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Journal of Sports Sciences


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The validity of estimating triceps brachii volume


from single MRI cross-sectional area before and after
resistance training
a b c a
Jelena Popadic Gacesa , Natasa R. Dragnic , Natasa M. Prvulovic , Otto F. Barak &
a
Nikola Grujic
a
Department of Physiology, Medical School , University of Novi Sad , Novi Sad, Serbia
b
Centre for Informatics and Biostatistics in Medicine , Institute for Public Health of
Vojvodina , Novi Sad, Serbia
c
Centre for Imaging Diagnostics , Institute for Oncology Sremska Kamenica , Novi Sad,
Serbia
Published online: 03 Mar 2011.

To cite this article: Jelena Popadic Gacesa , Natasa R. Dragnic , Natasa M. Prvulovic , Otto F. Barak & Nikola Grujic (2011)
The validity of estimating triceps brachii volume from single MRI cross-sectional area before and after resistance training,
Journal of Sports Sciences, 29:6, 635-641, DOI: 10.1080/02640414.2010.549498

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Journal of Sports Sciences, March 15th 2011; 29(6): 635–641

The validity of estimating triceps brachii volume from single MRI


cross-sectional area before and after resistance training

JELENA POPADIC GACESA1, NATASA R. DRAGNIC2, NATASA M. PRVULOVIC3,


OTTO F. BARAK1, & NIKOLA GRUJIC1
1
Department of Physiology, Medical School, University of Novi Sad, Novi Sad, Serbia, 2Centre for Informatics and
Biostatistics in Medicine, Institute for Public Health of Vojvodina, Novi Sad, Serbia and 3Centre for Imaging Diagnostics,
Downloaded by [Queensland University of Technology] at 20:33 06 November 2014

Institute for Oncology Sremska Kamenica, Novi Sad, Serbia

(Accepted 16 December 2010)

Abstract
The aim of this study was to determine whether triceps brachii muscle volume can be adequately estimated from a single
anatomical cross-sectional area (ACSA) and can the same model be used for prediction after training. Thirty-five healthy
male non-athletes (age 21.6 + 2.5 years, body mass index 24.8 + 3.5 kg  m72) volunteered for this study. The volumes of
the upper arm extensors were calculated from magnetic resonance imaging (MRI) sequence scans and regression models
were developed, which were used to predict muscle volumes from single MRI cross-sectional scans taken at different points
along the humerus length. The same procedure was repeated after 12 weeks of maximal resistance training of the elbow
extensors. Correlation coefficients were calculated for Model A with CSAmax, humerus length (HL), and body mass index
(r ¼ 0.919), a model with CSA50% and HL (r ¼ 0.922), and a model with CSA60% and HL (r ¼ 0.920) (P 5 0.001). The
standard error of estimate for Model A, Model CSA50%, and Model CSA60% was 8.0%, 7.7%, and 7.8% respectively.
The same prediction formula can be used for the left arm (r ¼ 0.904). If a single ACSA is used for triceps brachii volume
prediction, the best fit is with Model CSA60% and HL, both before and after training (r ¼ 0.941). By introducing humerus
length into the calculation, we simplify the procedure for volume measurement, since it can be obtained during MRI
scanning.

Keywords: Anatomical cross-sectional area, triceps brachii, muscle volume, magnetic resonance imaging

Beneke et al. (1991) compared MRI-skeletal muscle


Introduction
areas from two images to cadaver-skeletal muscle
Measurement of muscle volume is required for the and reported a mean error of 1.2%.
in vivo calculation of physiological cross-sectional However, MRI cannot always be performed and
area (PCSA; Fukunaga et al., 1992), or for muscle a number of alternatives have been used including
strength and power prediction (Abe, DeHoyos, anthropometry, ultrasound, and bioimpedance.
Pollock, & Garzarella, 2000; Chilibeck, Calder, Sale, Where imaging techniques have been used, the
& Webber, 1998; Kraemer et al., 2004). Contiguous simplest measure of muscle size is a single, trans-
transverse magnetic resonance imaging (MRI) scans verse, cross-sectional scan at right angles to the
are considered the ‘‘gold standard’’ for calculating longitudinal axis of the muscle, giving the so-called
muscle volume and has been validated with cadaveric ‘‘anatomical cross-sectional area’’ (ACSA).
muscle (Beneke, Neuerburg, & Bohndorf, 1991; Although ACSA of a muscle group shows a
Mitsiopoulos et al., 1998). Findings of Mitsiopoulos significant positive correlation with muscle strength
et al. (1998) strongly support the use of MRI and and torque production and muscle volume in a
computerized tomography (CT) as reference meth- relatively homogenous population (Fukunaga et al.,
ods for appendicular skeletal muscle measurement 2001; Miyatani, Kanehisa, Masuo, Ito, & Fukunaga,
in vivo (MRI: r ¼ 0.99, standard error of measure- 2001), it may be inadequate as a surrogate for
ment [SEE] ¼ 3.9 cm2 (10%), P 5 0.001; CT: muscle size in a population where muscle length
r ¼ 0.99, SEE ¼ 3.8 cm2 (9.5%), P 5 0.001), and varies markedly (e.g. between adults and children),

Correspondence: J. Popadic Gacesa, Department of Physiology, Medical School, University of Novi Sad, 3 Hajduk-Veljko St., 21000 Novi Sad, Serbia.
E-mail: jpopadic@uns.ac.rs
ISSN 0264-0414 print/ISSN 1466-447X online Ó 2011 Taylor & Francis
DOI: 10.1080/02640414.2010.549498
636 J. Popadic Gacesa et al.

where the shape of the individual muscles may vary, and the investigation was performed according to
or if the muscle is changing in size throughout time, the principles outlined in the Declaration of
so that tapering of the muscle causes the ACSA to Helsinki.
over- or underestimate muscle volume.
The reliable measurement of human muscle size is
Experimental study design
essential in determining to what extent changes in
muscle volume contribute to changes in muscle The volumes of the upper arm extensors and flexors
function during training, ageing, growth or disease. were calculated from MRI sequence scans and
Since most investigators use single cross-sectional regression models were developed to predict muscle
area (CSA) of a muscle to predict its changes in size/ volumes from single MRI cross-sectional scans taken
volume during training programmes (Abe et al., at different points along the humerus length. The
2000; Bamman, Newcomer, Larson-Meyer, Wein- same procedure was repeated after the resistance
sier, & Hunter, 2000; Hakkinen et al., 2003; training of the elbow extensors.
Kraemer et al., 2004; West et al., 2010; Widrick,
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Stelzer, Shoepe, & Garner, 2002), we wished to


MRI measurements
create the best prediction equation for calculating
upper arm muscle volume on the basis of a A series of cross-sectional images of the upper arm
single CSA in young non-athletes, and to determine were obtained by MRI scans with an extremity coil
whether the same prediction can be used before and on a Magnetom Avanto TIM Siemens, 1.5 T
after a training protocol for a specific muscle group. (Siemens, Erlangen, Germany). lulti-slice se-
Previous studies used different sites in the arm or quences of T1-weighted, flash (gradient echo) axial
leg for CSA measurements. None of them, to our images of both arms were obtained, starting from the
knowledge, investigated differences between volume head of the humerus to the medial epicondyle.
prediction based on multiple CSA measurements Repetition time (TR) and echo time (TE) were
and volume prediction using various single CSA 232 ms and 4.76 ms respectively. The field of view
measures. In addition, the influence of muscle was 162 6 288 mm, and the matrix size was
volume change as a result of training (when 288 6 512. Slice thickness was 10 mm with an
hypertrophy may occur), and the significance of inter-slice interval of 3 mm. Data processing was
other anthropometric parameters on the accuracy conducted using the MIPAV software, version 2.6
of these predictions, have not yet been assessed or (Medical Image Processing, Analysis and Visualiza-
reported. Therefore, the aims of the present study tion, Center for Information Technology, National
were as follows: (1) to compare volume prediction Institutes of Health, Bethesda, MD). The MIPAV
based on a single CSA value and volume measure- software was used to analyse images on a personal
ment calculation based on multiple CSA measures computer workstation (McAuliffe et al., 2001). This
along the length of the triceps brachii muscle; (2) to program calculates the surface area (in mm2) of the
determine which CSA is the best predictor of triceps manually selected region of interest. Briefly, for each
brachii muscle volume; and (3) to evaluate if the axial image, the CSA of the triceps brachii was
prediction of muscle volume with a single CSA is manually outlined as a region of interest from the first
sufficient in the case of volume changes with time section closest to the superior border of the humerus
(during training), or if other parameters have to be to a point where the muscle group is no longer reliably
included. distinguishable. The same number of sections distal
from the humerus was measured for each participant
before and after the training protocol to ensure within-
Methods participant measurement replication. All sequences
were analysed by the same person (J.P.G.). The
Participants
investigator was blinded to participant identification,
Thirty-five healthy young men (age 21.6 + 2.5 date of scan, and training status, for both baseline and
years, body mass index 24.8 + 3.5 kg  m72), who post-training analyses. The intra-class correlation
had not taken part in any formal resistance exercise coefficient for repeated measurements was 0.99.
regime in the 6 months before the study, volun- Cronbach’s alpha (a) for repeated measures on the
teered for the study. The participants did not same participant was 0.98.
engage in any other physical activity during the Multiplying each CSA value of the region of
experimental period. All participants were given an interest with the 10-mm slice thickness and then
oral and written explanation of the study before summing these individual volumes using the trun-
signing a consent form. The study received cated cone formula provided the final muscle volume
approval from the Ethics Committee of the (Vm). A control MRI was conducted 3–5 days after
Medical School of the University of Novi Sad, the final training session.
Prediction of triceps brachii volume from single CSA 637

In addition, the humerus length was measured


Results
using localizers, and it was defined as the length from
the upper border of the head of the humerus to the Values of participants’ elbow extensor muscle
end of the medial epicondyle, and three additional volumes and maximal CSA, as well as CSA at
slices were scanned: at 30%, 50%, and 60% of the 30%, 50%, and 60% of humerus length for both
humerus length. arms are presented in Table I. Humerus length was
used to predict and calculate muscle length. Hu-
merus length for the right arm was 34.8 + 1.5 cm,
Training protocol
and for the left arm 34.3 + 1.0 cm. No significant
Dynamic self-perceived maximal resistance training, differences were observed in the muscle volumes of
in which each participant was encouraged to perform the left and right arm (dominant and non-dominant
maximally according to personal perception, was arm) (P 4 0.05). The distribution of each slice cross-
undertaken for 12 weeks, with a frequency of five sectional area (CSA) in a sequence for muscle
sessions per week. Each training session included five volume calculation before and after training of the
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sets of 10 maximal contractions (elbow extensions of elbow extensors is presented in Figure 1.


both arms) after 15 min of a general warm-up. A When assessing the relative change in individual
1-min rest period was allowed between sets. The ACSA throughout the length of a muscle as a result
participants adopted the sitting bench press position. of strength training, the highest increase is registered
Training sessions were performed on an isoaccelera- in the second third of the muscle length. The relative
tion dynamometer Concept 2 Dyno (Concept 2, increase of some ACSA is strongly correlated with
Inc., Morrisville, VT). Values of maximal strength the relative increase in volume.
for each repetition (maximal contraction) were Correlations between whole muscle volumes and
recorded and shown on the display of the dynam- a single slice at 30%, 50%, and 60% of the humerus
ometer. length (CSA30%, CSA50%, CSA60%) and maximal
muscle CSA (CSAmax) are presented in Table II.
Statistical analysis
Estimation of triceps brachii muscle volume from a
All data are presented as means + standard deviation
single CSA
(s) unless otherwise indicated. The differences in
muscle volumes and CSA between left and right Using Pearson correlation, muscle volume showed a
arm, and in change in volume between left and right significant correlation with different CSA, but not
arm, were assessed using Wilcoxon’s test. The with body mass index (BMI) or humerus length
correlation between muscle volumes and CSA was (HL) alone. All variables of interest (regardless of
assessed using Pearson’s correlation coefficient. For their statistical significance alone) – HL, BMI, and
checking the assumptions of linear regression, we the relevant CSAx – were included in the multiple
conducted a residual analysis (outliers control, linear regression analysis with muscle volume as the
independence, normality assumption) as well as an dependent variable. Using stepwise selection, we
assessment of collinearity. All assumptions were met. observed a significant association between muscle
Selection of the independent variables in the volume and some CSA, HL, and BMI. The
different multiple regression models was made based following predictors were extracted: HL, BMI,
on the stepwise method. Adjusted R2, F-statistics, and CSAmax for Model A (for x ¼ max); HL and
standard error of estimate (SEE), and relative CSA50% for Model CSA50% (for x ¼ 50%); and
standard error of estimate (RSE) were used in the HL and CSA60% for Model CSA60% (x ¼ 60%).
interpretation of the results of the regression model. Model CSAmax was obtained using independent
Statistical significance was indicated if P 5 0.05. All variables HL and CSAmax (similar to Models
calculations were performed using SPSS, version CSA50% and CSA60%). This approach allowed us
10.0 (SPSS, Inc., Chicago, IL). to calculate muscle volume on the basis of different

Table I. Elbow extensors muscle volume and some CSA values for both arms before and after the training protocol.

Measured volume (cm3) CSAmax (cm2) CSA30% (cm2) CSA50% (cm2) CS60% (cm2)

Left Before 462.4 + 98.8 29.1 + 5.6 16.7 + 6.1 27.9 + 6.1 25.4 + 5.9
Left After 511.3 + 77.0 30.6 + 4.6 13.9 + 4.1 29.0 + 4.3 29.5 + 5.0
Right Before 474.7 + 91.9 29.8 + 5.4 16.1 + 5.0 28.5 + 5.6 25.9 + 6.2
Right After 525.3 + 73.7 31.1 + 4.5 14.9 + 3.2 30.2 + 4.7 29.2 + 5.0
638 J. Popadic Gacesa et al.

non-dependent variables, as shown in the following correlation between triceps brachii muscle volume
prediction equation: and the predicted value based on the regression
models before and after training. The correlation
V ¼ a þ b  HL þ c  BMI þ d  CSAx coefficients (r) before and after the training were:
where x ¼ 50%, 60% or max (x ¼ max for Model A; Model A, r ¼ 0.919 before and 0.941 after; Model
c ¼ 0 for Models CSA50%, CSA60%, and CSAmax). CSAmax, r ¼ 0.903 before and 0.911 after; Model
Unstandardized regression coefficients for all CSA50%, r ¼ 0.922 before and 0.882 after; and
models and their significance (P) are presented in Model CSA60%, r ¼ 0.920 before and 0.896 after
Table III. All independent variables in the models (P 5 0.001). This indicates that the pre-training
contributed significantly to the prediction of muscle prediction formula is adequate for the prediction
volume (P 5 0.05). The coefficient of determination of volume after muscle morphological adaptation
(adjusted R2) was in the range 0.80–0.84, and all following the training protocol. Prediction based on
models were statistically significant (F-statistics the model with slice CSA30% was not confirmed,
P 5 0.001), as presented in Table III. because only 20.5% of the variance in the triceps
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All models were tested before and after the brachii volume was explained with this model.
training protocol. There was a highly significant We also tested the same pre-training formula on
the prediction of left arm triceps brachii volume,
and found a strong correlation for pre- (r ¼ 0.904,
P 5 0.001) and post-training values (r ¼ 0.875,
P 5 0.001).
The standard error of estimate for Model A was
37.9 cm3 (RSE ¼ 8.0%), Model CSA60% 37.2 cm3
(RSE ¼ 7.8%), Model CSAmax 40.6 cm3 (RSE ¼
8.55%), and Model CSA50% 36.5 cm3 (RSE ¼
7.7%). The standard error of estimate for prediction
based on a single CSA not including BMI or HL was
44.9 cm3 (RSE ¼ 9.4%), 40.1 cm3 (RSE ¼ 8.4%),
and 39.5 cm3 (RSE ¼ 8.3%) for CSAmax, CSA60%,
and CSA50% respectively.
When we calculated volume change based on the
prediction models and compared it with multi-slice
volume changes, the best prediction results were
Figure 1. Anatomical cross-sectional area (ACSA) of the triceps obtained with Model CSA60%. Mean volume change
brachii muscles measured along the length of the humerus. Values
on the x-axis denote the scan number from the head of the
from before to after training based on multi-slice
humerus to the medial epicondyle. Each dot represents the calculation was þ37.9 cm3 (7.8%, s ¼ 3.95%, SEE
mean + s of all participants. All values are presented in cm2. 0.9%), while that with the Model CSA60% formula

Table II. Correlations (r) between extensors muscle volume and some CSA values for both arms before and after the training protocol.

Measured volume CSAmax (cm2) CSA30% (cm2) CSA50% (cm2) CS60% (cm2)

Vleft Before 0.86** 0.51** 0.85** 0.89**


After 0.85** 0.56** 0.78** 0.86**
Vright Before 0.88** 0.41* 0.91** 0.90**
After 0.92** 0.54* 0.87** 0.89**

*P 5 0.05; **P 5 0.01.

Table III. Values of unstandardized coefficients a, b, c, d, significance (P) of the coefficients, adjusted R2, and F-statistics are presented for
different regression models.

Model a b c d adjusted R2 F

A 7435.536 (0.007) 10.323 (0.023) 4.638 (0.021) 14.661 (0.000) 0.830** 58.087**
CSAmax 7420.164 (0.013) 12.963 (0.007) 0 14.929 (0.000) 0.805** 73.250**
CSA50% 314.523 (0.035) 10.502 (0.014) 0 14.889 (0.000) 0.842** 94.203**
CSA60% 7236.97 (0.110) 10.533 (0.015) 0 13.367 (0.000) 0.836** 90.321**

**P 5 0.001.
Prediction of triceps brachii volume from single CSA 639

was þ34.5 cm3 (7.0%). Using the Model A formula and time-consuming. Most investigators use single
gave a value of þ28.6 cm3 (6.3%). Volume change anatomical CSA to predict muscle volume and its
after training predicted with the Model CSA50% change over time (Abe et al., 2000; Bamman et al.,
formula was þ14.0 cm3 (3.3%), while that with the 2000; Hakkinen et al., 2003; Kraemer et al., 2004;
Model CSAmax formula was þ29.2 cm3 (6.4%). Losnegard et al., 2010; O’Hagan, Sale, MacDougall,
Prediction of triceps muscle volume before and after & Garner, 1995; West et al., 2010; Widrick et al.,
the training is presented in Figure 2. 2002). There is no consensus regarding the position
of a slice used for a single muscle volume prediction
based on a CSA measure, and therefore there is no
Discussion
unique protocol for individual muscles.
In the present study, we tried to develop a new Here, we have provided a detailed MRI sequen-
equation for prediction of triceps brachii volume cing for both upper arms in young non-athletes and
based on a single CSA value. Muscle volume values compared values of measured and calculated triceps
are one of the most important measures when brachii volume with predicted values, using several
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investigating muscle change after a programme of prediction equations and testing their precision and
physical activity, or during disease or with ageing. validity. Four single anatomical CSA values have
This parameter can provide valuable information on been used for predictions – at 30%, 50%, and 60% of
the efficiency of an intervention. Measuring muscle humerus length, and a maximal CSA. Our aim was
volume with imaging techniques is both expensive to establish the best prediction equation and we have
discovered that this equation includes not only the
CSA values, but that it also depends on the humerus
length and BMI. These findings are very interesting,
since no correlation between muscle volume and
body weight or height alone has been reported. Most
investigators emphasize the problem of standardizing
prediction formulae since there are inter-individual
variations in any population, and few of them
reported prediction models. A regression model
based on five MRI scans has been used to estimate
total thigh muscle volume (Tothill & Stewart, 2002).
Morse and colleagues obtained a regression model
for the cross-sectional area of each of the four
muscles of the quadriceps, as a function of muscle
length, based on data from 18 individuals (Morse,
Degens, & Jones, 2007).
Together with humerus length, our regression
model introduces one more antropometric measure –
BMI, as a measure of body size. In this way, we added
a new predictor in muscle volume calculations.
We also tried to obtain information on the
possibility of using a single anatomical CSA, instead
of three or four. We tested a few prediction models
and discovered the best fit is when CSA50% or
CSA60% is introduced into the equation. Other
investigators have reported different protocols. Some
of them used CSAmax for the prediction (Bamman
et al., 2000; Roman et al., 1993; West et al., 2010),
others the average of all ACSA in a sequence
(Losnegard et al., 2010), or some percentage
measured throughout the muscle or bone length to
calculate muscle volumes (Chilibeck et al., 1998;
Kraemer et al., 2004). Since different muscle groups
Figure 2. Correlation based on prediction of elbow extensors were investigated, and different measurement pro-
muscle volume models: (a) triceps brachii volume before training – cedures applied, literature does not provide consis-
right arm: measured and estimated volume using pre-training
formula; (b) triceps brachii volume after training– right arm:
tent findings.
measured and estimated volume using pre-training formula. All Skeletal muscle adaptation to physical activity in-
values are presented in cm3. cludes a morphological aspect of this phenomenon –
640 J. Popadic Gacesa et al.

hypertrophy (Hakkinen et al., 2003; Losnegard et al., There is limited, and somewhat contradictory,
2010; Popadic Gacesa et al., 2009; West et al., information about changes in muscle shape with
2010). For upper arm muscle volume and CSA resistance training. For instance, in the case of the
change with training, limited data are available. Abe vastus lateralis, one study reports that the greatest
et al. (2000) found an increase in triceps brachii relative increase occurs at the distal end (Housh,
thickness of 7–9% after 12 weeks of resistance Housh, Johnson & Chu, 1992), and at either end of
training, three times a week, with six dynamic the muscle in other reports (Narici, Roi, Landoni,
exercises with 8–12 1-RM in untrained men. Minetti, & Cerretelli, 1989; Narici et al., 1996). For
O’Hagan et al. (1995) showed that 20 weeks of the biceps brachii, the absolute change with training
resistance training led to an 8.3% increase in biceps shows only minimal variability along the length
brachii CSAmax. West et al. (2010) reported an (Roman et al., 1993; West et al., 2010). By
increase in the biceps brachii CSA after 15 weeks of calculating each anatomical CSA relative increase
resistance training of 10–12%. Losengard et al. as a result of training and comparing it with the
(2010) reported a 5.5% increase in average ACSA muscle volume relative increase, we can provide
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(mean of nine ACSA in a upper arm sequence) of the some information about muscle shape changes with
triceps brachii after 12 weeks of strength training. hypertrophy. Our results indicate that triceps brachii
Roman et al. (1993) evaluated the effects of elbow muscle change with training shows the best predic-
flexors training in older men and reported a 13.9% tion in the second third of the muscle length.
increase in muscle volume and 26% increase in The use of a regression equation as a model for
CSAmax after a 12-week training programme. They predicting muscle volume is not without limitations.
correlated muscle volume change with a single CSA Our regression model, derived from a relatively
change as a result of training, and found a 12–18% homogeneous group of 35 males only, showed a
difference between the CSA of consecutive MR very high correlation with the multi-slice measure-
images at mid-arm. ment, and a standard error of estimate equivalent to
Our findings indicate that the triceps muscle size 8% of the measured muscle volume. Although
change as a result of training keeps the same validation is required, as few as seven participants
functional relation as before the protocol. In addi- are enough for deriving the prediction formula for
tion, when we apply the same prediction formula for muscle volume calculation based on one slice before
post-training values, the correlation is significant and and after training with this method. The minimum
very high for all prediction models. However, volume required sample size for our study was seven, for the
change prediction in comparison to multi-slice following parameters: number of predictors ¼ 2,
volume calculation change showed less than a 1% type I error rate a ¼ 0.05, Cohen’s effects size ¼ 4
difference when Model CSA60% was used, and the (R2 ¼ 0.8), statistical power 1 – b ¼ 0.8.
standard deviation for the calculated volume change These findings show that further study on this
is 3.95%. These data indicate that the accuracy of the topic is necessary to validate the equations we have
prediction method is better than the variability derived for other population groups before they can
of muscle volume change with training. But, if be applied in general.
volume change is less than 4%, errors may occur. Finding the best prediction equation for muscle
Interestingly, if only the CSA change is taken into volume calculation, and small volume changes based
consideration, prediction is possible, but with higher on a single anatomical CSA measure, will consider-
error (RSE is 9.4%, 8.4%, and 8.5% for CSAmax, ably reduce the time required to estimate muscle
CSA60%, and CSA50% respectively, compared with volume using this and similar approaches. In
8.5%, 7.8%, and 7.7% when humerus length is addition, by introducing humerus length into the
included in the equation). This observation is valid equation, we simplify the procedure for its measure-
only for the triceps brachii, the muscle investigated in ment, since it can be obtained during MRI scanning.
the present study. Other investigators used muscle length, which can be
An important application of this technique is in the obtained only by using the ultrasound technique
assessment of muscle volumes in cross-sectional and together with MRI (Morse et al., 2007). Also, BMI
longitudinal studies of muscle hypertrophy or atro- can provide an additional dimension of muscle
phy occurring as a result of growth, ageing, training, volume measurements, especially because of popula-
disuse or disease. To be useful in these situations the tion variation in body size.
critical requirement is that the individual muscles
retain the same shape, i.e. can be described by the
Conclusions
regression equations derived here, no matter whether
they atrophy or hypertrophy. Preferential hypertro- For triceps brachii muscle volume calculation based
phy of a muscle would not be a problem as long as on CSA measures, the best prediction equation
the overall shape of the muscle remains constant. includes not only the values of CSA50% or CSA60%,
Prediction of triceps brachii volume from single CSA 641

but also the humerus length and BMI. If a single McAuliffe, M., Lalonde, F., McGarry, D., Gandler, W., Csaky,
anatomical CSA is used for prediction of triceps K., & Trus, B. (2001). Medical imaging processing, analysis
and visualization in clinical research. IEEE Computer-based
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