Reproducibility of manual segmentation in muscle imaging

Shaun Ivan Muzic 1*, Matteo Paoletti 2*, Francesca Solazzo 1, Eugenio Belatti 1, Raimondo Vitale 1, Niels Bergsland 3,4, Stefano Bastianello 1,2 Anna Pichiecchio 1,2

1 University of Pavia, Pavia, Italy; 2 Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy; 3 Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; 4 Don Carlo Gnocchi ONLUS Foundation IRCCS, Milan, Italy. *These authors have contributed equally to the study

DOI 10.36185/2532-1900-052

Purpose. To assess the reproducibility of a manual muscle MRI segmentation method that follows a specific set of recommendations developed in our center.

Materials and methods. Nine healthy volunteers underwent a muscle MRI examination that included a TSE T2 sequence of the thighs. Muscle segmentation was performed by three operators: an expert operator (OP1) with 3 years of experience and two radiology residents (OP2 and 3) who were both given basic segmentation instructions, whereas only OP2 underwent additional supervised training from OP1. Intra- and inter-operator Dice similarity coefficient (DSC) was calculated.

Results. OP1 showed the highest average intra-operator DSC values (0.885), whereas OP2 had higher average DSC (0.856) compared to OP3 (0.818). The highest inter-operator agreement was observed between Operators 1 and 2 (0.814) and the lowest between OP2 and OP3 (0.702). Confidence interval (CI) analysis showed that the most experienced operator also had the least variability in drawing the ROIs, whereas OP2 showed both higher intra-operator reproducibility compared to OP3 and higher inter-operator agreement with OP1. The muscles that showed the least reproducibility were the semimembranosus and the short head of the biceps femoris.

Discussion. Following specific recommendations such as these ones derived from our single-center experience leads to an overall high reproducibility of manual muscle segmentation and is helpful in improving both intra-operator and inter-operator reproducibility in less experienced operators.

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