MATLAB | Volume of Adipose and Muscle Tissue on T1-Weighted Transverse MRI Sections of Thigh
Updated 11/20/2022
About
This program takes a black-and-white T1-weighted MRI image of a transverse section of the thigh and displays the approximate volumes of muscle and adipose/soft tissue, along with health indicators.*
Map Key:
RED = Adipose/Soft Tissue
GREEN = Muscle Tissue
BLACK = Non-muscle Tissue**
WHITE = Space
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Important Info:
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This program is designed to run with standard-T1 weighted MRI slides, if your MRI slide is particularly bright, dark, high- or low-contrast, you may need to adjust the red and green parameters in the coloring loop.
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Area of the femur is approximated based on the radius of the thigh, assuming that the femur has a slight ellipse shape with a larger height than width. The area of the femur is subtracted from the area of adipose/soft tissue, since both show similar brightness. There is an error checking mechanism in place in case there are unusual areas of brightness outside of the thigh, outlier radius values will not affect the femur area calculation.
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A montage image is shown of the original MRI slide and the colorized map from which calculations for muscle and adipose/soft tissue amount are derived side-by-side so you can confirm that the parameters are appropriate and the calculations correct.
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*The usefulness of the health indicator based on muscle:adipose/soft tissue ratio is also dependent on how far down the thigh the transverse section is obtained, since more body fat typically accumulates more proximally toward the torso. For my parameters of athletic/healthy/deconditioned/unhealthy, I used sections from around the midpoint between the hip and knee.
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**Black areas on the map indicate areas that have the brightness of muscle tissue, but small areas of isolated muscle 'tissue' are likely not actual muscles, and are therefore discluded from muscle area.
Figure 1.1 Montage of program inputs and outputs for a range of patients, from healthy athletes (Row 3), healthy people (Rows 2, 5, 6), and a patient with Facioscapulohumeral Muscular Dystrophy 1 (FSHD1) (Row 1).
Implication - Tracking Disease Progression of Muscular Dystrophy
About Duchenne Muscular Dystrophy
Duchenne Muscular Dystrophy (DMD) is a universally fatal X-linked recessive genetic disease leading to the degeneration of muscle tissue into fat tissue. The disease progresses quickly through childhood, with symptoms of delayed milestones and muscle weakness first appearing in early childhood. The average age at diagnosis is 4. Proximal muscles are affected to a greater degree through childhood. Distal limb muscles and muscles of the torso become severely affected during adolescence. Over time, muscles in the heart, diaphragm, and other organs will also degrade, leading to serious health problems. Eventually, cardiomyopathy is the most common cause of death. Most DMD patients do not outlive their 30's, with an average life expectancy of 22 years. Current treatment options involve symptom management, lifestyle changes, assistive devices, and clinical trials.
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Program Implication - Tracking Disease Progression
Clinical trials involving gene therapy to replace the function of the missing dystrophin proteins are the best current hope for treating DMD. The criteria for acceptance into many clinical trials hinges on how much the patient (usually a younger child with less severe disease) has already progressed. Tests of muscle strength are used as exclusion criteria in some trials. Analysis of standardized MRI sections could provide a quantitative way to assess disease progression and judge trial eligibility.
Figure 1.2 Montage of program inputs and outputs demonstrating progression of DMD over time in a similar patient group. Row 1: Patient at baseline with beginning signs of muscle wasting, 5-years-old. Row 2: Patient with muscle wasting, still able to ambulate independently, 9.2-years-old. Row 3: Patient with muscle wasting, unable to ambulate independently, 9.8-years-old. Row 4: Patient with near-complete muscle wasting of most thigh muscles, unable to ambulate, 12.8-years-old.
References
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Banerji, C. R. S., & Zammit, P. S. (2021). Pathomechanisms and biomarkers in facioscapulohumeral muscular dystrophy: roles of DUX4 and PAX7. EMBO Molecular Medicine, 13(8), e13695. https://doi.org/10.15252/emmm.202013695
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Bardakov, S. (n.d.). Muscle MRI. Wustl.edu. Retrieved November 20, 2022, from https://neuromuscular.wustl.edu/pathol/diagrams/musclemri.htm
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Bonati, U., Hafner, P., Schädelin, S., Schmid, M., Naduvilekoot Devasia, A., Schroeder, J., Zuesli, S., Pohlman, U., Neuhaus, C., Klein, A., Sinnreich, M., Haas, T., Gloor, M., Bieri, O., Fischmann, A., & Fischer, D. (2015). Quantitative muscle MRI: A powerful surrogate outcome measure in Duchenne muscular dystrophy. Neuromuscular Disorders: NMD, 25(9), 679–685. https://doi.org/10.1016/j.nmd.2015.05.006
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Duchenne muscular dystrophy - About the Disease - Genetic and Rare Diseases Information Center. (n.d.). Nih.gov. Retrieved November 20, 2022, from https://rarediseases.info.nih.gov/diseases/6291/duchenne-muscular-dystrophy
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Hartman, R. P., Sundaram, M., Okuno, S. H., & Sim, F. H. (2004). Effect of granulocyte-stimulating factors on marrow of adult patients with musculoskeletal malignancies: incidence and MRI findings. AJR. American Journal of Roentgenology, 183(3), 645–653. https://doi.org/10.2214/ajr.183.3.1830645
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Preston, M. K., Tawil, R., & Wang, L. H. (2020). Facioscapulohumeral Muscular Dystrophy. In GeneReviews® [Internet]. University of Washington, Seattle.
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What is Duchenne muscular dystrophy? - Parent Project MD. (2017, November 15). Parent Project Muscular Dystrophy. https://www.parentprojectmd.org/about-duchenne/what-is-duchenne/
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(N.d.-a). Researchgate.net. Retrieved November 20, 2022, from https://www.researchgate.net/figure/Transverse-T1-weighted-muscle-MRI-images-of-a-clinically-presymptomatic-patient-On-the_fig4_275281151
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(N.d.-b). Researchgate.net. Retrieved November 20, 2022, from https://www.researchgate.net/profile/Christoph-Heyer/publication/275281151/figure/fig4/AS:294452502515712@1447214355021/Transverse-T1-weighted-muscle-MRI-images-of-a-clinically-presymptomatic-patient-On-the.png