title: Subcutaneous fat patterning in athletes: selection of appropriate sites and standardisation of a novel ultrasound measurement technique: ad hoc working group on body composition, health and performance, under the auspices of the IOC Medical Commission.
abstract: BACKGROUND
  Precise and accurate field methods for body composition analyses in athletes are needed urgently.
  
  
  OBJECTIVE
  Standardisation of a novel ultrasound (US) technique for accurate and reliable measurement of subcutaneous adipose tissue (SAT).
  
  
  METHODS
  Three observers captured US images of uncompressed SAT in 12 athletes and applied a semiautomatic evaluation algorithm for multiple SAT measurements.
  
  
  RESULTS
  Eight new sites are recommended: upper abdomen, lower abdomen, erector spinae, distal triceps, brachioradialis, lateral thigh, front thigh, medial calf. Obtainable accuracy was 0.2 mm (18 MHz probe; speed of sound: 1450 m/s). Reliability of SAT thickness sums (N=36): R(2)=0.998, SEE=0.55 mm, ICC (95% CI) 0.998 (0.994 to 0.999); observer differences from their mean: 95% of the SAT thickness sums were within ± 1 mm (sums of SAT thicknesses ranged from 10 to 50 mm). Embedded fibrous tissues were also measured.
  
  
  CONCLUSIONS
  A minimum of eight sites is suggested to accommodate inter-individual differences in SAT patterning. All sites overlie muscle with a clearly visible fascia, which eases the acquisition of clear images and the marking of these sites takes only a few minutes. This US method reaches the fundamental accuracy and precision limits for SAT measurements given by tissue plasticity and furrowed borders, provided the measurers are trained appropriately.
authors.affiliation: Medical University of Graz, Institute of Biophysics, Graz, Austria.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Müller
authors.affiliation: University of Arizona, Tucson, Arizona, USA.
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Lohman
authors.affiliation: Robert Gordon University, Aberdeen, UK.
authors.forename: Arthur D
authors.initials: AD
authors.lastname: Stewart
authors.affiliation: Loughborough University, School of Sport and Exercise Sciences, Loughborough, UK.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Maughan
authors.affiliation: University of Colorado, Colorado Springs, Colorado, USA.
authors.forename: Nanna L
authors.initials: NL
authors.lastname: Meyer
authors.affiliation: Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.
authors.forename: Luis B
authors.initials: LB
authors.lastname: Sardinha
authors.affiliation: University of Colorado, Colorado Springs, Colorado, USA.
authors.forename: Nuwanee
authors.initials: N
authors.lastname: Kirihennedige
authors.affiliation: University of Colorado, Colorado Springs, Colorado, USA.
authors.forename: Alba
authors.initials: A
authors.lastname: Reguant-Closa
authors.affiliation: University of Colorado, Colorado Springs, Colorado, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Risoul-Salas
authors.affiliation: The Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: Jorunn
authors.initials: J
authors.lastname: Sundgot-Borgen
authors.affiliation: Medical University of Graz, Institute of Biophysics, Graz, Austria.
authors.forename: Helmut
authors.initials: H
authors.lastname: Ahammer
authors.affiliation: Medical University of Graz, Institute of Anatomy, Graz, Austria.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Anderhuber
authors.affiliation: Medical University of Graz, Institute of Biophysics, Graz, Austria.
authors.forename: Alfred
authors.initials: A
authors.lastname: Fürhapter-Rieger
authors.affiliation: Medical University of Graz, Institute of Biophysics, Graz, Austria.
authors.forename: Philipp
authors.initials: P
authors.lastname: Kainz
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Materna
authors.affiliation: Medical University of Graz, Institute of Anatomy, Graz, Austria.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Pilsl
authors.affiliation: Medical University of Graz, Institute of Biophysics, Graz, Austria.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Pirstinger
authors.affiliation: University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Ackland
mesh_terms: D054874:Athletic Performance / Q000502:physiology; D001823:Body Composition / Q000502:physiology; D050218:Body Fat Distribution; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D015588:Observer Variation; D013177:Sports / Q000502:physiology*; D050151:Subcutaneous Fat / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014463:Ultrasonography