Developing a three-dimensional convolutional neural network for automated full-volume multi-tissue segmentation of the shoulder with comparisons to Goutallier classification and partial volume muscle quality analysis.

Journal: Journal of shoulder and elbow surgery
Published Date: Feb 5, 2025

Abstract

BACKGROUND: Preoperative intramuscular fat (IMF) is a strong predictor of tendon failure after a rotator cuff repair. Due to the contemporary labor intensive and time-dependent manual segmentation required for quantitative assessment of IMF, clinical implementation remains a challenge. The emergence of accurate three-dimensional evaluation of the rotator cuff may permit implementation with greater inter-rater reliability than common subjective scales (eg, Goutallier classification (GC)). Here, we developed and validated a convolutional neural network (CNN) model for auto-segmentation of the shoulder on Dixon magnetic resonance imaging. Also, we aimed to assess the agreement among GC, two-dimensional (2D), and 3D IMF, including their discriminatory ability for the identification of muscles above an IMF threshold shown to negatively impact surgical outcomes (ie, GC ≥ 3).

Authors

  • Brian Kim
    The Kolling Institute, The University of Sydney, Faculty of Medicine and Health & The Northern Sydney Local Health District, St Leonards, NSW, Australia; School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. Electronic address: brian.kim@sydney.edu.au.
  • Ziba Gandomkar
    Image Optimisation and Perception, Discipline of Medical Imaging and Radiation Sciences, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia. Electronic address: ziba.gandomkar@sydney.edu.au.
  • Marnee J McKay
    School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
  • Amee L Seitz
    Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Evert O Wesselink
    Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Benjamin Cass
    Sydney Shoulder Research Institute, Sydney, NSW, Australia.
  • Allan A Young
    Sydney Shoulder Research Institute, Sydney, NSW, Australia.
  • James M Linklater
    Castlereagh Imaging, Sydney, NSW, Australia.
  • Jeremy Szajer
    Castlereagh Imaging, Sydney, NSW, Australia.
  • Kushalappa Subbiah
    Sydney Shoulder Research Institute, Sydney, NSW, Australia.
  • James M Elliott
    Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
  • Kenneth A Weber
    Department of Radiology, Stanford University School of Medicine, Stanford, California, USA.

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