Correlation Analysis of Quantitative MRI Measurements of Thigh Muscles with Histopathology in Patients with Idiopathic Inflammatory Myopathy

Overview

Journal Eur Radiol Exp

Date 2023 Aug 17

PMID 37589922

Authors

Fengdan Wang

Shiyuan Fang

Jia Li

Ling Yuan

Bo Hou

Jinxia Zhu

Yang Jiao

Zhi Liu

Min Qian

Francesco Santini

Qian Wang

Lin Chen

Feng Feng

Affiliations

Soon will be listed here.

Abstract

Objectives: To validate the correlation between histopathological findings and quantitative magnetic resonance imaging (qMRI) fat fraction (FF) and water T2 mapping in patients with idiopathic inflammatory myopathy (IIM).

Methods: The study included 13 patients with histopathologically confirmed IIM who underwent dedicated thigh qMRI scanning within 1 month before open muscle biopsy. For the biopsied muscles, FF derived from the iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation (IDEAL-IQ) and T2 time from T2 mapping with chemical shift selective fat saturation were measured using a machine learning software. Individual histochemical and immunohistochemical slides were evaluated using a 5-point Likert score. Inter-reader agreement and the correlation between qMRI markers and histopathological scores were analyzed.

Results: Readers showed good to perfect agreement in qMRI measurements and most histopathological scores. FF of the biopsied muscles was positively correlated with the amount of fat in histopathological slides (p = 0.031). Prolonged T2 time was associated with the degree of variation in myofiber size, inflammatory cell infiltration, and amount of connective tissues (p ≤ 0.008 for all).

Conclusions: Using the machine learning-based muscle segmentation method, a positive correlation was confirmed between qMRI biomarkers and histopathological findings of patients with IIM. This finding provides a basis for using qMRI as a non-invasive tool in the diagnostic workflow of IIM.

Relevance Statement: By using ML-based muscle segmentation, a correlation between qMRI biomarkers and histopathology was found in patients with IIM: qMRI is a potential non-invasive tool in this clinical setting.

Key Points: • Quantitative magnetic resonance imaging measurements using machine learning-based muscle segmentation have good consistency and reproductivity. • Fat fraction of idiopathic inflammatory myopathy (IIM) correlated with the amount of fat at histopathology. • Prolonged T2 time was associated with muscle inflammation in IIM.

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References

Ran J, Ji S, Morelli J, Wu G, Li X . T2 mapping in dermatomyositis/polymyositis and correlation with clinical parameters. Clin Radiol. 2018; 73(12):1057.e13-1057.e18. DOI: 10.1016/j.crad.2018.07.106. View

May D, Disler D, Jones E, Balkissoon A, Manaster B . Abnormal signal intensity in skeletal muscle at MR imaging: patterns, pearls, and pitfalls. Radiographics. 2000; 20 Spec No:S295-315. DOI: 10.1148/radiographics.20.suppl_1.g00oc18s295. View

Naarding K, Reyngoudt H, van Zwet E, Hooijmans M, Tian C, Rybalsky I . MRI vastus lateralis fat fraction predicts loss of ambulation in Duchenne muscular dystrophy. Neurology. 2020; 94(13):e1386-e1394. PMC: 7274919. DOI: 10.1212/WNL.0000000000008939. View

Smith A, Parrish T, Abbott R, Hoggarth M, Mendoza K, Chen Y . Muscle-fat MRI: 1.5 Tesla and 3.0 Tesla versus histology. Muscle Nerve. 2014; 50(2):170-6. PMC: 6778690. DOI: 10.1002/mus.24255. View

Prisco F, Papparella S, Paciello O . The correlation between cardiac and skeletal muscle pathology in animal models of idiopathic inflammatory myopathies. Acta Myol. 2021; 39(4):313-319. PMC: 7783441. DOI: 10.36185/2532-1900-035. View

Zhang L, Ding J, Wang Y, Zhang W, Deng X, Chen J . MRI quantitative study and pathologic analysis of crush injury in rabbit hind limb muscles. J Surg Res. 2010; 167(2):e357-63. DOI: 10.1016/j.jss.2010.09.014. View

Yao L, Gai N . Fat-corrected T2 measurement as a marker of active muscle disease in inflammatory myopathy. AJR Am J Roentgenol. 2012; 198(5):W475-81. DOI: 10.2214/AJR.11.7113. View

Findlay A, Goyal N, Mozaffar T . An overview of polymyositis and dermatomyositis. Muscle Nerve. 2015; 51(5):638-56. DOI: 10.1002/mus.24566. View

Kim H, Serai S, Lindquist D, Merrow A, Horn P, Kim D . Quantitative Skeletal Muscle MRI: Part 2, MR Spectroscopy and T2 Relaxation Time Mapping-Comparison Between Boys With Duchenne Muscular Dystrophy and Healthy Boys. AJR Am J Roentgenol. 2015; 205(2):W216-23. DOI: 10.2214/AJR.14.13755. View

10.

Schweitzer M, Fort J . Cost-effectiveness of MR imaging in evaluating polymyositis. AJR Am J Roentgenol. 1995; 165(6):1469-71. DOI: 10.2214/ajr.165.6.7484589. View

11.

Wang F, Zhou S, Hou B, Santini F, Yuan L, Guo Y . Assessment of idiopathic inflammatory myopathy using a deep learning method for muscle T2 mapping segmentation. Eur Radiol. 2022; 33(4):2350-2357. PMC: 9672653. DOI: 10.1007/s00330-022-09254-9. View

12.

Hernando D, Sharma S, Ghasabeh M, Alvis B, Arora S, Hamilton G . Multisite, multivendor validation of the accuracy and reproducibility of proton-density fat-fraction quantification at 1.5T and 3T using a fat-water phantom. Magn Reson Med. 2016; 77(4):1516-1524. PMC: 4835219. DOI: 10.1002/mrm.26228. View

13.

Guttsches A, Rehmann R, Schreiner A, Rohm M, Forsting J, Froeling M . Quantitative Muscle-MRI Correlates with Histopathology in Skeletal Muscle Biopsies. J Neuromuscul Dis. 2021; 8(4):669-678. DOI: 10.3233/JND-210641. View

14.

Meyer A, Scire C, Talarico R, Alexander T, Amoura Z, Avcin T . Idiopathic inflammatory myopathies: state of the art on clinical practice guidelines [corrected]. RMD Open. 2019; 4(Suppl 1):e000784. PMC: 6397434. DOI: 10.1136/rmdopen-2018-000784. View

15.

Tomasova Studynkova J, Charvat F, Jarosova K, Vencovsky J . The role of MRI in the assessment of polymyositis and dermatomyositis. Rheumatology (Oxford). 2007; 46(7):1174-9. DOI: 10.1093/rheumatology/kem088. View

16.

Lundberg I, Tjarnlund A, Bottai M, Werth V, Pilkington C, de Visser M . 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Ann Rheum Dis. 2017; 76(12):1955-1964. PMC: 5736307. DOI: 10.1136/annrheumdis-2017-211468. View

17.

Wang F, Zhang H, Wu C, Wang Q, Hou B, Sun Y . Quantitative T2 mapping accelerated by GRAPPATINI for evaluation of muscles in patients with myositis. Br J Radiol. 2019; 92(1102):20190109. PMC: 6774592. DOI: 10.1259/bjr.20190109. View

18.

Gaeta M, Scribano E, Mileto A, Mazziotti S, Rodolico C, Toscano A . Muscle fat fraction in neuromuscular disorders: dual-echo dual-flip-angle spoiled gradient-recalled MR imaging technique for quantification--a feasibility study. Radiology. 2011; 259(2):487-94. DOI: 10.1148/radiol.10101108. View

19.

Maillard S, Jones R, Owens C, Pilkington C, Woo P, Wedderburn L . Quantitative assessment of MRI T2 relaxation time of thigh muscles in juvenile dermatomyositis. Rheumatology (Oxford). 2004; 43(5):603-8. DOI: 10.1093/rheumatology/keh130. View

20.

Huber A, Lamy J, Bravetti M, Bouazizi K, Bacoyannis T, Roux C . Comparison of MR T1 and T2 mapping parameters to characterize myocardial and skeletal muscle involvement in systemic idiopathic inflammatory myopathy (IIM). Eur Radiol. 2019; 29(10):5139-5147. DOI: 10.1007/s00330-019-06054-6. View