title: Accuracy of ultrasound imaging technique for assessing lipoatrophy in HIV-infected subjects.
abstract: OBJECTIVE
  To compare the accuracy of ultrasound imaging technique to that of clinical diagnosis in evaluating subcutaneous fat changes in HIV-infected subjects.
  
  
  METHODS
  HIV-uninfected control subjects (Group A), HIV-infected subjects with clinically assessed lipoatrophy (Group B), and HIV-infected subjects without clinical lipoatrophy (Group C) underwent ultrasound measurements of subcutaneous fat thickness at facial, brachial and thigh regions. ROC curve analyses were used to estimate ultrasound prediction accuracy and cut-off values of subcutaneous fat thickness.
  
  
  RESULTS
  228 subjects were enrolled: 78 in Group A, 73 in Group B, and 77 in Group C. Facial lipoatrophy: ROC curve analysis identified optimal cut-off value of 13.3 mm [sensitivity, 96.0%; specificity, 76.9% AUC 0.92], 5.0 mm [sensitivity, 71.4%; specificity, 92.3%; AUC 0.90] and 11.2 mm [sensitivity, 95.8%; specificity, 89.7%; AUC 0.97] for females and 12.05 mm [sensitivity, 51.2%; specificity, 87.2%; AUC 0.74], 4.1 mm [sensitivity, 76.2%; specificity, 89.7%; AUC 0.85] and 4.35 mm [sensitivity, 60.0%; specificity, 89.7%; AUC 0.82] for males in assessing facial, brachial and crural lipoatrophy respectively. Using this cut-off values, 12/25 (48%) females and 17/49 (34.7%) males, 12/28 (42.9%) females and 23/49 (46.9%) males, 19/28 (67.9%) females and 12/49 (24.5%) males in Group C would be classified as "sub-clinical" facial, brachial and crural lipoatrophy respectively.
  
  
  CONCLUSIONS
  The results of our study show that in the assessment of subtle subcutaneous fat changes ultrasound is more accurate than clinical evaluation and confirm the usefulness of ultrasound imaging technique in identifying lipoatrophy at an early stage.
authors.affiliation: Ultrasound Unit - Infectious Diseases Department, Foundation IRCCS Policlinico San Matteo Hospital- University of Pavia, Italy. giovanna.ferraioli@unipv.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Ferraioli
authors.forename: Carmine
authors.initials: C
authors.lastname: Tinelli
authors.forename: Luigia
authors.initials: L
authors.lastname: Scudeller
authors.forename: Gaetano
authors.initials: G
authors.lastname: Filice
authors.forename: Carlo
authors.initials: C
authors.lastname: Filice
mesh_terms: D000328:Adult; D001132:Arm; D003430:Cross-Sectional Studies; D005145:Face; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging*; D013848:Thigh / Q000000981:diagnostic imaging; D014463:Ultrasonography