A quantitative alternative to the Goutallier classification system using Lava Flex and Ideal MRI techniques: volumetric intramuscular fatty infiltration of the supraspinatus muscle, a cadaveric study

Jose H. Trevino, Krzysztof R Gorny, Angel Gomez-Cintron, Chunfeng Zhao, Hugo Giambini

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Objective: The Goutallier classification system is the most commonly used method for grading intramuscular fatty infiltration in rotator cuff tears. This grading system presents low inter-observer reliability and an inability to provide quantitative and repeatable outcomes for intramuscular fat. We determined the correlation and reliability of two methods, the Lava Flex and Ideal IQ MRI techniques, in quantifying volumetric intramuscular fat, while also comparing to the Goutallier method. Materials and methods: The supraspinatus muscles of seventeen cadaveric shoulders were scanned using the Lava Flex and Ideal IQ MRI imaging protocols. Histological analysis was performed on the same muscles. Agreement, reliability, and correlation analyses were performed to compare all outcomes. Results: The Lava Flex protocol took an average of ~ 4 min, while the Ideal IQ required about ~ 11 min to complete. Bland–Altman analysis showed good agreement between the Lava Flex and Ideal IQ [LOA (− 0.10 and 0.05)], and ICC analyses showed excellent reliability (ICC (1,1) 0.948; ICC (2,1) 0.947). There was a 91% correlation between the Lava Flex and Ideal IQ MR protocols. Weighted Kappa analysis between histology and the Goutallier classification showed fair-to-moderate agreement. Discussion: The Lava Flex technique, taking about 30% of the acquisition time, may prevent motion artifacts in outcomes associated with the longer Ideal IQ technique. However, potential magnetic field inhomogeneities should be considered. The Lava Flex technique may be a faster and valid alternative to the Goutallier classification system.

Original languageEnglish (US)
Pages (from-to)607-615
Number of pages9
JournalMagnetic Resonance Materials in Physics, Biology and Medicine
Volume32
Issue number6
DOIs
StatePublished - Dec 1 2019

Keywords

  • Fat infiltration
  • Goutallier classification
  • Magnetic resonance imaging
  • Muscle properties
  • Rotator cuff tear

ASJC Scopus subject areas

  • Biophysics
  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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