Neurogenic and Myogenic Diseases: Quantitative Texture Analysis of Muscle US Data for Differentiation

Abstract

Purpose To assess the multiple texture features of skeletal muscles in neurogenic and myogenic diseases by using ultrasonography (US). Materials and Methods After institutional review board approval, muscle US studies of the medial head of the gastrocnemius were performed prospectively in patients with neurogenic diseases (n = 25 [18 men]; mean age, 66.0 years ± 12.3 [standard deviation]), in patients with myogenic diseases (n = 21 [12 men]; mean age, 68.3 years ± 11.5), and in healthy control subjects (n = 21 [11 men]; mean age, 70.5 years ± 8.4) between January 2013 and May 2016. Written informed consent was obtained. Muscle texture parameters were obtained, and five algorithms were used to classify the groups. Results The neurogenic and myogenic disease groups showed higher echo intensities than the control subjects. The histogram-derived texture parameters had overlaps between the neurogenic and myogenic groups and thus had a low discrimination rate. With assessment of more classes of texture parameters, three groups were correctly classified (100% correct, according to four of five classification algorithms). Tenfold cross validation showed 93.5%-95.7% correct classification between the neurogenic and myogenic groups. The run-length matrix, autoregressive model, and co-occurrence matrix were particularly useful in distinguishing the neurogenic and myogenic groups. Conclusion Texture analysis of muscle US data can enable differentiation between neurogenic and myogenic diseases and is useful in noninvasively assessing underlying disease mechanisms. RSNA, 2017 Online supplemental material is available for this article.

Age‐dependent texture features in skeletal muscle ultrasonography

“…(5) The AR model assumes a local interaction between image pixels in that pixel intensity is a weighted sum of neighboring pixel intensities. (6) The discrete wavelet transform is a linear transformation that operates on a data vector whose length is an integer power of two, transforming it into a numerically different vector of the same length. It separates data into different frequency components and studies each component with resolution matched to its scale.…”

“…Given the recent advent of radiomics that utilizes quantitative imaging features including texture features in oncology and related fields (5,13), there would be little doubt that this methodology of quantitative imaging analysis can be applicable to neuromuscular ultrasound. Indeed, there have been several studies to assess the texture characteristics of skeletal muscles ( 6,12,14,8,(15)(16)(17). Among these, texture analysis of muscle ultrasound was reported to be useful in identifying the underlying etiology (i.e., myogenic vs. neurogenic in nature) (6) and in being potentially utilized as a disease biomarker, such as in amyotrophic lateral sclerosis (17).…”

“…Indeed, there have been several studies to assess the texture characteristics of skeletal muscles ( 6,12,14,8,(15)(16)(17). Among these, texture analysis of muscle ultrasound was reported to be useful in identifying the underlying etiology (i.e., myogenic vs. neurogenic in nature) (6) and in being potentially utilized as a disease biomarker, such as in amyotrophic lateral sclerosis (17). However, before reliably using muscle texture features in any clinical settings, these should be carefully assessed in the confounding factors, such as gender and aging.…”

“…Texture analysis of skeletal muscle ultrasound has potential clinical implications in neuromusclar diseases. For instance, Sogawa and colleagues recently reported that texture analysis of muscle ultrasound can distinguish patients with myogenic and neurogenic diseases, thus texture analysis could be a useful technique to assess underlying muscle pathology (6). Nevertheless, detailed information in muscle texture features is yet fully available and clinical application of texture analysis should be based on careful evaluation of texture parameters, including potential agedependency.…”

Repeatability of ultrasound in assessment of distal biceps brachii tendon

“…In addition to comparisons with MRI, repeatability studies of the dBB should be performed in populations where the sonographic appearance of structures may be reduced, such as in older adults [21] as well as muscle disease populations. [22] The contact between the ultrasound probe and the skin also creates the possibility of added pressure displacing the internal structures, however extreme care was taken to ensure this did not occur during resting or contracted measures. But, one limitation of MRI that can be overcome with ultrasound is the ease and flexibility in acquiring the tendon during muscular contractions where the architecture does not remain static but changes in longitudinal as well as lateral planes.…”