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THE INFLUENCE OF SONOGRAPHER EXPERIENCE ON MEASUREMENTS OF SKELETAL MUSCLE CROSS-SECTIONAL AREA

Abstract

Jonathan P. Beausejour1, Caleb C. Voskuil2, Dustin Dunnick3, Kristen M. Badillo1, Joel E. Harden4, Jason I. Pagan1, Kylie K. Harmon1, Ryan M. Girts1, Gena R. Gerstner4, Joshua C. Carr2, Matt S. Stock1. 1University of Central Florida, Orlando, FL. 2Texas Christian University, Fort Worth, TX. 3Arkansas Tech University, Russellville, AR. 4Old Dominion University, Norfolk, VA.

BACKGROUND: The affordability and convenience of B-mode ultrasound devices has made their use widespread in university research settings, clinics, and hospitals. As such, establishing a reliable image acquisition protocol is essential for reporting consistent measurements. Since ultrasound image acquisition requires training and skill, relying on the same sonographer to conduct all imaging can be challenging, especially if turnover of research support is frequent. The purpose of this study was to investigate whether sonographer experience influences ultrasound-derived measures of muscle cross-sectional area (mCSA). By assessing three muscles, we sought to determine whether the influence of experience is muscle specific. METHODS: An experienced (7 years) and novice sonographer independently acquired images of the biceps brachii, vastus lateralis, and medial gastrocnemius of 17 participants (10 females, 7 males; mean ± SD age = 22 ± 3 years). Images were captured in the transverse plane with use of a panoramic function while participants rested in the supine (biceps brachii, vastus lateralis) or prone (medial gastrocnemius) position. Before data collection, the novice sonographer engaged in a 2-hr training session with the experienced sonographer, which included acquiring images together on 2 pilot participants not included in the sample. The sonographers were not together in the laboratory during image acquisition and the order in which images were acquired between sonographers and muscles was randomized. Images were analyzed in ImageJ by a blinded, experienced investigator not present during data collection. Statistical analyses included paired samples t-tests, Cohen’s d effect sizes, intraclass correlation coefficients (ICC ), and the standard error of measurement (SEM). RESULTS: Similar mCSA values were observed for the biceps brachii (p = .280, d = .271, ICC = .975, SEM = 6.5%) and vastus lateralis (p = .417, d = .202, ICC = .986, SEM = 6.6%). There were significant differences between sonographers for the medial gastrocnemius (p = .035; d = .559; ICC = .939, SEM = 8.2%). CONCLUSION: The influence of sonographer experience on mCSA measurements is muscle specific. Specifically, medial gastrocnemius mCSA values differ between an experienced versus a novice sonographer. Our findings have important implications for laboratories that use ultrasound and possess research team members of varying experience levels.

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