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Low muscle density in children with osteogenesis imperfecta using opportunistic low-dose chest CT: a case-control
Yi Yuan1, Yun-Feng Xu2, Chao Feng2
1Department of Radiology, Beijing Jishuitan Hospital, Capital Medical University, National Center for Orthopaedics, No. 31, Xinjiekou East Street, Beijing, 100035, China.
Insights
Children with osteogenesis imperfecta (OI) exhibit reduced trunk muscle density, suggesting impaired muscle quality. The Gaussian mixture model is more effective for muscle segmentation in children than fixed thresholds.
Area of Science:
- Medical imaging
- Pediatric radiology
- Musculoskeletal imaging
Background:
- Osteogenesis imperfecta (OI) is a genetic disorder characterized by brittle bones.
- Muscle involvement in OI is not well understood.
- Low-dose chest CT scans offer an opportunity to assess muscle characteristics.
Purpose of the Study:
- To investigate muscle differences in children with osteogenesis imperfecta (OI).
- To compare muscle segmentation methods using CT imaging.
- To assess trunk muscle size and density in pediatric OI patients.
Main Methods:
- Retrospective analysis of low-dose chest CT scans from children with OI and controls.
- Measurement of trunk muscle cross-sectional area and Hounsfield Units (HU) at T4 and T10 levels.
- Comparison of fixed threshold and Gaussian mixture model for muscle segmentation, using Bland-Altman analysis.
Main Results:
- Children with OI showed significantly lower trunk muscle density compared to controls.
- The Gaussian mixture model revealed lower muscle size and density in OI patients at T4 and T10 levels.
- Both segmentation methods showed good agreement, but fixed thresholds may be less suitable for pediatric muscle analysis.
Conclusions:
- Osteogenesis imperfecta may negatively impact muscle quality, indicated by reduced muscle density.
- The Gaussian mixture model is a potentially more reliable method for assessing muscle characteristics in pediatric CT imaging.
- Further research is needed to understand the full extent of muscle involvement in OI.
Background:
The aim of the study was to investigate the muscle differences in children with osteogenesis imperfecta (OI) using opportunistic low-dose chest CT and to compare different methods for the segmentation of muscle in children.
Methods:
This single center retrospective study enrolled children with OI and controls undergoing opportunistic low-dose chest CT obtained during the COVID pandemic. From the CT images, muscle size (cross-sectional area) and density (mean Hounsfield Units [HU]) of the trunk muscles were measured at the mid-T4 and the mid-T10 level using two methods, the fixed thresholds and the Gaussian mixture model. The Bland-Altman method was also used to compute the strength of agreement between two methods. Comparison of muscle results between OI and controls were analyzed with Student t tests.
Results:
20 children with OI (mean age, 9.1 ± 3.3 years, 15 males) and 40 age- and sex-matched controls were enrolled. Mean differences between two methods were good. Children with OI had lower T4 and T10 muscle density than controls measured by the fixed thresholds (41.2 HU vs. 48.0 HU, p < 0.01; 37.3 HU vs. 45.9 HU, p < 0.01). However, children with OI had lower T4 muscle size, T4 muscle density, T10 muscle size and T10 muscle density than controls measured by the Gaussian mixture model (110.9 vs. 127.2 cm2, p = 0.03; 44.6 HU vs. 51.3 HU, p < 0.01; 72.6 vs. 88.0 cm2, p = 0.01; 41.6 HU vs. 50.3 HU, p < 0.01, respectively).
Conclusions:
Children with OI had lower trunk muscle density indicating that OI might also impair muscle quality. Moreover, the fixed thresholds may not be suitable for segmentation of muscle in children.
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