Interrater reliability of quantitative ultrasound using force feedback among examiners with varied levels of experience

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Abstract

Background. Quantitative ultrasound measures are influenced by multiple external factors including examiner scanning force. Force feedback may foster the acquisition of reliable morphometry measures under a variety of scanning conditions. The purpose of this study was to determine the reliability of force-feedback image acquisition and morphometry over a range of examiner-generated forces using a muscle tissue-mimicking ultrasound phantom.

Methods. Sixty material thickness measures were acquired from a muscle tissue mimicking phantom using B-mode ultrasound scanning by six examiners with varied experience levels (i.e., experienced, intermediate, and novice). Estimates of interrater reliability and measurement error with force feedback scanning were determined for the examiners. In addition, criterion-based reliability was determined using material deformation values across a range of examiner scanning forces (1–10 Newtons) via automated and manually acquired image capture methods using force feedback.

Results. All examiners demonstrated acceptable interrater reliability (intraclass correlation coefficient, ICC = .98, p < .001) for material thickness measures obtained using force feedback. Individual examiners exhibited acceptable reliability with the criterion-based reference measures (ICC > .90, p < .001), independent of their level of experience. The measurement error among all examiners was 1.5%–2.9% across all applied stress conditions.

Conclusion. Manual image capture with force feedback may aid the reliability of morphometry measures across a range of examiner scanning forces, and allow for consistent performance among examiners with differing levels of experience.

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Influence of concentric and eccentric resistance training on architectural adaptation in human quadriceps muscles.

Dale Cannavan, Denis Coleman, L S Horne … (2007)

Studies using animal models have been unable to determine the mechanical stimuli that most influence muscle architectural adaptation. We examined the influence of contraction mode on muscle architectural change in humans, while also describing the time course of its adaptation through training and detraining. Twenty-one men and women performed slow-speed (30 degrees /s) concentric-only (Con) or eccentric-only (Ecc) isokinetic knee extensor training for 10 wk before completing a 3-mo detraining period. Fascicle length of the vastus lateralis (VL), measured by ultrasonography, increased similarly in both groups after 5 wk (Delta(Con) = +6.3 +/- 3.0%, Delta(Ecc) = +3.1 +/- 1.6%, mean = +4.7 +/- 1.7%; P < 0.05). No further increase was found at 10 wk, although a small increase (mean approximately 2.5%; not significant) was evident after detraining. Fascicle angle increased in both groups at 5 wk (Delta(Con) = +11.1 +/- 4.0%, Delta(Ecc) = +11.9 +/- 5.4%, mean = 11.5 +/- 3.2%; P < 0.05) and 10 wk (Delta(Con) = +13.3 +/- 3.0%, Delta(Ecc) = +21.4 +/- 6.9%, mean = 17.9 +/- 3.7%; P < 0.01) in VL only and remained above baseline after detraining (mean = 13.2%); smaller changes in vastus medialis did not reach significance. The similar increase in fascicle length observed between the training groups mitigates against contraction mode being the predominant stimulus. Our data are also strongly indicative of 1) a close association between VL fascicle length and shifts in the torque-angle relationship through training and detraining and 2) changes in fascicle angle being driven by space constraints in the hypertrophying muscle. Thus muscle architectural adaptations occur rapidly in response to resistance training but are strongly influenced by factors other than contraction mode.

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Use of diagnostic ultrasound for assessing muscle size.

Michael G. Bemben (2002)

The typical "gold standard" for assessing muscle size has been magnetic resonance imaging (MRI) and computerized tomography; however, these processes are very expensive and generally require a medical facility. The advent of B-mode diagnostic ultrasound (US) can perhaps offer a quick, cost-effective method to measure muscle size. The purpose of this study was to document the reliability of B-mode US for assessing muscle size in a variety of populations. Thirty-eight postmenopausal women (avg. age = 58.9 +/- 0.7 years) had both their right rectus femoris and biceps brachii imaged, 85 older men and women (avg. age = 65.0 +/- 0.4 yrs) had their right rectus femoris imaged, and 10 young men and women (avg. age = 26.1 +/- 2.4 yrs) had their right rectus femoris imaged by both US and MRI. The location used for imaging on the right rectus femoris was a point 15 cm above to the superior border of the patella following the midline of the anterior surface of the thigh, whereas the biceps brachii was measured at maximal girth following the midline of the anterior surface of the upper arm. All trials utilizing US (Fukuda Denshi, model 4500) and a 5 Mz transducer (FUT-L104) were obtained in duplicate on 2 separate days. The young subjects that also had their rectus femoris measured by MRI were imaged with a Picker 1.5 Tesla (The Edge), which used a fast spin sequence and 192 x 256 resolution to obtain 2 5-mm-thick slices separated by a 1-mm-thick space. All intraclass correlation coefficients for the various groups and muscles measured by US ranged from r = 0.72-0.99, whereas coefficients of variation (CVs) ranged between 3.5% and 6.7%. The intraclass correlation for the MRI images was r = 0.90 and the CV was 5.2%. In conclusion, it appears that diagnostic US can provide a reliable and cost-effective alternative method for assessing muscle.

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Diagnostic ultrasound estimates of muscle mass and muscle quality discriminate between women with and without sarcopenia

Catheeja Ismail, Johannah Zabal, Haniel J. Hernandez … (2015)

Introduction: Age-related changes in muscle mass and muscle tissue composition contribute to diminished strength in older adults. The objectives of this study are to examine if an assessment method using mobile diagnostic ultrasound augments well-known determinants of lean body mass (LBM) to aid sarcopenia staging, and if a sonographic measure of muscle quality is associated with muscle performance. Methods: Twenty community-dwelling female subjects participated in the study (age = 43.4 ± 20.9 years; BMI: 23.8, interquartile range: 8.5). Dual energy X-ray absorptiometry (DXA) and diagnostic ultrasound morphometry were used to estimate LBM. Muscle tissue quality was estimated via the echogenicity using grayscale histogram analysis. Peak force was measured with grip dynamometry and scaled for body size. Bivariate and multiple regression analyses were used to determine the association of the predictor variables with appendicular lean mass (aLM/ht2), and examine the relationship between scaled peak force values and muscle echogenicity. The sarcopenia LBM cut point value of 6.75 kg/m2 determined participant assignment into the Normal LBM and Low LBM subgroups. Results: The selected LBM predictor variables were body mass index (BMI), ultrasound morphometry, and age. Although BMI exhibited a significant positive relationship with aLM/ht2 (adj. R 2 = 0.61, p < 0.001), the strength of association improved with the addition of ultrasound morphometry and age as predictor variables (adj. R 2 = 0.85, p < 0.001). Scaled peak force was associated with age and echogenicity (adj. R 2 = 0.53, p < 0.001), but not LBM. The Low LBM subgroup of women (n = 10) had higher scaled peak force, lower BMI, and lower echogenicity values in comparison to the Normal LBM subgroup (n = 10; p < 0.05). Conclusions: Diagnostic ultrasound morphometry values are associated with LBM, and improve the BMI predictive model for aLM/ht2 in women. In addition, ultrasound proxy measures of muscle quality are more strongly associated with strength than muscle mass within the study sample.

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Author and article information

Contributors

Michael O. Harris-Love

Journal

Journal ID (nlm-ta): PeerJ

Journal ID (iso-abbrev): PeerJ

Journal ID (publisher-id): peerj

Journal ID (pmc): peerj

Title: PeerJ

Publisher: PeerJ Inc. (San Francisco, USA )

ISSN (Electronic): 2167-8359

Publication date (Electronic): 21 June 2016

Publication date Collection: 2016

Volume: 4

Electronic Location Identifier: e2146

Affiliations

[1 ]Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center, Veterans Affairs Medical Center , Washington, D.C., United States

[2 ]Geriatrics and Extended Care Service, Veterans Affairs Medical Center , Washington, D.C., United States

[3 ]Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University , Washington, D.C., United States

[4 ]Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Hospital , Washington, D.C., United States

[5 ]Health Sciences Division, Howard Community College , Columbia, MD, United States

[6 ]Research Service, Veterans Affairs Medical Center , Washington, D.C., United States

[7 ]Departments of Medicine, Biochemistry & Molecular Medicine, School of Medicine and Health Sciences, George Washington University , Washington, D.C., United States

[8 ]Departments of Medicine and Rehabilitation Medicine, School of Medicine, Georgetown University , Washington, D.C., United States

Article

Publisher ID: 2146

DOI: 10.7717/peerj.2146

PMC ID: 4924341

PubMed ID: 27366647

SO-VID: 0a2b386d-49a7-418c-8213-2e847345cf17

License:

This is an open access article, free of all copyright, made available under the Creative Commons Public Domain Dedication. This work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.

History

Date received : 5 April 2016

Date accepted : 26 May 2016

Funding

Funded by: NIH National Center for Advancing Translational Sciences (NCATS)

Award ID: UL1TR000075

Award ID: UL1TR000101

Funded by: National Institutes of Health (NIH)

This publication was partially supported by Award Number UL1TR000075 and UL1TR000101 from the NIH National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), through the Clinical and Translational Science Awards Program (CTSA), and a VISN 5 Pilot Research Grant (VISN 5; VA Station: 688)—VHA/VA Capitol Health Care Network. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Interrater reliability of quantitative ultrasound using force feedback among examiners with varied levels of experience

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Most cited references 20

Influence of concentric and eccentric resistance training on architectural adaptation in human quadriceps muscles.

Use of diagnostic ultrasound for assessing muscle size.

Diagnostic ultrasound estimates of muscle mass and muscle quality discriminate between women with and without sarcopenia

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