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Correlation of texture analysis of paraspinal musculature on MRI with different clinical endpoints: Lumbar Stenosis Outcome Study (LSOS)

  • Musculoskeletal
  • Published:
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Abstract

Objectives

The aim of this study was to apply texture analysis (TA) on paraspinal musculature in T2-weighted (T2w) magnetic resonance images (MRI) of symptomatic lumbar spinal stenosis (LSS) patients and correlate the findings with clinical outcome measures.

Methods

Ninety patients were prospectively enrolled in the multi-centric Lumbar Stenosis Outcome Study (LSOS). All patients received a T2w MRI, from which we selected axial images perpendicular to the intervertebral disc at level L3/4 for TA. Regions-of-interest (ROI) were drawn of the paraspinal musculature and 304 TA features/ ROI were calculated. As clinical outcome measurements, we analysed three commonly applied measures: Spinal Stenosis Measure (SSM), Roland-Morris Disability Questionnaire (RMDQ), as well as the Numeric Rating Scale (NRS). We used two machine learning-based classifiers: Decision table, and k-nearest neighbours (k-NN).

Results

We observed no meaningful correlation between TA in paraspinal musculature and the two clinical outcome measures SSM symptoms and SSM function, while a moderate correlation was observed regarding the outcome measures RMDQ (k-NN: r = 0.56) and NRS (Decision Table: r = 0.72).

Conclusions

In conclusion, MR TA is a viable tool to quantify medical images and illustrate correlations of microarchitectural changes invisible to a human reader with potential clinical impact.

Key Points

• TA is feasible on paraspinal musculature using MRI.

• TA on paraspinal musculature correlates with SSM and RMDQ.

• TA may enable a statement regarding clinical impact of imaging findings.

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Abbreviations

AUC:

Area under the curve

BMI:

Body-mass-index

CSA:

Cross-sectional muscle area

DICOM:

Digital imaging and communications in medicine

GLCM:

Grey-level co-occurrence matrix

k-NN:

k-Nearest Neighbour

LBP:

Lumbar back pain

LSS:

Lumbar spinal stenosis

MRI:

Magnetic resonance imaging

NRS:

Numeric rating scale (pain)

PACS:

Picture archiving and communication system

RLM:

Run-length matrix

RMDQ:

Roland-Morris-disability questionnaire

ROC:

Receiver-operating characteristics

ROI:

Region of interest

SSM:

Spinal stenosis measure

TA:

Texture analysis

TSE:

Turbo spin echo

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Funding

This study has received funding by Helmut Horten Foundation, Baugarten Foundation, Pfizer-Foundation for geriatrics & research in geriatrics, Symphasis Charitable Foundation and OPO Foundation funds.

Author information

Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Manoj Mannil & Roman Guggenberger

  2. Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Pestalozzistrasse 24, 8032, Zurich, Switzerland

    Jakob M. Burgstaller & Ulrike Held

  3. Department of Orthopaedics, Balgrist University Hospital Zurich, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland

    Mazda Farshad

Authors
  1. Manoj Mannil
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  2. Jakob M. Burgstaller
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  4. Mazda Farshad
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  5. Roman Guggenberger
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Corresponding author

Correspondence to Roman Guggenberger.

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Guarantor

The scientific guarantor of this publication is Roman Guggenberger, MD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Ulrike Held and Jakob M. Burgstaller kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

http://www.lumbalstenose.ch/home/

Methodology

• retrospective

• observational

• multicentre study

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Mannil, M., Burgstaller, J.M., Held, U. et al. Correlation of texture analysis of paraspinal musculature on MRI with different clinical endpoints: Lumbar Stenosis Outcome Study (LSOS). Eur Radiol 29, 22–30 (2019). https://doi.org/10.1007/s00330-018-5552-6

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  • DOI: https://doi.org/10.1007/s00330-018-5552-6

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