Journal of Manipulative and Physiological Therapeutics
Original ArticleReliability of the Goutallier Classification in Quantifying Muscle Fatty Degeneration in the Lumbar Multifidus Using Magnetic Resonance Imaging
Section snippets
Selection of Subject Images
After approval from the Logan University Institutional Review Board, a sample of lumbar spine MRI scans was obtained retrospectively through the department of radiology picture archiving and communication system. The picture archiving and communication system data set consists of images obtained at both hospitals and imaging centers. In an effort to homogenize the sample, MRI examinations were only included if they were performed using a 1.5T GE system (GE Healthcare, Milwaukee, WI) and were
Results
The scan subject mean age was 55.84 years (range, 27-82). The mean GCS grade was 1.90 (standard deviation, 0.966; min, 0 and max, 4). Of the 400 assigned GCS grades, there were 34 grade 0, 82 grade 1, 198 grade 2, 62 grade 3, and 24 grade 4. Intra and interobserver reliability statistics in assigning a GCS grade are displayed in Table 1, Table 2. Table 3 summarizes the correlation data between respective GCS grades and LM percent fat. Interobserver reliability in quantifying LM percent fat
Discussion
To the best of the author’s knowledge, this is the first work to study the reliability of this grading system in grading LM fatty degeneration.
The primary aim of this study was to determine the intra and interobserver reliability of the GCS to grading LM fatty degeneration using MRI scans. In support of our hypothesis, the data indicated that there was substantial to almost perfect intra and interobserver reliability when assigning a GCS grade. Our secondary aim was to correlate the GCS grade
Limitations
The sample is small, and a larger study might influence the results in either direction. As MRI scans were obtained from multiple imaging centers, they inherently have different pixel intensity profiles. In an effort to mitigate this, only MRI scans obtained using a GE 1.5T scanner were included. However, individual MR imaging system scanner and acquisition parameters may influence the quantitative measures. Multiple 1.5T GE scanners were used to generate the patient images in this study.
Conclusion
The data from this study show substantial to almost perfect reliability of the GCS for grading fatty degeneration of the LM. The establishment of a reliable and convenient scale of grading LM fatty degeneration using MRI will facilitate future clinical research evaluating the relationship between LM fatty degeneration and the segmental instability of LBP along with its response to therapeutic effects of stabilization interventions.
Funding Sources and Potential Conflicts of Interest
No funding sources or conflicts of interest were reported for this study.
Contributorship Information
Concept development (provided idea for the research): PB, YM, AW, BH, and NK.
Design (planned the methods to generate the results): PB, YM, AW, BH, and NK.
Supervision (provided oversight, responsible for organization and implementation, and writing of the manuscript): PB, YM, AW, BH, and NK.
Data collection/processing (responsible for experiments, patient management, organization, or reporting data): PB, YM, AW, BH, and NK.
Analysis/interpretation (responsible for statistical analysis, evaluation,
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