Abstract
Open-access scripts to perform muscle anatomical cross-sectional area (ACSA) evaluation in ultrasound images are currently unavailable. This study presents a novel semi-automatic ImageJ script (named “ACSAuto”) for quantifying the ACSA of lower limb muscles. We compared manual ACSA measurements from 180 ultrasound scans of vastus lateralis (VL) and rectus femoris (RF) muscles to measurements assessed by the ACSAuto script. We investigated inter- and intra-investigator reliability of the script. Consecutive-pairwise intra-class correlations (ICC) and standard error of measurement (SEM) with 95% compatibility interval were calculated. Bland–Altman analyses were employed to test the agreement between measurements. Comparing manual and ACSAuto measurements, ICCs and SEMs ranged from 0.96 to 0.999 and 0.12 to 0.96 cm2 (1.2–5.9%) and mean bias was smaller than 0.5 cm2 (4.3%). Inter-investigator comparison revealed ICCs, SEMs and mean bias ranging from 0.85 to 0.999, 0.07 to 1.16 cm2 (0.9–7.6%) and − 0.16 to 0.66 cm2 (− 0.6 to 3.2%). Intra-investigator comparison revealed ICCs, SEMs and mean bias between 0.883–0.998, 0.07–0.93 cm2 (1.1–7.6%) and − 0.80 to 0.15 cm2 (− 3.4 to 1.8%). Image quality needs to be high for efficient and accurate ACSAuto analyses. Taken together, the ACSAuto script represents a reliable tool to measure RF and VL ACSA, is comparable to manual analysis and can reduce time needed to evaluate ultrasound images.
Highlights
Open-access scripts to perform muscle anatomical cross-sectional area (ACSA) evaluation in ultrasound images are currently unavailable
intra-class correlations (ICC), standard error of measurement (SEM), mean bias and standardized mean bias with 95% compatibility intervals (CI) for all muscles and modes comparing manual to ACSAuto measurements are shown in Table 1 and Fig. 2
We found no obvious differences for ICC, SEM, mean bias and standardized mean bias in “Manual”, “Fixed Pixel” and “Automatic” options to define outline-finder starting points (Table 1)
Summary
Open-access scripts to perform muscle anatomical cross-sectional area (ACSA) evaluation in ultrasound images are currently unavailable. The ACSAuto script represents a reliable tool to measure RF and VL ACSA, is comparable to manual analysis and can reduce time needed to evaluate ultrasound images. Due to the size and shape of the quadriceps femoris muscles, conventional static B-mode ultrasound might be unsuitable to assess the ACSA of these muscles This is mostly related to the limited field of view of the employed transducers[9, 10]. None of these fully automated programs are openly accessible In these regards, a reliable, openly accessible, semi-automatic program could decrease the effort and time needed to evaluate ACSA in ultrasound images. The amount of subjective interpretation and image processing could be reduced and the comparability across studies increased
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