European journal of radiology · 2026
Gaussian mixture modelling enables valid intramuscular fat quantification on T2- and intermediate-weighted shoulder MRI relative to two-point Dixon.
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Kim Brian, Wesselink Evert O, Gandomkar Ziba, McKay Marnee J, Seitz Amee L, Elliott James M, Ashok Kumar Anand, Cass Benjamin, Young Allan A, Linklater James M, Moopanar Terence R, Weber Kenneth A
Аннотация
OBJECTIVES: To evaluate the accuracy and reliability of automated Gaussian Mixture Modelling (GMM) and K-means clustering for intramuscular fat (IMF) quantification on T2-weighted (T2W) and intermediate-weighted (IW) shoulder MRI, using two-point Dixon as the reference standard.
MATERIALS & METHODS: This retrospective study collected MRI datasets of patients who underwent both two-point Dixon with T2W and/or IW shoulder MRI. GMM and K-means were applied to quantify IMF of the supraspinatus, subscapularis, infraspinatus, teres minor, and deltoid. Accuracy and reliability relative to Dixon were evaluated using Bland-Altman analysis and intraclass correlation coefficients (ICC2,1). Raw IMF values from GMM, K-means and Dixon were compared using repeated-measures ANOVA with post-hoc Dunnett's test (∝=0.05).
RESULTS: Eighty patients (mean age, 58 years ± 15 [standard deviation]; 41 males) were evaluated. On T2W MRI, GMM outperformed K-means with a maximum mean bias of -3.07% and excellent reliability for supraspinatus, subscapularis, infraspinatus and deltoid (ICC2,1 ≥ 0.90). K-means produced poor to moderate reliability. On IW MRI, GMM mean bias did not exceed -2.81% and showed excellent reliability for infraspinatus (ICC2,1 = 0.92) with good reliability for other muscles. K-means showed higher bias (-4.36%) and lower reliability (ICC2,1 ≤ 0.81) than GMM. GMM was the only model that did not significantly differ from Dixon IMF values on T2W (p ≥ 0.074) and IW (p ≥ 0.243) MRI.
CONCLUSION: IMF quantification using GMM thresholding achieves better agreement with Dixon IMF values than K-Means on T2W and IW MRI.
MATERIALS & METHODS: This retrospective study collected MRI datasets of patients who underwent both two-point Dixon with T2W and/or IW shoulder MRI. GMM and K-means were applied to quantify IMF of the supraspinatus, subscapularis, infraspinatus, teres minor, and deltoid. Accuracy and reliability relative to Dixon were evaluated using Bland-Altman analysis and intraclass correlation coefficients (ICC2,1). Raw IMF values from GMM, K-means and Dixon were compared using repeated-measures ANOVA with post-hoc Dunnett's test (∝=0.05).
RESULTS: Eighty patients (mean age, 58 years ± 15 [standard deviation]; 41 males) were evaluated. On T2W MRI, GMM outperformed K-means with a maximum mean bias of -3.07% and excellent reliability for supraspinatus, subscapularis, infraspinatus and deltoid (ICC2,1 ≥ 0.90). K-means produced poor to moderate reliability. On IW MRI, GMM mean bias did not exceed -2.81% and showed excellent reliability for infraspinatus (ICC2,1 = 0.92) with good reliability for other muscles. K-means showed higher bias (-4.36%) and lower reliability (ICC2,1 ≤ 0.81) than GMM. GMM was the only model that did not significantly differ from Dixon IMF values on T2W (p ≥ 0.074) and IW (p ≥ 0.243) MRI.
CONCLUSION: IMF quantification using GMM thresholding achieves better agreement with Dixon IMF values than K-Means on T2W and IW MRI.