Reports using computed tomography (CT) to estimate thigh skeletal muscle cross-sectional area and mean muscle attenuation are often difficult to evaluate due to inconsistent methods of quantification and/or poorly described analysis methods. This CT tutorial provides step-by-step instructions in using free, NIH Image J software to quantify both muscle size and composition in the mid-thigh, which was validated against a robust commercially available software, SliceOmatic. CT scans of the mid-thigh were analyzed from 101 healthy individuals aged 65 and older. Mean cross-sectional area and mean attenuation values are presented across seven defined Hounsfield unit (HU) ranges along with the percent contribution of each region to the total mid-thigh area. Inter-software correlation coefficients ranged from R2 = 0.92–0.99 for all specific area comparisons measured using the Image J method compared to SliceOmatic. We recommend reporting individual HU ranges for all areas measured. Although HU range 0–100 includes the majority of skeletal muscle area, HU range -29 to 150 appears to be the most inclusive for quantifying total thigh muscle. Reporting all HU ranges is necessary to determine the relative contribution of each, as they may be differentially affected by age, obesity, disease, and exercise. This standardized operating procedure will facilitate consistency among investigators reporting computed tomography characteristics of the thigh on single slice images.
Trial Registration: ClinicalTrials.gov NCT02308228.
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This work was supported by the University of Kentucky Gill Imaging Center and University of Kentucky CTSA (UL1TR001998). The original research was funded by the National Institutes of Health, National Institute on Aging AG046920, to Charlotte Peterson, PhD, Philip Kern, M.D., and Marcas Bamman, PhD. The SliceOmatic software was purchased by VA Rehabilitation Merit Review Award # RX0012030 (RAD).
S1 Table. Step-by-step methods for utilizing Image J to assess cross-sectional area and mean attenuation of the thigh. https://doi.org/10.1371/journal.pone.0211629.s001 (DOCX)
S2 Table. Generation of a macro to run semi-automated analysis of body composition. https://doi.org/10.1371/journal.pone.0211629.s002 (DOCX)
S1 File. CT Image. https://doi.org/10.1371/journal.pone.0211629.s003 (DCM)
S2 File. CT analysis of S1 file. https://doi.org/10.1371/journal.pone.0211629.s004 (XLSX)
S3 File. NIH Image J dataset. https://doi.org/10.1371/journal.pone.0211629.s005 (CSV)
Long, Douglas E.; Villasante Tezanos, Alejandro G.; Wise, James N.; Kern, Philip A.; Bamman, Marcas M.; Peterson, Charlotte A.; and Dennis, Richard A., "A Guide for Using NIH Image J for Single Slice Cross-Sectional Area and Composition Analysis of the Thigh from Computed Tomography" (2019). Center for Muscle Biology Faculty Publications. 12.
S1 Table. Step-by-step methods for utilizing Image J to assess cross-sectional area and mean attenuation of the thigh.
journal.pone.0211629.s002.docx (110 kB)
S2 Table. Generation of a macro to run semi-automated analysis of body composition.
journal.pone.0211629.s003.dcm (515 kB)
S1 File. CT Image.
journal.pone.0211629.s004.xlsx (15 kB)
S2 File. CT analysis of S1 file.
journal.pone.0211629.s005.csv (26 kB)
S3 File. NIH Image J dataset.