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Texture analysis of paraspinal musculature in MRI of the lumbar spine: analysis of the lumbar stenosis outcome study (LSOS) data

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Abstract

Objective

To evaluate association of fatty infiltration in paraspinal musculature with clinical outcomes in patients suffering from lumbar spinal stenosis (LSS) using qualitative and quantitative grading in magnetic resonance imaging (MRI).

Materials and methods

In this retrospective study, texture analysis (TA) was performed on postprocessed axial T2 weighted (w) MR images at level L3/4 using dedicated software (MaZda) in 62 patients with LSS. Associations in fatty infiltration between qualitative Goutallier and quantitative TA findings with two clinical outcome measures, Spinal stenosis measure (SSM) score and walking distance, at baseline and regarding change over time were assessed using machine learning algorithms and multiple logistic regression models.

Results

Quantitative assessment of fatty infiltration using the histogram TA feature “mean” showed higher interreader reliability (ICC 0.83–0.97) compared to the Goutallier staging (κ = 0.69–0.93). No correlation between Goutallier staging and clinical outcome measures was observed. Among 151 TA features, only TA feature “mean” of the spinotransverse group showed a significant but weak correlation with worsened SSM (p = 0.046). TA feature “S(3,3) entropy” showed a significant but weak association with worsened WD over 12 months (p = 0.046).

Conclusion

MR TA is a reproducible tool to quantitatively assess paraspinal fatty infiltration, but there is no clear association with the clinical outcome in asymptomatic LSS patients.

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Abbreviations

CSA:

cross-sectional surface area

FID:

free induction decay

GLCM:

gray level co-occurrence

ICC:

intraclass correlation coefficients

ROC:

receiver operating characteristic

TSE:

turbo spin echo

w:

weighted

AUC:

area under the curve

BMI:

body mass index

LSOS:

Lumbar Stenosis Outcome Study

LSS:

lumbar spinal stenosis

MRI:

magnetic resonance imaging

ROI:

regions of interest

SSM:

spinal stenosis measure

TA:

texture analysis

WD:

walking distance

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland

    Manoj Mannil, Arjun Thanabalasingam & Roman Guggenberger

  2. Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Pestalozzistrasse 24, 8032, Zurich, Switzerland

    Jakob M. Burgstaller & Ulrike Held

  3. Department of Neuroradiology, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland

    Sebastian Winklhofer

  4. Department of Orthopaedics, Balgrist University Hospital University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland

    Michael Betz

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  1. Manoj Mannil
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Correspondence to Roman Guggenberger.

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Mannil, M., Burgstaller, J.M., Thanabalasingam, A. et al. Texture analysis of paraspinal musculature in MRI of the lumbar spine: analysis of the lumbar stenosis outcome study (LSOS) data. Skeletal Radiol 47, 947–954 (2018). https://doi.org/10.1007/s00256-018-2919-3

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  • DOI: https://doi.org/10.1007/s00256-018-2919-3

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