Multi-parametric MRI evaluation of skeletal muscle alterations using FF, T1H2O, and T2H2O in healthy and pathological subjects

Motivation: Fat fraction (FF), water T2 (T2H2O) and water T1 (T1H2O) are used to evaluate muscle tissues. It remains unclear whether their combination may provide further insight into muscle tissue characterization. Goal(s): We investigated the relationship between these variables and explored how their combination identifies muscle clusters differentiating various conditions. Approach: We analyzed five muscles groups in healthy and diseased subjects from which we extracted 15 features and performed k-means clustering. Results: Six muscle clusters were identified: muscles from healthy controls were classified in 2 clusters, while the remaining were found only in patients. The correlation between T1H2O and T2H2O differed between muscle clusters. Impact: FF, T1H2O and T2H2O are sensitive biomarkers for detecting muscle alterations. Their combination allows categorizing muscles into clusters which may reflect different underlying pathological processes. This approach holds promise for improving patient phenotyping and enhancing diagnostic precision in neuromuscular diseases.