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Updated: Dec 18, 2025
Focused Assessment with Sonography for Trauma FAST Exam: Image Acquisition
Published on: September 22, 2023
Increased body mass index does not impact the imaging quality of focused assessment with sonography in trauma
Oluwatomilona I Ifelayo1, Kafayat A Oyemade1, Sarah S Tawfic1
1Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA.
Background:
Many clinicians believe that a patient's body mass index (BMI) affects the likelihood of obtaining high quality ultrasound images.
Objectives:
To assess the hypothesis that increased BMI is associated with worsening focused assessment with sonography in trauma (FAST) image quality.
Methods:
We conducted a retrospective single-center study of FAST examinations performed in a large academic emergency department (ED) with fellowship-trained emergency ultrasonography faculty performing quality assurance review.
Results:
Mean (SD) BMI was 28.0 (6.6) among the 302 included studies. The overall quality rating tended to decrease as BMI increased but did not achieve statistical significance in a univariable setting (P = .06) or after adjustment for age and sex (P = .06). Operators perception of image adequacy was largely unaffected by BMI, with the exception of the pericardial view.
Conclusion:
This study did not identify a statistically significant difference in FAST quality with increased BMI. This result may help assuage clinician concerns about ultrasonography for patients in the ED.
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