THU0122 Quantitative assessment and analysis of hand muscle volume
Authors: A Friedberger, C Figueiredo, O Museyko, A Grimm, I D'Oliveira, T Bäuerle, J Rech, O Chaudry, M Uder, G Schett, K Engelke
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by bone, cartilage and muscle loss. While bone and cartilage damage have been extensively studied in the past, the effects of RA on volume and composition of hand muscles have not yet been studied. This situation is surprising, since visible hand muscle atrophy is a hallmark of RA and quantification of muscle composition is of growing interest. <h3>Objectives</h3> Quantitative assessment of hand muscle volume and fat using MRI. <h3>Methods</h3> A random forest based method was used to segment hand muscle in T1 weighted MR scans of 76 RA patients (37 males, 26–87 years, mean 61 years). The segmentation procedure is fully automated but allows for manual corrections of wrongly segmented areas. Multimodal registration of the muscle segmentation masks to MR Dixon Fat Fraction images was used for fat quantification. Outcome parameters were absolute hand and muscle volume (V<sup>abs</sup><sub>H</sub> resp. V<sup>abs</sup><sub>M</sub>), relative muscle volume V<sup>rel</sup><sub>M</sub> = V<sup>abs</sup><sub>M</sub>/V<sup>abs</sup><sub>H</sub> and absolute and relative fat content (V<sup>abs</sup><sub>F</sub> resp. V<sup>rel</sup><sub>F</sub>). Student9s t-tests were performed for gender discrimination. Linear regression was used to model age dependency. Further a multivariate regression was used to model dependence on predictors BMI, RA disease duration, DMARD treatment duration, HAQ, DAS28, RF, ESR and CRP after age adjustment. Dixon sequences were not available for all patients, therefore fat analysis could only be done in 17 females. <h3>Results</h3> V<sup>abs</sup><sub>M</sub> in males was significantly higher than in females (p&lt;0.001, means: 63 cm<sup>3</sup> vs. 29 cm<sup>3</sup>). Similar results were observed for V<sup>abs</sup><sub>H</sub> (p&lt;0.001, means: 243 cm<sup>3</sup> vs. 163 cm<sup>3</sup>) and V<sup>rel</sup><sub>M</sub> (p=0.02, means: 0.256 vs. 0.239). The table shows the results of the linear regression analysis for significant predictors of males and females, respectively. The figure shows age dependence of V<sup>abs</sup><sub>M</sub> and V<sup>abs</sup><sub>H</sub>. V<sup>abs</sup><sub>F</sub> and V<sup>rel</sup><sub>F</sub> showed no dependence on age or disease duration. V<sup>abs</sup><sub>F</sub> but not V<sup>rel</sup><sub>F</sub> was highly correlated with V<sup>abs</sup><sub>M</sub> and V<sup>abs</sup><sub>H</sub> (both: p&lt;0.001, R<sup>2</sup>=0.75). V<sup>rel</sup><sub>F</sub> was positively correlated with BMI (p=0.03, R<sup>2</sup>=0.32), a weaker but not significant effect was observed for V<sup>abs</sup><sub>F</sub>. <h3>Conclusions</h3> Results for muscle volume were highly sex specific. Males showed higher V<sup>abs</sup><sub>M</sub>, V<sup>abs</sup><sub>H</sub> and V<sup>rel</sup><sub>M</sub>. Nevertheless V<sup>abs</sup><sub>M</sub> and V<sup>abs</sup><sub>H</sub> in males showed significant decrease with age while the opposite but weaker effects were observed in females. Relative fat volume depends on BMI but is independent of muscle volume. <h3>Disclosure of Interest</h3> None declared