplasty? A Magnetic Resonance Imaging Observation

10.21203/rs.3.rs-676712/v1 ◽

2021 ◽

Author(s):

He Zhao ◽

Yan He ◽

Jun-Song Yang ◽

Wei Bao ◽

Jian Chen ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Paraspinal Muscle ◽

Muscle Degeneration ◽

Resonance Imaging ◽

Paraspinal Muscles ◽

Mineral Density ◽

Mri Scan ◽

Percutaneous Kyphoplasty

Abstract Background: Vertebral augmentation (VA) techniques are used to treat acute osteoporotic vertebral compression fractures (OVCFs). However, the incidence of recurrent vertebral fractures after VA is controversial. Various factors have been discussed in the literature, but no convincing study on the quality of paraspinal muscles has been reported. The purposes of this study were to evaluate the changes in paraspinal muscles and discuss the relationship between paraspinal muscle degeneration and vertebral refractures after percutaneous kyphoplasty (PKP).Methods: This retrospective study was conducted in patients who underwent PKP for an initial OVCF between July 2017 and August 2018. Patients were followed up and categorized in the refractured or non-refractured group. A final magnetic resonance imaging (MRI) scan and a preoperative MRI scan were used to determine the measurements. The paraspinal muscles at the mid-height level of the initial fractured vertebral body were measured using regions of interest (ROIs), including the cross-sectional area (CSA) and signal intensity (SI). The changes in the observed data were compared between the groups using rank-sum tests.Results: Overall, 92 patients were enrolled in the study; 33 of them sustained vertebral refractures during the follow-up and the other 59 patients did not. There were no significant differences in terms of sex, age, preoperative bone mineral density, and body mass index between the groups (all, P>0.05). The refractured group had a significantly higher decrease in the ROI-CSA and CSA/SI, and a higher increase in ROI-SI, compared with the preoperative data (all, P<0.05).Conclusions: The quality of paraspinal muscles significantly decreased in patients with new OVCFs after PKP. This brings a new perspective to the study of postoperative recurrent fractures; patients and physicians need to pay more attention to the efficacy of bed rest and bracing.

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