Quantitative muscle ultrasound assessment using automatic thresholding methods in amyotrophic lateral sclerosis

Area of Science:

• Neurology
• Medical Imaging
• Biomarkers

Background:

• Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease.
• Accurate assessment of muscle changes is crucial for ALS diagnosis and monitoring.
• Quantitative muscle echogenicity analysis using ultrasound shows promise.

Purpose of the Study:

• To evaluate the effectiveness of automatic thresholding methods for assessing muscle echogenicity in ALS patients.
• To compare automatic thresholding with traditional grayscale analysis.
• To investigate correlations between ultrasound parameters and muscle strength.

Main Methods:

• Ultrasound examination of biceps brachii, rectus femoris, and tibialis anterior muscles in 31 ALS patients and 31 controls.
• Muscle echogenicity assessment using grayscale analysis and 16 ImageJ automatic thresholding methods.
• Analysis of diagnostic value and correlation with muscle strength.

Main Results:

• Significant differences in muscle echogenicity (grayscale values and hyperechoic fractions) between ALS patients and controls were found using 8 automatic thresholding methods.
• Four methods (Default, Li, Moments, Otsu) showed strong correlations between hyperechoic fractions and muscle strength, with diagnostic accuracy comparable or superior to grayscale values.
• The Otsu method identified ultrasound changes even in ALS patients with normal muscle strength.

Conclusions:

• Automatic thresholding methods are useful supplementary tools for muscle echogenicity analysis in ALS research.
• These methods provide quantitative data that complements traditional ultrasound assessments.
• The findings support the integration of these techniques into clinical research for ALS.