基于深度学习的腹部CT肌肉分割与量化：应用于成人肌肉减少症评估的纵向筛查队列

Deep learning-based muscle segmentation and quantification at abdominal CT: application to a longitudinal adult screening cohort for sarcopenia assessment.

作者信息

Graffy Peter M, Liu Jiamin, Pickhardt Perry J, Burns Joseph E, Yao Jianhua, Summers Ronald M

机构信息

1 University of Wisconsin School of Medicine and Public Health 600 Highland Avenue, Madison, WI 53705.

2 Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Drive, Bethesda, MD 20892-1182.

出版信息

Br J Radiol. 2019 Aug;92(1100):20190327. doi: 10.1259/bjr.20190327. Epub 2019 Jun 24.

DOI:10.1259/bjr.20190327

PMID:31199670

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6724622/

Abstract

OBJECTIVE

To investigate a fully automated abdominal CT-based muscle tool in a large adult screening population.

METHODS

A fully automated validated muscle segmentation algorithm was applied to 9310 non-contrast CT scans, including a primary screening cohort of 8037 consecutive asymptomatic adults (mean age, 57.1±7.8 years; 3555M/4482F). Sequential follow-up scans were available in a subset of 1171 individuals (mean interval, 5.1 years). Muscle tissue cross-sectional area and attenuation (Hounsfield unit, HU) at the L3 level were assessed, including change over time.

RESULTS

Mean values were significantly higher in males for both muscle area (190.6±33.6 133.3±24.1 cm, <0.001) and density (34.3±11.1 HU 27.3±11.7 HU, <0.001). Age-related losses were observed, with mean muscle area reduction of -1.5 cm/year and attenuation reduction of -1.5 HU/year. Overall age-related muscle density (attenuation) loss was steeper than for muscle area for both sexes up to the age of 70 years. Between ages 50 and 70, relative muscle attenuation decreased significantly more in females (-30.6% -18.0%, <0.001), whereas relative rates of muscle area loss were similar (-8%). Between ages 70 and 90, males lost more density (-22.4% -7.5%) and area (-13.4% -6.9%, <0.001). Of the 1171 patients with longitudinal follow-up, 1013 (86.5%) showed a decrease in muscle attenuation, 739 (63.1%) showed a decrease in area, and 1119 (95.6%) showed a decrease in at least one of these measures.

CONCLUSION

This fully automated CT muscle tool allows for both individualized and population-based assessment. Such data could be automatically derived at abdominal CT regardless of study indication, allowing for opportunistic sarcopenia detection.

ADVANCES IN KNOWLEDGE

This fully automated tool can be applied to routine abdominal CT scans for prospective or retrospective opportunistic sarcopenia assessment, regardless of the original clinical indication. Mean values were significantly higher in males for both muscle area and muscle density. Overall age-related muscle density (attenuation) loss was steeper than for muscle area for both sexes, and therefore may be a more valuable predictor of adverse outcomes.

摘要

目的

在大量成年筛查人群中研究一种基于腹部CT的全自动肌肉分析工具。

方法

将一种经过验证的全自动肌肉分割算法应用于9310例非增强CT扫描，其中包括一个由8037名连续无症状成年人组成的初筛队列（平均年龄57.1±7.8岁；男性3555例/女性4482例）。1171名个体的子集有连续的随访扫描（平均间隔5.1年）。评估了L3水平的肌肉组织横截面积和衰减值（亨氏单位，HU），包括随时间的变化。

结果

男性的肌肉面积（190.6±33.6对133.3±24.1cm，P<0.001）和密度（34.3±11.1HU对27.3±11.7HU，P<0.001）的平均值均显著更高。观察到与年龄相关的肌肉量减少，平均肌肉面积每年减少-1.5cm²，衰减值每年减少-1.5HU。在70岁之前，总体上与年龄相关的肌肉密度（衰减）损失比肌肉面积损失更陡峭。在50至70岁之间，女性的相对肌肉衰减值下降更为显著（-30.6%对-18.0%，P<0.001），而肌肉面积损失的相对速率相似（-8%）。在70至90岁之间，男性的密度（-22.4%对-7.5%）和面积（-13.4%对-6.9%，P<0.001）损失更多。在1171例接受纵向随访的患者中，1013例（86.5%）肌肉衰减值下降，739例（63.1%）面积下降，1119例（95.6%）至少其中一项指标下降。