Optimizing methods to quantify intramuscular fat in rotator cuff tears with normalization

Paul S. Micevych, Ankur Garg, Lucas Theodore Buchler, Guido Marra, Matthew David Saltzman, Todd B Parrish, Amee L Seitz*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: To determine which normalization method may best account for confounding individual factors, such as age or BMI, when quantifying fat infiltration on MRI in patients with rotator cuff tears, the effects of normalization using three different muscles (teres major; triceps brachii; teres minor) were compared. Methods: Thirty-seven consecutive patients diagnosed with rotator cuff pathology were included. MRI fat–water sequences were used to quantify rotator cuff intramuscular fat (%fat). Three reference muscles (teres major, triceps, teres minor) were used to derive normalized %fat. Relationships between intramuscular %fat and tear size, age, and BMI in each rotator cuff muscle, before and after normalization, were compared with Fisher transformations (α = 0.05). Results: Normalization with teres major ameliorated confounding relationships of age and BMI on rotator cuff %fat. In contrast, normalization with triceps maintained the confounding relationships between %fat and age in supraspinatus (p = 0.03) and infraspinatus/teres minor (p = 0.028). Normalization with teres minor maintained the confounding relationship between %fat and BMI in subscapularis (p = 0.039). Normalization with teres major best-maintained relationships between tear size and infraspinatus/teres minor %fat (p = 0.021). In contrast, normalization with triceps or teres minor eliminated all significant relationships with tear size. Conclusions: Results of this pilot study suggest normalization to teres major using MRI-based %fat quantification methods can effectively control for individual factors, such as BMI or age, and may have utility in evaluating and monitoring rotator cuff fat infiltration attributed specifically to a tendon tear.

Original languageEnglish (US)
Pages (from-to)1111-1118
Number of pages8
JournalSkeletal Radiology
Volume48
Issue number7
DOIs
StatePublished - Jul 1 2019

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Rotator Cuff
Fats
Tears
Rotator Cuff Injuries
Muscles
Tendons

Keywords

  • Dixon fat–water separation
  • Fatty infiltration
  • Intramuscular degeneration
  • Supraspinatus

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{8b814ca44e6e40d29f2922056872c476,
title = "Optimizing methods to quantify intramuscular fat in rotator cuff tears with normalization",
abstract = "Objective: To determine which normalization method may best account for confounding individual factors, such as age or BMI, when quantifying fat infiltration on MRI in patients with rotator cuff tears, the effects of normalization using three different muscles (teres major; triceps brachii; teres minor) were compared. Methods: Thirty-seven consecutive patients diagnosed with rotator cuff pathology were included. MRI fat–water sequences were used to quantify rotator cuff intramuscular fat ({\%}fat). Three reference muscles (teres major, triceps, teres minor) were used to derive normalized {\%}fat. Relationships between intramuscular {\%}fat and tear size, age, and BMI in each rotator cuff muscle, before and after normalization, were compared with Fisher transformations (α = 0.05). Results: Normalization with teres major ameliorated confounding relationships of age and BMI on rotator cuff {\%}fat. In contrast, normalization with triceps maintained the confounding relationships between {\%}fat and age in supraspinatus (p = 0.03) and infraspinatus/teres minor (p = 0.028). Normalization with teres minor maintained the confounding relationship between {\%}fat and BMI in subscapularis (p = 0.039). Normalization with teres major best-maintained relationships between tear size and infraspinatus/teres minor {\%}fat (p = 0.021). In contrast, normalization with triceps or teres minor eliminated all significant relationships with tear size. Conclusions: Results of this pilot study suggest normalization to teres major using MRI-based {\%}fat quantification methods can effectively control for individual factors, such as BMI or age, and may have utility in evaluating and monitoring rotator cuff fat infiltration attributed specifically to a tendon tear.",
keywords = "Dixon fat–water separation, Fatty infiltration, Intramuscular degeneration, Supraspinatus",
author = "Micevych, {Paul S.} and Ankur Garg and Buchler, {Lucas Theodore} and Guido Marra and Saltzman, {Matthew David} and Parrish, {Todd B} and Seitz, {Amee L}",
year = "2019",
month = "7",
day = "1",
doi = "10.1007/s00256-018-3090-6",
language = "English (US)",
volume = "48",
pages = "1111--1118",
journal = "Skeletal Radiology",
issn = "0364-2348",
publisher = "Springer Verlag",
number = "7",

}

TY - JOUR

T1 - Optimizing methods to quantify intramuscular fat in rotator cuff tears with normalization

AU - Micevych, Paul S.

AU - Garg, Ankur

AU - Buchler, Lucas Theodore

AU - Marra, Guido

AU - Saltzman, Matthew David

AU - Parrish, Todd B

AU - Seitz, Amee L

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Objective: To determine which normalization method may best account for confounding individual factors, such as age or BMI, when quantifying fat infiltration on MRI in patients with rotator cuff tears, the effects of normalization using three different muscles (teres major; triceps brachii; teres minor) were compared. Methods: Thirty-seven consecutive patients diagnosed with rotator cuff pathology were included. MRI fat–water sequences were used to quantify rotator cuff intramuscular fat (%fat). Three reference muscles (teres major, triceps, teres minor) were used to derive normalized %fat. Relationships between intramuscular %fat and tear size, age, and BMI in each rotator cuff muscle, before and after normalization, were compared with Fisher transformations (α = 0.05). Results: Normalization with teres major ameliorated confounding relationships of age and BMI on rotator cuff %fat. In contrast, normalization with triceps maintained the confounding relationships between %fat and age in supraspinatus (p = 0.03) and infraspinatus/teres minor (p = 0.028). Normalization with teres minor maintained the confounding relationship between %fat and BMI in subscapularis (p = 0.039). Normalization with teres major best-maintained relationships between tear size and infraspinatus/teres minor %fat (p = 0.021). In contrast, normalization with triceps or teres minor eliminated all significant relationships with tear size. Conclusions: Results of this pilot study suggest normalization to teres major using MRI-based %fat quantification methods can effectively control for individual factors, such as BMI or age, and may have utility in evaluating and monitoring rotator cuff fat infiltration attributed specifically to a tendon tear.

AB - Objective: To determine which normalization method may best account for confounding individual factors, such as age or BMI, when quantifying fat infiltration on MRI in patients with rotator cuff tears, the effects of normalization using three different muscles (teres major; triceps brachii; teres minor) were compared. Methods: Thirty-seven consecutive patients diagnosed with rotator cuff pathology were included. MRI fat–water sequences were used to quantify rotator cuff intramuscular fat (%fat). Three reference muscles (teres major, triceps, teres minor) were used to derive normalized %fat. Relationships between intramuscular %fat and tear size, age, and BMI in each rotator cuff muscle, before and after normalization, were compared with Fisher transformations (α = 0.05). Results: Normalization with teres major ameliorated confounding relationships of age and BMI on rotator cuff %fat. In contrast, normalization with triceps maintained the confounding relationships between %fat and age in supraspinatus (p = 0.03) and infraspinatus/teres minor (p = 0.028). Normalization with teres minor maintained the confounding relationship between %fat and BMI in subscapularis (p = 0.039). Normalization with teres major best-maintained relationships between tear size and infraspinatus/teres minor %fat (p = 0.021). In contrast, normalization with triceps or teres minor eliminated all significant relationships with tear size. Conclusions: Results of this pilot study suggest normalization to teres major using MRI-based %fat quantification methods can effectively control for individual factors, such as BMI or age, and may have utility in evaluating and monitoring rotator cuff fat infiltration attributed specifically to a tendon tear.

KW - Dixon fat–water separation

KW - Fatty infiltration

KW - Intramuscular degeneration

KW - Supraspinatus

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U2 - 10.1007/s00256-018-3090-6

DO - 10.1007/s00256-018-3090-6

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JO - Skeletal Radiology

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SN - 0364-2348

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