Standardized Ultrasound Measurement of Subcutaneous Fat Patterning: High Reliability and Accuracy in Groups Ranging from Lean to Obese

Ultrasound Med Biol. 2017 Feb;43(2):427-438. doi: 10.1016/j.ultrasmedbio.2016.09.014. Epub 2016 Nov 18.


A recently standardized ultrasound technique for measuring subcutaneous adipose tissue (SAT) was applied to normal-weight, overweight and obese persons. Eight measurement sites were used: upper abdomen, lower abdomen, erector spinae, distal triceps, brachioradialis, lateral thigh, front thigh and medial calf. Fat compression was avoided. Fat patterning in 38 participants (body mass index: 18.6-40.3 kgm-2; SAT thickness sums from eight sites: 12-245 mm) was evaluated using a software specifically designed for semi-automatic multiple thickness measurements in SAT (sound speed: 1450 m/s) that also quantifies embedded fibrous structures. With respect to ultrasound intra-observer results, the correlation coefficient ρ = 0.999 (p < 0.01), standard error of the estimate = 1.1 mm and 95% of measurements were within ±2.2 mm. For the normal-weight subgroup, the median measurement deviation was 0.43 mm (1.1% of mean thickness), and for the obese/overweight subgroup it was 0.89 mm (0.5%). The eight sites used here are suggested to represent inter-individual differences in SAT patterning. High measurement accuracy and reliability can be obtained in all groups, from lean to overweight and obese, provided that measurers are trained appropriately.

Keywords: Body composition; Obesity; Overweight; Subcutaneous adipose tissue; Ultrasound measurement precision.

MeSH terms

  • Adult
  • Body Composition / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / diagnostic imaging*
  • Reproducibility of Results
  • Subcutaneous Fat / diagnostic imaging*
  • Thinness / diagnostic imaging*
  • Ultrasonography / methods*