Big Bones Mean Big Muscles: AI Quantifies 71 Individual Muscles Across the Whole Body, Revealing Widespread Links Between Muscle, Bone, and Body Size

Abstract

Body sizes and shapes vary widely, even among healthy adults, resulting in diverse muscle sizes, strengths, and performance capacities. This study developed a novel AI-driven algorithm to segment and analyze individual muscles and bones from whole-body MRI. Validated via inter- and intra-observer analyses, the algorithm created 3D segmentations of 71 muscles and 13 bones across the upper limbs, trunk, and lower limbs in 48 healthy adults (24 males, 24 females) aged 18-49 years. Muscle volume, asymmetry, length, and fat fraction were quantified. While asymmetry and fat fraction varied across muscles, they did not differ significantly between sexes. Total muscle volume was the strongest predictor of individual muscle volume, followed by bone volume, which correlated with muscle size at whole-body, regional, and individual levels. Muscle-to-body size relationships (e.g., mass, height, BMI) differed between sexes, while bone-to-body size relationships did not. These findings suggest that skeletal size ("frame size") is a key determinant of muscularity. This study provides the most comprehensive in vivo dataset of human skeletal muscle to date, offering a multi-factorial explanation for variation in muscularity and benchmarks for applications ranging from athletic performance to clinical assessments in muscle disorders. SUMMARYUnderstanding how muscle size varies across the body and what influences these differences is key to advancing both health and performance. This study uses cutting-edge AI to analyze individual muscles across the whole body from MRI scans, creating the most detailed dataset of human muscle and bone relationships to date. The findings reveal how skeletal size ("frame size") and body dimensions shape muscularity, providing new insights into why people differ in muscle size and strength. These results have broad implications, from optimizing athletic training to diagnosing and treating muscle disorders. By uncovering the intricate connections between muscles, bones, and body size, this research offers a powerful framework for understanding human movement and variability.