title: Reliability tests and guidelines for B-mode ultrasound assessment of central adiposity.
abstract: BACKGROUND
  Ultrasound represents a validated and relatively inexpensive diagnostic device for assessing central adiposity; however, widespread adoption has been impeded by the lack of reliable standard operating procedures.
  
  
  OBJECTIVE
  To examine the reliability of, and describe guidelines for, ultrasound-derived recording of intra-abdominal fat thickness (IAT) and maximal preperitoneal fat thickness (PFT).
  
  
  METHODS
  Ultrasound scans were obtained from 20 adults (50% female, 26 ± 7 years, 24·5 kg/m(2) ) on three different mornings. IAT was assessed 2 cm above the umbilicus (transverse plane) measuring from linea alba to: (i) anterior aorta, (ii) posterior aorta and (iii) anterior aspect of the vertebral column. PFT was measured from linea alba to visceral peritoneum in (i) sagittal and (ii) transverse planes, immediately over and inferior to the xiphi-sternum, respectively.
  
  
  RESULTS
  For IAT, the criterion intraclass correlation coefficient (ICC) of 0·75 was exceeded for measurements to anterior aorta (0·95), posterior aorta (0·94) and vertebra (0·96). The reliability coefficient expressed as a percentage of the mean (RC%) was lowest (better) for measurement to vertebrae (9·8%). For PFT, mean thickness was comparable for sagittal (1·74 cm) and transverse (1·76 cm) planes; ICC values were also comparable for both planes (0·98 vs. 0·98, respectively), as were RC% (7·5% vs. 7·1%, respectively).
  
  
  CONCLUSIONS
  IAT assessments to the vertebra were marginally more reliable than those to other structures. While PFT assessments were equally reliable for both measurements planes, precise probe placement was easier for the sagittal plane. Based on these findings, guidelines for the reliable measurement of central adiposity using ultrasound are presented.
authors.affiliation: School of Sport and Exercise, Massey University, Wellington, New Zealand.
authors.forename: Lee
authors.identifier: http://orcid.org/0000-0002-0682-2270
authors.initials: L
authors.lastname: Stoner
authors.affiliation: Institute of Food, Nutrition and Human Health, Massey University, Wellington, New Zealand.
authors.forename: Victoria
authors.initials: V
authors.lastname: Chinn
authors.affiliation: Department of Physiology, University of Otago, Dunedin, New Zealand.
authors.forename: Jon
authors.initials: J
authors.lastname: Cornwall
authors.affiliation: Department of Radiology, Dunedin Public Hospital, Southern District Health Board, Dunedin, New Zealand.|Department of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Grant
authors.initials: G
authors.lastname: Meikle
authors.affiliation: Institute of Food, Nutrition and Human Health, Massey University, Wellington, New Zealand.
authors.forename: Rachel
authors.initials: R
authors.lastname: Page
authors.affiliation: Faculty of Health Sciences, University of Southampton, Hants, UK.
authors.forename: Danielle
authors.initials: D
authors.lastname: Lambrick
authors.affiliation: Department of Sport & Exercise, University of Winchester, Winchester, UK.
authors.forename: James
authors.initials: J
authors.lastname: Faulkner
mesh_terms: D050154:Adiposity; D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008297:Male; D056128:Obesity, Abdominal / Q000000981:diagnostic imaging*; D009929:Organ Size; D010537:Peritoneum / Q000000981:diagnostic imaging*; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D013131:Spine / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult
keywords: Guidelines; intra-abdominal; preperitoneal; reliability; reproducibility; ultrasound