Pectoralis Cross-Sectional Area can be Accurately Measured using Panoramic Ultrasound: A Validity and Repeatability...

The objective of the current study was to examine the validity and repeatability of panoramic ultrasound in evaluating the anatomical cross-sectional area (ACSA) of the pectoralis major. Specifically, we aimed to quantify the measurement errors generated during the image acquisition and analysis (repeatability), as well as when comparing with magnetic resonance imaging (MRI) (validity). Moreover, we aimed to analyze the influence of the operator's experience on these measurement errors. Both sides of the chest of 16 participants (n = 32) were included. Errors made by two operators (trained and novice) when measuring pectoralis major ACSA (50% of sternum-areola mammae distance) were examined. Acquisition errors included the comparison of two images acquired 5 min apart. Acquisition 1 was analyzed twice to quantify analysis errors. Thereafter, acquisition 1 was compared with MRI. Statistics include the standard error of measurement (SEM), expressed in absolute (cm²) and relative (%) terms as a coefficient of variation (CV), and the calculation of systematic bias. Errors made by the trained operator were lower than those made by the novice, especially during the image acquisition (SEM = 0.25 vs. 0.66 cm², CV = 1.06 vs. 2.98%) and when compared with MRI (SEM = 0.27 vs. 1.90 cm², CV = 1.13 vs. 8.16%). Furthermore, although both operators underestimated the ACSA, magnitude and variability [SD] of these errors were lower for the trained operator (bias = -0.19 [0.34] cm²) than for the novice (bias = -1.97 [2.59] cm²). Panoramic ultrasound is a valid and repeatable technique for measuring pectoralis major ACSA, especially when implemented by a trained operator.