Evidence map›Paper›PMID 39060637›Full record

ArticleEuropean radiology experimental2024

Development of an initial training and evaluation programme for manual lower limb muscle MRI segmentation.

Jasper M Morrow, Sachit Shah, Lara Cristiano, Matthew R B Evans, Carolynne M Doherty, Talal Alnaemi, Abeer Saab, Ahmed Emira, Uros Klickovic, Ahmed Hammam and 6 more

Abstract read
In one paragraph

Article in European radiology experimental, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. The MR quality landscape in Europe.Insights into imaging · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Jasper M MorrowDepartment of Neuromuscular Diseases, Queen Square UCL Institute of Neurology, London, UK.ORCID http://orcid.org/0000-0001-6879-8539
Sachit ShahLysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, UCLH, London, UK.
Lara CristianoNeuroradiological Academic Unit, Queen Square UCL Institute of Neurology, London, UK.
Matthew R B EvansDepartment of Neuromuscular Diseases, Queen Square UCL Institute of Neurology, London, UK.
Carolynne M DohertyDepartment of Neuromuscular Diseases, Queen Square UCL Institute of Neurology, London, UK.
Talal AlnaemiNeuroradiological Academic Unit, Queen Square UCL Institute of Neurology, London, UK.
Abeer SaabNeuroradiological Academic Unit, Queen Square UCL Institute of Neurology, London, UK.
Ahmed EmiraNeuroradiological Academic Unit, Queen Square UCL Institute of Neurology, London, UK.
Uros KlickovicDepartment of Neuromuscular Diseases, Queen Square UCL Institute of Neurology, London, UK.
Ahmed HammamNeuroradiological Academic Unit, Queen Square UCL Institute of Neurology, London, UK.
Afnan AltuwaijriNeuroradiological Academic Unit, Queen Square UCL Institute of Neurology, London, UK.
Stephen WastlingLysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, UCLH, London, UK.
Mary M ReillyDepartment of Neuromuscular Diseases, Queen Square UCL Institute of Neurology, London, UK.
Michael G HannaDepartment of Neuromuscular Diseases, Queen Square UCL Institute of Neurology, London, UK.
Tarek A YousryLysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, UCLH, London, UK. t.yousry@ucl.ac.uk.
John S ThorntonLysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, UCLH, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMagnetic resonance imaging (MRI) quantification of intramuscular fat accumulation is a responsive biomarker in neuromuscular diseases. Despite emergence of automated methods, manual muscle segmentation remains an essential foundation. We aimed to develop a training programme for new observers to demonstrate competence in lower limb muscle segmentation and establish reliability benchmarks for future human observers and machine learning segmentation packages.

methodsThe learning phase of the training programme comprised a training manual, direct instruction, and eight lower limb MRI scans with reference standard large and small regions of interest (ROIs). The assessment phase used test-retest scans from two patients and two healthy controls. Interscan and interobserver reliability metrics were calculated to identify underperforming outliers and to determine competency benchmarks.

resultsThree experienced observers undertook the assessment phase, whilst eight new observers completed the full training programme. Two of the new observers were identified as underperforming outliers, relating to variation in size or consistency of segmentations; six had interscan and interobserver reliability equivalent to those of experienced observers. The calculated benchmark for the Sørensen-Dice similarity coefficient between observers was greater than 0.87 and 0.92 for individual thigh and calf muscles, respectively. Interscan and interobserver reliability were significantly higher for large than small ROIs (all p < 0.001).

conclusionsWe developed, implemented, and analysed the first formal training programme for manual lower limb muscle segmentation. Large ROI showed superior reliability to small ROI for fat fraction assessment. RELEVANCE STATEMENT: Observers competent in lower limb muscle segmentation are critical to application of quantitative muscle MRI biomarkers in neuromuscular diseases. This study has established competency benchmarks for future human observers or automated segmentation methods. KEY POINTS: • Observers competent in muscle segmentation are critical for quantitative muscle MRI biomarkers. • A training programme for muscle segmentation was undertaken by eight new observers. • We established competency benchmarks for future human observers or automated segmentation methods.

Indexed as

Lower ExtremityMagnetic Resonance ImagingMuscle, SkeletalAdultFemaleHumansMaleMiddle AgedObserver VariationReproducibility of ResultsBenchmarkingMagnetic resonance imagingMuscle (skeletal)Neuromuscular diseasesThigh

Identifiers

PMID39060637
PMCPMC11282017

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.