{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:59:12Z","timestamp":1787032752068,"version":"build-2736575974"},"reference-count":37,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T00:00:00Z","timestamp":1723766400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"crossref","award":["HI22C0494"],"award-info":[{"award-number":["HI22C0494"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hip fractures are a common and debilitating condition, particularly among older adults. Loss of muscle mass and strength is a common consequence of hip fractures, which further contribute to functional decline and increased disability. Assessing changes in individual thigh muscles volume in follow-up patients can provide valuable insights into the quantitative recovery process and guide rehabilitation interventions. However, accurately measuring anatomical individual thigh muscle volume can be challenging due to various, labor intensive and time-consuming.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This study aimed to evaluate differences in thigh muscle volume in followed-up hip fracture patients computed tomography (CT) scans using an AI based automatic muscle segmentation model. The study included a total of 18 patients at Gyeongsang National University, who had undergone surgical treatment for a hip fracture. We utilized the automatic segmentation algorithm which we have already developed using UNETR (U-net Transformer) architecture, performance dice score = 0.84, relative absolute volume difference 0.019 \u00b1 0.017%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results revealed intertrochanteric fractures result in more significant muscle volume loss (females: \u221297.4 cm\n                      <jats:sup>3<\/jats:sup>\n                      , males: \u2013178.2 cm\n                      <jats:sup>3<\/jats:sup>\n                      ) compared to femoral neck fractures (females: \u221283 cm\n                      <jats:sup>3<\/jats:sup>\n                      , males: \u2212147.2 cm\n                      <jats:sup>3<\/jats:sup>\n                      ). Additionally, the study uncovered substantial disparities in the susceptibility to volume loss among specific thigh muscles, including the Vastus lateralis, Adductor longus and brevis, and Gluteus maximus, particularly in cases of intertrochanteric fractures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of an automatic muscle segmentation model based on deep learning algorithms enables efficient and accurate analysis of thigh muscle volume differences in followed up hip fracture patients. Our findings emphasize the significant muscle loss tied to sarcopenia, a critical condition among the elderly. Intertrochanteric fractures resulted in greater muscle volume deformities, especially in key muscle groups, across both genders. Notably, while most muscles exhibited volume reduction following hip fractures, the sartorius, vastus and gluteus groups demonstrated more significant disparities in individuals who sustained intertrochanteric fractures. This non-invasive approach provides valuable insights into the extent of muscle atrophy following hip fracture and can inform targeted rehabilitation interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.17509","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T07:03:55Z","timestamp":1723791835000},"page":"e17509","source":"Crossref","is-referenced-by-count":4,"title":["A retrospective evaluation of individual thigh muscle volume disparities based on hip fracture types in followed-up patients: an AI-based segmentation approach using UNETR"],"prefix":"10.7717","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6883-5448","authenticated-orcid":true,"given":"Hyeon Su","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Biomedical Research Institute, Inha University Hospital, Incheon, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinjune","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biomedical Research Institute, Inha University Hospital, Incheon, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunbin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biomedical Research Institute, Inha University Hospital, Incheon, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8484-7572","authenticated-orcid":true,"given":"Sang-Youn","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghan","family":"Cha","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Daejeon Eulji Medical Center, Daejeon, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Taek","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Ajou University School of Medicine, Ajou Medical Center, Suwon, Republic of South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Woo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Nowon Eulji Medical Center, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Chan","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Seoul Bumin Hospital, Seoul, Republic of South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-Il","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2024,8,16]]},"reference":[{"key":"10.7717\/peerj.17509\/ref-1","article-title":"Anatomy, bony pelvis and lower limb: femur","volume-title":"StatPearls","author":"Chang","year":"2023"},{"issue":"12","key":"10.7717\/peerj.17509\/ref-2","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1177\/07334648211006519","article-title":"The association between sarcopenia and postoperative outcomes among older adults with hip fracture: a systematic review","volume":"40","author":"Chiang","year":"2021","journal-title":"Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society"},{"issue":"1","key":"10.7717\/peerj.17509\/ref-3","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1007\/s11657-019-0668-0","article-title":"Reduced leg muscle mass and lower grip strength in women are associated with osteoporotic vertebral compression fractures","volume":"14","author":"Eguchi","year":"2019","journal-title":"Archives of Osteoporosis"},{"key":"10.7717\/peerj.17509\/ref-4","doi-asserted-by":"publisher","first-page":"1841","DOI":"10.2147\/CIA","article-title":"Effects of transcutaneous electrical nerve stimulation (TENS) on acute postoperative pain intensity and mobility after hip fracture: a double-blinded, randomized trial","volume":"14","author":"Elboim-Gabyzon","year":"2019","journal-title":"Clinical Interventions in Aging"},{"issue":"10","key":"10.7717\/peerj.17509\/ref-5","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.jot.2018.10.004","article-title":"Quantitative analysis of skeletal muscle by computed tomography imaging\u2014State of the art","volume":"15","author":"Engelke","year":"2018","journal-title":"Journal of Orthopaedic Translation"},{"issue":"7","key":"10.7717\/peerj.17509\/ref-6","doi-asserted-by":"publisher","first-page":"1626","DOI":"10.1016\/j.injury.2020.04.054","article-title":"Association of abductor hip muscle atrophy with fall-related proximal femur fractures in the elderly","volume":"51","author":"Erin\u00e7","year":"2020","journal-title":"Injury"},{"issue":"9","key":"10.7717\/peerj.17509\/ref-7","doi-asserted-by":"publisher","first-page":"2528","DOI":"10.3390\/nu12092528","article-title":"Hip fracture patients in geriatric rehabilitation show poor nutritional status, dietary intake and muscle health","volume":"12","author":"Groenendijk","year":"2020","journal-title":"Nutrients"},{"key":"10.7717\/peerj.17509\/ref-8","doi-asserted-by":"publisher","DOI":"10.48550\/arXiv.2103.10504","article-title":"UNETR: transformers for 3D medical image segmentation","author":"Hatamizadeh","year":"2021"},{"issue":"4","key":"10.7717\/peerj.17509\/ref-9","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1111\/j.1440-1673.2004.01351.x","article-title":"Reference ranges for bone densitometers adopted Australia-wide: geelong osteoporosis study","volume":"48","author":"Henry","year":"2004","journal-title":"Australasian Radiology"},{"key":"10.7717\/peerj.17509\/ref-10","doi-asserted-by":"publisher","DOI":"10.48550\/arXiv.1907.08915","article-title":"Automated muscle segmentation from clinical CT using Bayesian U-Net for personalized musculoskeletal modeling","author":"Hiasa","year":"2019"},{"issue":"1","key":"10.7717\/peerj.17509\/ref-11","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1186\/1471-2474-12-182","article-title":"Reference ranges for bone mineral density and prevalence of osteoporosis in Vietnamese men and women","volume":"12","author":"Ho-Pham","year":"2011","journal-title":"BMC Musculoskeletal Disorders"},{"issue":"1","key":"10.7717\/peerj.17509\/ref-12","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1186\/s12891-019-2551-y","article-title":"Cross-sectional area of the paraspinal muscles and its association with muscle strength among fighter pilots: a 5-year follow-up","volume":"20","author":"Honkanen","year":"2019","journal-title":"BMC Musculoskeletal Disorders"},{"issue":"4","key":"10.7717\/peerj.17509\/ref-13","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1016\/j.jamda.2014.10.018","article-title":"Phenotype of osteosarcopenia in older individuals with a history of falling","volume":"16","author":"Huo","year":"2015","journal-title":"Journal of the American Medical Directors Association"},{"issue":"10","key":"10.7717\/peerj.17509\/ref-14","first-page":"2246","article-title":"Evaluation of the gluteus medius muscle after a pelvic support osteotomy to treat congenital dislocation of the hip","volume":"87","author":"Inan","year":"2005","journal-title":"The Journal of Bone and Joint Surgery American"},{"issue":"12","key":"10.7717\/peerj.17509\/ref-15","doi-asserted-by":"publisher","first-page":"3743","DOI":"10.3390\/nu12123743","article-title":"Undernutrition, sarcopenia, and frailty in fragility hip fracture: advanced strategies for improving clinical outcomes","volume":"12","author":"Inoue","year":"2020","journal-title":"Nutrients"},{"key":"10.7717\/peerj.17509\/ref-16","doi-asserted-by":"publisher","first-page":"21514593231181988","DOI":"10.1177\/21514593231181988","article-title":"Rehabilitation after hip fracture surgery improves physical and cognitive function in patients with or without sarcopenia","volume":"14","author":"Kanaya","year":"2023","journal-title":"Geriatric Orthopaedic Surgery & Rehabilitation"},{"issue":"1","key":"10.7717\/peerj.17509\/ref-17","doi-asserted-by":"publisher","first-page":"3301","DOI":"10.1038\/s41598-024-53707-8","article-title":"Precise individual muscle segmentation in whole thigh CT scans for sarcopenia assessment using U-net transformer","volume":"14","author":"Kim","year":"2024","journal-title":"Scientific Reports"},{"issue":"1","key":"10.7717\/peerj.17509\/ref-18","doi-asserted-by":"publisher","first-page":"010901","DOI":"10.1117\/1.JMI.8.1.010901","article-title":"Quick guide on radiology image pre-processing for deep learning applications in prostate cancer research","volume":"8","author":"Masoudi","year":"2021","journal-title":"Journal of Medical Imaging"},{"issue":"3","key":"10.7717\/peerj.17509\/ref-19","doi-asserted-by":"publisher","first-page":"225","DOI":"10.5535\/arm.21110","article-title":"Clinical practice guideline for postoperative rehabilitation in older patients with hip fractures","volume":"45","author":"Min","year":"2021","journal-title":"Annals of Rehabilitation Medicine"},{"issue":"10","key":"10.7717\/peerj.17509\/ref-20","doi-asserted-by":"publisher","first-page":"e173","DOI":"10.1093\/gerona\/glaa158","article-title":"Efficacy of combined antigravity treadmill and conventional rehabilitation after hip fracture in patients with sarcopenia","volume":"75","author":"Oh","year":"2020","journal-title":"The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences"},{"issue":"4","key":"10.7717\/peerj.17509\/ref-21","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1007\/s00774-022-01334-6","article-title":"Sarcopenia: an unsolved problem after hip fracture","volume":"40","author":"Park","year":"2022","journal-title":"Journal of Bone and Mineral Metabolism"},{"issue":"6","key":"10.7717\/peerj.17509\/ref-22","doi-asserted-by":"publisher","first-page":"1565","DOI":"10.1093\/ije\/dyr148","article-title":"Cohort profile: geelong osteoporosis study","volume":"41","author":"Pasco","year":"2012","journal-title":"International Journal of Epidemiology"},{"issue":"3","key":"10.7717\/peerj.17509\/ref-23","doi-asserted-by":"publisher","first-page":"101680","DOI":"10.1016\/j.rehab.2022.101680","article-title":"Association between vertebral fragility fractures, muscle strength and physical performance: a cross-sectional study","volume":"66","author":"Peres-Ueno","year":"2023","journal-title":"Annals of Physical and Rehabilitation Medicine"},{"issue":"4","key":"10.7717\/peerj.17509\/ref-24","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1002\/jbmr.3037","article-title":"Association of muscle weakness with post-fracture mortality in older men and women: a 25-year prospective study","volume":"32","author":"Pham","year":"2017","journal-title":"Journal of Bone and Mineral Research"},{"issue":"4","key":"10.7717\/peerj.17509\/ref-25","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1177\/11207000221114456","article-title":"Muscle recovery after total hip arthroplasty: prospective MRI comparison of anterior and posterior approaches","volume":"33","author":"Robinson","year":"2023","journal-title":"HIP International"},{"key":"10.7717\/peerj.17509\/ref-26","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-24574-4","article-title":"U-Net: convolutional networks for biomedical image segmentation","author":"Ronneberger","year":"2015"},{"key":"10.7717\/peerj.17509\/ref-27","doi-asserted-by":"publisher","first-page":"e32689","DOI":"10.7759\/cureus.32689","article-title":"Rehabilitation towards functional independence in a patient with intertrochanteric fracture and paraplegia: a case report","volume":"14","author":"Satone","year":"2022","journal-title":"Cureus"},{"key":"10.7717\/peerj.17509\/ref-28","doi-asserted-by":"publisher","first-page":"110844","DOI":"10.1016\/j.ejrad.2023.110844","article-title":"Is AI the way forward for reducing metal artifacts in CT? Development of a generic deep learning-based method and initial evaluation in patients with sacroiliac joint implants","volume":"163","author":"Selles","year":"2023","journal-title":"European Journal of Radiology"},{"issue":"9","key":"10.7717\/peerj.17509\/ref-29","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1249\/MSS.0b013e31825871fa","article-title":"Regulation of physiological and metabolic function of muscle by female sex steroids","volume":"44","author":"Spangenburg","year":"2012","journal-title":"Medicine and Science in Sports and Exercise"},{"issue":"4","key":"10.7717\/peerj.17509\/ref-30","doi-asserted-by":"publisher","first-page":"613","DOI":"10.3233\/BMR-181389","article-title":"Osteosarcopenia increases hip fracture risk: a case-controlled study in the elderly","volume":"32","author":"Turkmen","year":"2019","journal-title":"Journal of Back and Musculoskeletal Rehabilitation"},{"issue":"5","key":"10.7717\/peerj.17509\/ref-31","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1049\/ipr2.12419","article-title":"Medical image segmentation using deep learning: a survey","volume":"16","author":"Wang","year":"2022","journal-title":"IET Image Processing"},{"issue":"1","key":"10.7717\/peerj.17509\/ref-32","doi-asserted-by":"publisher","first-page":"3","DOI":"10.4235\/agmr.19.0001","article-title":"Intermuscular adipose tissue: a brief review of etiology, association with physical function and weight loss in older adults","volume":"23","author":"Waters","year":"2019","journal-title":"Annals of Geriatric Medicine and Research"},{"issue":"1","key":"10.7717\/peerj.17509\/ref-33","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1186\/s12891-019-2950-0","article-title":"Predictors of poor functional outcomes and mortality in patients with hip fracture: a systematic review","volume":"20","author":"Xu","year":"2019","journal-title":"BMC Musculoskeletal Disorders"},{"issue":"5","key":"10.7717\/peerj.17509\/ref-34","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1177\/11207000221101169","article-title":"Effect of psoas and gluteus medius muscles attenuation on hip fracture type","volume":"33","author":"Yerli","year":"2022","journal-title":"Hip International: The Journal of Clinical and Experimental Research on Hip Pathology and Therapy"},{"key":"10.7717\/peerj.17509\/ref-35","doi-asserted-by":"publisher","first-page":"503","DOI":"10.3389\/fendo.2020.00503","article-title":"Associations of muscle size and density with proximal femur bone in a community dwelling older population","volume":"11","author":"Yin","year":"2020","journal-title":"Frontiers in Endocrinology"},{"issue":"1","key":"10.7717\/peerj.17509\/ref-36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5371\/hp.2022.34.1.1","article-title":"Diagnosis and management of sarcopenia after hip fracture surgery: current concept review","volume":"34","author":"Yoo","year":"2022","journal-title":"Hip & Pelvis"},{"issue":"10","key":"10.7717\/peerj.17509\/ref-37","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.3349\/ymj.2018.59.10.1240","article-title":"Concerns for older adult patients with acute hip fracture","volume":"59","author":"Yoo","year":"2018","journal-title":"Yonsei Medical Journal"}],"container-title":["PeerJ"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/peerj.com\/articles\/17509.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/17509.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/17509.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/17509.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T07:04:03Z","timestamp":1723791843000},"score":1,"resource":{"primary":{"URL":"https:\/\/peerj.com\/articles\/17509"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,16]]},"references-count":37,"alternative-id":["10.7717\/peerj.17509"],"URL":"https:\/\/doi.org\/10.7717\/peerj.17509","archive":["CLOCKSS","LOCKSS","Portico"],"relation":{},"ISSN":["2167-8359"],"issn-type":[{"value":"2167-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,16]]},"article-number":"e17509"}}