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Keywords:

  • magnetic resonance imaging (MRI);
  • water-fat imaging;
  • subcutaneous adipose tissue (SAT);
  • intermuscular adipose tissue (IMAT);
  • fat quantification;
  • multi-parametric clustering

Abstract

Purpose:

To introduce and validate an automated unsupervised multi-parametric method for segmentation of the subcutaneous fat and muscle regions to determine subcutaneous adipose tissue (SAT) and intermuscular adipose tissue (IMAT) areas based on data from a quantitative chemical shift-based water-fat separation approach.

Materials and Methods:

Unsupervised standard k-means clustering was used to define sets of similar features (k = 2) within the whole multi-modal image after the water-fat separation. The automated image processing chain was composed of three primary stages: tissue, muscle, and bone region segmentation. The algorithm was applied on calf and thigh datasets to compute SAT and IMAT areas and was compared with a manual segmentation.

Results:

The IMAT area using the automatic segmentation had excellent agreement with the IMAT area using the manual segmentation for all the cases in the thigh (R2: 0.96) and for cases with up to moderate IMAT area in the calf (R2: 0.92). The group with the highest grade of muscle fat infiltration in the calf had the highest error in the inner SAT contour calculation.

Conclusion:

The proposed multi-parametric segmentation approach combined with quantitative water-fat imaging provides an accurate and reliable method for an automated calculation of the SAT and IMAT areas reducing considerably the total postprocessing time. J. Magn. Reson. Imaging 2013;37:917–927. © 2012 Wiley Periodicals, Inc.