A New Method for Measuring Temporal Muscle Thickness: Reliability and Agreement Study.

Study Overview
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Brief Summary
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The aim of this study is to propose a new measurement point for temporal muscle thickness (TMT) that can be similarly localized in computerized tomography (CT) /magnetic resonance imaging (MRI) and ultrasonography (USG), and to evaluate the reliability and consistency of these measurements.

Detailed Description
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Recently, temporal muscle thickness (TMT) has been proposed as a new marker of whole-body muscle function. In addition, TMT has been shown to be a useful parameter for estimating skeletal muscle mass. Measurement of temporal muscle mass with CT and MRI has been studied in the literature in recent years. All stroke patients undergo cranial CT or MRI examinations at the time of admission. However, the literature indicates that USG can also be used to measure temporal muscle thickness. The recommended measurement points for CT, MRI, or USG in the studies performed to date depend on the particular imaging modality, and it does not seem possible to use them interchangeably. The aim of this study is to propose a new TMT measurement point that can be localized in a similar way in CT /MRI and USG, and to evaluate the reliability and agreement of these measurements.

Official Title
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A New Method for Measuring Temporal Muscle Thickness: Reliability and Agreement Study.

Conditions
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Sarcopenia, Stroke

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Referral to the radiology department for an MRI or CT scan Exclusion Criteria: Medically unstable condition (presence or high risk of impaired consciousness, respiration, or circulation). Vulnerable populations (patients with a terminal illness, people living in nursing homes, unemployed or poor people, people in need of urgent medical care, children, people unable to consent, etc.).

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with cranial MRI<br>Axial sections of 5 mm and 1 mm thickness will be imaged. The thickness of the temporal muscle will be measured from the posterior angle, where the temporal fossa loses its cavity. After the MRI measurements are completed, the thickness of the muscle will be measured by ultrasound at the same location by two clinicians (a radiologist and a physiatrist) who are expertise in musculoskeletal ultrasonography. | |
| Patients with cranial CT<br>Axial sections of 5 mm and 1 mm thickness will be imaged. The thickness of the temporal muscle will be measured from the posterior angle, where the temporal fossa loses its cavity. After the MRI measurements are completed, the thickness of the muscle will be measured by ultrasound at the same location by two clinicians (a radiologist and a physiatrist) who are expertise in musculoskeletal ultrasonography. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intra-rater reliability of ultrasonographic TMT measurement. | The intraclass correlation coefficient (ICC) of the two measurements performed by the physiatrist will be calculated using the Two-way mixed effects, absolute agreement, single rater/measurement model. | Baseline | 
| Inter-rater reliability of ultrasonographic TMT measurement. | Intraclass correlation coefficients of TMT measurements performed by the radiologist and physiatrist will be calculated using the Two-way random effects, absolute agreement, multiple raters/measurements ICC (2,k) model. | Baseline | 
| Inter-rater reliability of TMT measurements of MRI | Intraclass correlation coefficients of TMT measurements performed by the radiologist and physiatrist will be calculated using the Two-way random effects, absolute agreement, single rater/measurement ICC (2.1) model. | Baseline | 
| Agreement of ultrasonographic TMT measurement with MRI and CT measurements. | The intraclass correlation coefficient of the measurements will be calculated using the two-way random effects, absolute agreement, multiple raters/measurements ICC (2,k) model. In addition, the agreement of the measurements will be evaluated using the Bland-Altman method. Furthermore, the Technical Error of Measurement (TEM) will be calculated. | Baseline |