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. 2020 Aug;10(8):1699–1722. doi: 10.21037/qims-19-1048

Table 2. Validation and reliability of main parameters of adiposity assessed by ultrasound.

Parameter Reference Validation and reliability
IAFT (14,27-32) Good correlation with CT- and MRI-derived areas and volumes. Very good correlation with CT linear measurements
(32) CV range 1–7%
(29) Inter-observer correlation coefficient: 0.94
(14) ICC: 0.96
MFT (14) Few and ambiguous data on accuracy and after reliability:
   Weak correlation with CT measurements (Lin’s correlation coefficient =0.18)
   Low intra- and inter-reader agreement values (ICC =0.17–0.51)
(33) Liu et al. reported strong ICC coefficient for inter- (0.89) and intra- (0.97) operator agreement
PFT Few and ambiguous data on accuracy and reliability after available:
(14)    Strong correlation between linear measurements of CT and ultrasound reported by Bazzocchi et al. (Lin’s correlation coefficient =0.87). Low intra- and inter-observer variability (ICC =0.75–0.90)
(34)    Poor correlation with a CT-derived measure of visceral fat area (Pearson correlation coefficient =0.328) reported by Kim et al.
(35)    Intra-observer CV =4.3%; inter-observer CV =6.4%
WFI Few and ambiguous data available on after accuracy:
(36)    Strong correlation between WFI and the CT-derived ratio of visceral and subcutaneous fat area (r=0.746; P<0.0001) reported by Suzuki et al.
(34)    Very weak correlation between a CT-derived measure of visceral area and WFI (r=0.101) reported by Kim et al.
(31,34,36) Good reliability: CV less than 9%
Epicardial fat thickness (37) Very good correlations of US measurement of epicardial tissue with MRI measurements of epicardial fat thickness (r=0.905) and visceral fat area (r=0.864)
(38) High intra- (ICC ranging between 0.90 and 0.98) and inter-operator (ICC ranging between 0.93 and 0.98) reliability
(38) Excellent concordance of long-axis and short-axis average epicardial fat thickness measurement with P=0.98 (95% CI, 0.97–0.98)
Peri- and para-renal fat (39,40) Two studies showed a great accuracy of ultrasound measures of peri- and para-renal fat with the area of visceral abdominal fat measured with CT (P=0.75; P<0.0001) and with MRI (P=0.77; P<0.0001)
(40) Good inter- and intra-observer reliability of 0.433 and 0.725 (correlation coefficients), respectively
(39) Intra-operator CV ranging from 4.7% to 6.7%; inter-operator CV of 3.2%
MinASFT (14) Very strong correlation between ultrasound measures of MinASFT and CT-linear measurements and high reliability (Lin 0.95–0.98) reported by Bazzocchi et al.
(35) High reliability reported also from Hamagawa et al.: intra-observer CV of 4.3% and inter-observer CV of 4.6%.
MaxASFT (14) Very strong correlation between ultrasound measures of MaxASFT and CT-linear measurements and high reliability (Lin 0.95–0.98) reported by Bazzocchi et al.
(34) CV reported to range between 3.5% and 8.1%

IAFT, intra-abdominal fat thickness; CT, computed tomography; MRI, magnetic resonance imaging; CV, coefficient of variation; ICC, intraclass correlation coefficient; MFT, mesenteric fat thickness; PFT, pre-peritoneal fat thickness; WFI, wall fat index; US, ultrasonography; MinASFT, minimum subcutaneous fat thickness; MaxASFT, maximum abdominal subcutaneous fat thickness.