What Fat Is That? Scanning Perirenal Fat: A Survey of Australasian Sonographers

Ultrasound measures of perirenal adipose tissue (PRAT) have emerged as potentially efficient, cost-effective, and accessible methods for assessing cardiovascular disease (CVD) risk. Our recent systematic review supported the utility of PRAT measurement using ultrasound but highlighted a lack of standardised protocols for its clinical implementation. This measurement could be added to abdominal ultrasound examinations for little added time or cost to provide an important indicator of cardiovascular-significant obesity. The aim of this survey was to explore current practices and awareness of PRAT measurement among Australasian sonographers.

We conducted an online survey of Australasian sonographers aiming to explore respondents' knowledge of the distinct types of renal adipose tissue, and their understanding of PRAT thickness and its association with CVD. We asked if they measure it and, if so, what technique they use. Responses were assessed in terms of answers to knowledge questions or ability, and of interest or engagement.

Albeit a low response rate, n = 42, both student and qualified sonographers were represented from metropolitan, rural, and remote settings, with a broad range of professional experience. Knowledge of renal anatomy, PRAT links with metabolic disease, and peri-renal fat layers varied. There was no consensus in the ultrasound technique for measuring PRAT.

Findings revealed considerable variations in knowledge of PRAT and its clinical relevance. These differences are influenced by workplace setting, patient demographics, and level of sonographer experience. The results underscore the need for a standardised protocol to support the broader implementation of PRAT measurement in routine ultrasound practice.