Melissa T. Hooijmans1,2,3, Carly Lockard2, Crystal Coolbaugh1, Mark George1, Xingyu Zhou1,2,4, and Bruce Damon1,2,4
1Institute of Imaging Sciences, Vanderbilt University, Nashville, TN, United States, 2Carle Health, Stephens Family Clinical Research Institute, Urbana, IL, United States, 3Radiology and Nuclear Medicine, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam UMC, Amsterdam, Netherlands, 4Biomedical Engineering, Vanderbilt University, Nashville, TN, United States
Synopsis
Keywords: Muscle, Diffusion Tensor Imaging, Muscle architecture
In this study we explored if displacement
fields, derived from registration of high-resolution anatomical images in
different foot positions, could be used to transform muscle fiber architecture
from plantar-flexed to dorsi-flexed foot position (passive shortening). Our
data revealed that muscle fiber architecture from one foot position can be transformed
in the other foot position and that the original and transformed fibers
demonstrate similar architectural characteristics, i.e. fiber lengths,
pennation angle, curvature, and physiological cross-sectional area.
Introduction
Skeletal muscle architecture is a key
determinant of muscle function and can be non-invasively characterized using
Diffusion Tensor Imaging (DTI) (1-2). DTI, in combination with other quantitative
MRI techniques, can characterize architectural changes in healthy muscle due to
training and in diseased muscle (3-8). However, there are open questions about
how these architectural changes directly impact muscle function. To answer
these questions, DTI data would ideally be acquired during a muscle contraction;
but this is not feasible due to long scan times required for whole-muscle DTI (9-10).
Therefore, the aim of this study was to explore if displacement fields, derived
from registration of high-resolution anatomical images in different foot
positions, could be used to transform muscle fiber architecture from an
extended to a flexed position. For this purpose, we first optimized
the registration parameters of the anatomical images; thereafter used
interpolation to transform fibers to a dorsi-flexed foot position; and finally,
compared the architectural features of the original fibers and of the
transformed fibers.Methods
MR datasets were acquired in the right lower leg
of seven healthy subjects (5 men; Age: 25.1±2.7yrs. Range: 23-31yrs.) on a 3T
MR system (Elition, Philips, Best, The Netherlands) using a 16-channel surface
coil and 8-channel table top coils. Image acquisition included a 3D high
resolution Dixon scans (3D; 6 echoes; TR/TE/ΔTE 6.7/1.01/0.96ms; FOV
192x192x308; slice thickness 3.5mm) and a DTI sequence (SE-EPI; 24 directions;
b=450mm2/s; TR/TE 5300/53ms; NSA 4; voxel size 2x2x7; fat
suppression using SPAIR, slice selective gradient reversal and olefinic signal
saturation (11)). Subjects were positioned supine with a fully extended knee
and their right foot fixed in +20° plantarflexion position for one
scan and -10° dorsiflexion position for the second scan.Data-analysis
All data-analysis was
performed in Matlab using the MuscleDTI_Toolbox (12) and additional
custom-written scripts. Diffusion data were registered and denoised
using an anisotropic smoothing method (13),
after which the tensor was calculated. Masks of the Tibialis Anterior (TA) boundaries
and aponeurosis were manually drawn in ITK-snap (14) on the high resolution Dixon water image for the two foot
positions. The aponeurosis masks were converted to a seedpoint mesh (size: 30x20).
Fiber tracking was initiated from the aponeurosis mesh and propagated using fourth-order
Runge-Kutta integration. For the original fibers, in the -10° foot position,
the transformed mesh (+20° plantarflexion position) was used to start fiber
tracking to ensure direct comparison between datasets. The two high resolution
anatomical scans were 3D registered using MATLAB’s imregdemons function with 2000 iterations, 4 pyramid levels, AccumulatedFieldSmoothing
of 1.0. A variety of registration inputs have been explored including, various contrasts
(2), slice thickness (3) and masking options (2). The quality of the
registration options was assessed by calculating the Dice Similarity
Coefficient (DSC), Hausdorff distance
(Hd) and Euclidean distance (Ed) for the aponeurosis mesh, muscle mask and
aponeurosis mask. The registration strategy with the best result was determined
with ordinal grading and used to transform (by interpolation) the mesh and
fibers from +20° plantarflexion to the -10° degree position. Paired t-tests
were used to evaluate the difference in architectural parameters (pennation
angle, fiber lengths, fiber curvature and Physiological Cross-sectional Area
(PCSA)) between the original and transformed fibers in the deep compartment,
superficial compartment, and full TA muscle. Results
The DSC, Hd and Ed for the muscle mask,
aponeurosis mask and aponeurosis mesh using the different registration
approaches are shown in Figure 2. Overall, the out-of-phase (TE=NN ms) images with a slice thickness of 3.5mm
resulted in the lowest ordinal scale and were selected to transform the fibers.
A representative dataset is shown in Figure 3. No differences were detected
between the original and transformed fibers for pennation angle and curvature in
the deep compartment, superficial compartment and full TA muscle (Figure 4-5). Fascicle
lengths of the transformed fibers were significantly shorter (p=0.03) in
comparison to the original fibers for the deep compartment of the TA muscle but
not for the superficial compartment or full TA muscle (Figure 4). No
differences were detected in PCSA between the original and transformed fibers
in the full TA muscle.Discussion and conclusion
We showed that 1) muscle fiber tracts from a
plantarflexed position can be transformed to the dorsiflexed position using
registration of high resolution anatomical images and 2) the original and
transformed fibers demonstrate similar architectural characteristics, i.e.
fiber tract lengths, pennation angle, curvature, and PCSA. These architectural
characteristics are also in the same range as values previously reported in the
TA muscle (15-16). Besides non-invasively reflecting anatomy, fiber
architecture assessed with DTI is also used to predict function. Specifically, PCSA (17) is considered a key predictor. Not
finding changes in PCSA between the transformed and original fibers is
therefore very relevant with respect to predictive modelling. How well fibers
can be transformed depends highly on the quality of the registration.
Consequently, innovations in registration strategies or approaches could
improve the outcomes further. In conclusion, this approach to transform muscle
architecture is very promising, and our next step will be to evaluate if muscle
architecture can be reconstructed in a contracted state using a similar
approach.Acknowledgements
This work is supported by a grant from the National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases, R01 AR073831References
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