Acceptability, Precision and Accuracy of 3D Photonic Scanning for Measurement of Body Shape in a Multi-Ethnic Sample of Children Aged 5-11 Years: The SLIC Study

Body surface scan anthropometrics are associated with grip strength in the general population

BACKGROUND AND AIM

Body shape and anthropometrics are well-known risk factors for cardiovascular diseases (CVD) and mortality. Hand-grip strength (HGS) is also a meaningful marker of health and a promising predictor of CVD and mortality. There is a lack of studies that have systematically investigated associations between body shape and anthropometrics with HGS. In a population-based study, we investigated if anthropometric markers derived from 3D body scanning are related to HGS.

METHODS AND RESULTS

We used the data of 1,599 individuals aged 36 to 93 years, who participated in the Study of Health in Pomerania. A total of 87 anthropometric markers, determined by a 3D body scanner, were included in the analysis. Anthropometric measurements were standardized and used as exposure variables. HGS was measured with a hand dynamometer and used as outcome. Sex-stratified linear regression models adjusted for age and height were used to relate standardized anthropometrics and HGS. Anthropometric markers were ranked according to -log-p-values. In men, left and right forearm circumference, left arm length to neck (C7), left forearm length, and forearm-fingertip length were most strongly related to HGS. In women, right forearm circumference, forearm-fingertip length, shoulder breadth, left forearm circumference, and right wrist circumference showed the most significant associations with HGS. The final prediction models contained 13 anthropometric markers in males (R2=0.54) and eight anthropometric markers in females (R2=0.37).

CONCLUSIONS

The identified parameters may help estimate HGS in the clinical setting. However, studies in clinical settings are essential to validating our findings.

Automated body composition estimation from device-agnostic 3D optical scans in pediatric populations

BACKGROUND

Excess adiposity in children is strongly correlated with obesity-related metabolic disease in adulthood, including diabetes, cardiovascular disease, and 13 types of cancer. Despite the many long-term health risks of childhood obesity, body mass index (BMI) Z-score is typically the only adiposity marker used in pediatric studies and clinical applications. The effects of regional adiposity are not captured in a single scalar measurement, and their effects on short- and long-term metabolic health are largely unknown. However, clinicians and researchers rarely deploy gold-standard methods for measuring compartmental fat such as magnetic resonance imaging (MRI) and dual X-ray absorptiometry (DXA) on children and adolescents due to cost or radiation concerns. Three-dimensional optical (3DO) scans are relatively inexpensive to obtain and use non-invasive and radiation-free imaging techniques to capture the external surface geometry of a patient's body. This 3D shape contains cues about the body composition that can be learned from a structured correlation between 3D body shape parameters and reference DXA scans obtained on a sample population.

STUDY AIM

This study seeks to introduce a radiation-free, automated 3D optical imaging solution for monitoring body shape and composition in children aged 5-17.

METHODS

We introduce an automated, linear learning method to predict total and regional body composition of children aged 5-17 from 3DO scans. We collected 145 male and 206 female 3DO scans on children between the ages of 5 and 17 with three scanners from independent manufacturers. We used an automated shape templating method first introduced on an adult population to fit a topologically consistent 60,000 vertex (60 k) mesh to 3DO scans of arbitrary scanning source and mesh topology. We constructed a parameterized body shape space using principal component analysis (PCA) and estimated a regression matrix between the shape parameters and their associated DXA measurements. We automatically fit scans of 30 male and 38 female participants from a held-out test set and predicted 12 body composition measurements.

RESULTS

The coefficient of determination (R2) between 3DO predicted body composition and DXA measurements was at least 0.85 for all measurements with the exception of visceral fat on 3D scan predictions. Precision error was 1-4 times larger than that of DXA. No predicted variable was significantly different from DXA measurement except for male trunk lean mass.

CONCLUSION

Optical imaging can quickly, safely, and inexpensively estimate regional body composition in children aged 5-17. Frequent repeat measurements can be taken to chart changes in body adiposity over time without risk of radiation overexposure.

Digital Anthropometry: A Systematic Review on Precision, Reliability and Accuracy of Most Popular Existing Technologies

Digital anthropometry (DA) has been recently developed for body composition evaluation and for postural analysis. The aims of this review are to examine the current state of DA technology, as well as to verify the methods for identifying the best technology to be used in the field of DA by evaluating the reliability and accuracy of the available technologies on the market, and lay the groundwork for future technological developments. A literature search was performed and 28 studies met the inclusion criteria. The reliability and accuracy of DA was high in most studies, especially in the assessment of patients with obesity, although they varied according to the technology used; a good correlation was found between DA and conventional anthropometry (CA) and body composition estimates. DA is less time-consuming and less expensive and could be used as a screening tool before more expensive imaging techniques or as an alternative to other less affordable techniques. At present, DA could be useful in clinical practice, but the heterogeneity of the available studies (different devices used, laser technologies, population examined, etc.) necessitates caution in the interpretation of the obtained results. Furthermore, the need to develop integrated technologies for analyzing body composition according to multi-compartmental models is increasingly evident.

Acceptability and Experiences with the Use of 3D Scans to Measure Anthropometry of Young Children in Surveys and Surveillance Systems from the Perspective of Field Teams and Caregivers

Background

Portable systems using three-dimensional (3D) scan data to calculate young child anthropometry measurements in population-based surveys and surveillance systems lack acceptability data from field workers and caregivers.

Objective

The aim was to assess acceptability and experiences with 3D scans measuring child aged 0-59 mo anthropometry in population-based surveys and surveillance systems in Guatemala, Kenya, and China (0-23 mo only) among field teams and caregivers of young children as secondary objectives of an external effectiveness evaluation.

Methods

Manual data were collected twice and 12 images captured per child by anthropometrist/expert and assistant (AEA) field teams (individuals/country, n = 15/Guatemala, n = 8/Kenya, n = 6/China). Caregivers were interviewed after observing their child's manual and scan data collection. Mixed methods included an administered caregiver interview (Guatemala, n = 465; Kenya, n = 496; China, n = 297) and self-administered AEA questionnaire both with closed- and open-ended questions, and 6 field team focus group discussions (FGDs; Guatemala, n = 2; Kenya, n = 3; China, n = 1). Qualitative data were coded by 2 authors and quantitative data produced descriptive statistics. Mixed-method results were compared and triangulated.

Results

Most AEAs were female with secondary or higher education. Approximately 80-90% of caregivers were the child's mother. To collect all anthropometry data, 62.1% of the 29 AEAs preferred scan, while 31% preferred manual methods. In FGDs, a key barrier for manual and scan methods was lack of child cooperation. Across countries, approximately 30% to almost 50% of caregivers said their child was bothered by each manual and scan method, while ≥95% of caregivers were willing to have their child measured by scans in the future.

Conclusions

Use of 3D scans to calculate anthropometry measurements was generally at least as acceptable as manual anthropometry measurement among AEA field workers and caregivers of young children aged <60 mo, and in some cases preferred.

Surface topography index: a novel deformity severity assessment index for pectus excavatum

BACKGROUND

The surface topography index (STI) has great potential in both routine computed tomography (CT) scan and emerging optical imaging systems. However, the diagnostic accuracy and stability of the STI as a deformity severity assessment index has not been fully confirmed. Therefore, the aim of the present study was to determine the diagnostic performance of the STI as a novel deformity severity assessment index for pectus excavatum.

METHODS

The present study consisted of 722 chest CT images from a single center. The standard CT index (CTI) and STI were calculated for all patients. The between-group difference and the level of compliance between the CTI and STI was analyzed by t-test and Pearson correlation. The diagnostic value and optimum discriminatory values of the CTI and STI were calculated by a receiver-operating characteristic (ROC) curve and DeLong's test.

RESULTS

The distributions of the CTI and STI were similar and showed a slight overlap between the pectus excavatum (PE) and non-PE groups. Both the CTI and STI significantly differed between the 2 groups (P<0.001). The STI demonstrated a strong Pearson correlation with the CTI (r=0.91, 95% confidence interval: 0.88-0.91, P<0.001). The ROC curves showed that STI =1.58 (sensitivity: 0.93, specificity: 0.95) could be considered equivalent to CTI =2.72 (sensitivity: 0.93, specificity: 0.97) as the optimum discriminatory values. DeLong's test showed no significant difference in the ROC curve results between the CTI and STI (Z=0.90, P=0.37).

CONCLUSIONS

The STI has comparative discrimination ability in PE diagnosis and deformity severity assessment when used with the standard CTI. The STI as a novel index is not only an ideal evaluation metric of PE deformity but also an objective trait for PE patients just as weight and height for everyone.

Severe acute malnutrition morphological patterns in children under five

Current methods for infant and child nutritional assessment rely on anthropometric measurements, whose implementation faces technical challenges in low- and middle-income countries. Anthropometry is also limited to linear measurements, ignoring important body shape information related to health. This work proposes the use of 2D geometric morphometric techniques applied to a sample of Senegalese participants aged 6–59 months with an optimal nutritional condition or with severe acute malnutrition to address morphometric variations due to nutritional status. Significant differences in shape and size body changes were described according to nutritional status, resulting age, sex and allometric effect crucial factors to establish nutritional morphological patterns. The constructed discriminant functions exhibited the best classification rates in the left arm. A landmark-based template registering body shape could be useful to both assess acute malnutrition and better understand the morphological patterns that nutritional status promotes in children during their first 5 years of growth and development.

Total body and regional surface area: Quantification with low-cost three-dimensional optical imaging systems

OBJECTIVES

Body surface area (SA) is a widely used physical measure incorporated into multiple thermophysiology and evolutionary biology models currently estimated in humans either with empirical prediction equations or costly whole-body laser imaging systems. The introduction of low-cost 3D scanners provides a new opportunity to quantify total body (TB) and regional SA, although a critical question prevails: can these devices acquire the quality of depth information and process this initial data to form a mesh that has the fidelity needed to generate accurate SA estimates?

MATERIALS AND METHODS

This question was answered by comparing SA estimates calculated using images from four commercial 3D scanners in 108 adults to corresponding estimates acquired with a whole-body laser system. This was accomplished by processing initial mesh data from all devices, including the laser system, with the same universal software adapted specifically for repairing mesh gaps, identifying landmarks, and generating SA measurements.

RESULTS

TB SA measured on all four 3D scanners was highly correlated with corresponding laser system estimates (R² s, 0.98-0.99; all p < 0.001) with some small but significant mean differences (-0.19 to 0.06 m² ); root-mean square errors (RMSEs) were small (0.02-0.03 m² ); and significant bias was present for one device. Qualitatively similar results (e.g., R² s, 0.78-0.95; mean Δs, -0.05 to 0.02 m² ; RMSEs, 0.01-0.03 m² ) were present for trunk, arm, and leg SA comparisons.

DISCUSSION

The current study observations demonstrate that low-cost and practical 3D optical scanners are capable of accurately quantifying TB and regional SA, thus opening new opportunities for evaluating human phenotypes and related physiological characteristics.

Multiple measures derived from 3D photonic body scans improve predictions of fat and muscle mass in young Swiss men

INTRODUCTION

Digital tools like 3D laser-based photonic scanners, which can assess external anthropometric measurements for population based studies, and predict body composition, are gaining in importance. Here we focus on a) systematic deviation between manually determined and scanned standard measurements, b) differences regarding the strength of association between these standard measurements and body composition, and c) improving these predictions of body composition by considering additional scan measurements.

METHODS

We analysed 104 men aged 19-23. Bioelectrical Impedance Analysis was used to estimate whole body fat mass, visceral fat mass and skeletal muscle mass (SMM). For the 3D body scans, an Anthroscan VITUSbodyscan was used to automatically obtain 90 body shape measurements. Manual anthropometric measurements (height, weight, waist circumference) were also taken.

RESULTS

Scanned and manually measured height, waist circumference, waist-to-height-ratio, and BMI were strongly correlated (Spearman Rho>0.96), however we also found systematic differences. When these variables were used to predict body fat or muscle mass, explained variation and prediction standard errors were similar between scanned and manual measurements. The univariable predictions performed well for both visceral fat (r2 up to 0.92) and absolute fat mass (AFM, r2 up to 0.87) but not for SMM (r2 up to 0.54). Of the 90 body scanner measures used in the multivariable prediction models, belly circumference and middle hip circumference were the most important predictors of body fat content. Stepwise forward model selection using the AIC criterion showed that the best predictive power (r2 up to 0.99) was achieved with models including 49 scanner measurements.

CONCLUSION

The use of a 3D full body scanner produced results that strongly correlate to manually measured anthropometric measures. Predictions were improved substantially by including multiple measurements, which can only be obtained with a 3D body scanner, in the models.

Body height and waist circumference of young Swiss men as assessed by 3D laser-based photonic scans and by manual anthropometric measurements

Overweight and obesity are considered among the major health concerns worldwide. The body mass index is a frequently used measure for overweight and obesity and is associated with common non-communicable diseases such as diabetes type II, cardiovascular diseases and certain cancers. However, the body mass index does not account for the distribution of body fat and relative fat to muscle mass. 3D laser-based photonic full body scans provide detailed information on various body circumferences, surfaces, and volumes as well as body height and weight (using an integrated scale). In the literature, body scans showed good feasibility, reliability, and validity, while also demonstrating a good correlation with health parameters linked to the metabolic syndrome. However, systematic differences between body scan derived measurements and manual measurements remain an issue. This study aimed to assess these systematic differences for body height, waist circumference, and body mass index using cross-sectional data from a homogenous sample of 52 young Swiss male volunteers. In addition to 3D laser-based photonic full body scans and correlative manual measurements, body fat distribution was assessed through bioelectrical impedance analysis. Overall, an excellent correlation was found between measurements of waist circumference and body mass index, and good correlation between body mass index and total fat mass, as well as between waist circumference and visceral fat mass as assessed by bioelectrical impedance analysis. Volunteers were shorter in height measured by body scan when compared to manual measurements. This systematic difference became smaller when volunteers stood in the scanner in a completely upright position with their feet together. Waist circumference was slightly smaller for manual measurements than for body scan derived values. This systematic difference was larger in overweight volunteers compared to leaner volunteers.

Effects of dietary intake patterns from 1 to 4 years on BMI z-score and body shape at age of 6 years: a prospective birth cohort study from Brazil

PURPOSE

To assess the association between dietary intake patterns from 1 to 4 years and BMI and body shape at age of 6 years.

METHODS

This longitudinal study was based on 3374 Brazilian children from the 2004 Pelotas Birth Cohort Study. We used previously described dietary patterns from 1 to 4 years as the main exposure. We defined body shape using scores for corpulence (a recently described body shape component measured by Photonic Scanner), and trunk and gynoid fat mass percentage from DXA. We run linear regression models to evaluate the associations between dietary patterns from 1 to 4 years and BMI and body shape at 6 years.

RESULTS

Several apparent associations between dietary patterns and BMI or body shape were explained by sociodemographic factors. High adherence to snacks (positive loadings to coffee, bread and cookies) at 4 years predicted lower BMI, but higher gynoid fat mass percentage at 6 years, while higher adherence to staple at 2 years (positive loadings to rice and beans) predicted higher trunk fat mass and lower gynoid fat mass. Finally, higher scores on milks at 1 year (positive loading to breast milk) predicted higher gynoid fat mass at 6 years.

CONCLUSION

There were inconsistent associations between dietary patterns in infancy and early childhood and BMI and body shape at 6 years. In adjusted analyses, higher adherence to breast milk at 1 year and to snacks at 4 years appeared to be beneficial for body shape, associated with lower BMI, but higher peripheral fat.

A comparison of trunk circumference and width indices for hypertension and type 2 diabetes in a large-scale screening: a retrospective cross-sectional study

Anthropometric indices determine important risk factors for many chronic diseases. However, to date, no study has simultaneously analyzed the capabilities of trunk circumference and width indices to identify hypertension and type 2 diabetes in a large-scale screening study. The objectives of this study were to examine the associations of hypertension and - diabetes with circumference and width indices measured at the five identical positions (axillary, chest, rib, waist, and pelvic) and to compare the capabilities of circumference and width indices to identify the two diseases. Data were obtained from the Korean Health and Genome Epidemiology Study database. The associations and abilities of the circumference indices to identify diabetes were greater than those for hypertension. Overall, trunk circumference indices displayed stronger associations with and greater abilities to identify hypertension and diabetes than did trunk width indices at the five positions. In the comparative analysis between index pairs of circumference and width in patients with diabetes, significant differences were shown at all five positions and in the adjusted analysis of axillary, chest, rib, and pelvic positions. Therefore, width indices should not be used as an alternative indicator of type 2 diabetes in either men or women, except when measured at the waist.

The use of consumer depth cameras for 3D surface imaging of people with obesity: A feasibility study

OBJECTIVE

Three dimensional (3D) surface imaging is a viable alternative to traditional body morphology measures, but the feasibility of using this technique with people with obesity has not been fully established. Therefore, the aim of this study was to investigate the validity, repeatability and acceptability of a consumer depth camera 3D surface imaging system in imaging people with obesity.

METHODS

The concurrent validity of the depth camera based system was investigated by comparing measures of mid-trunk volume to a gold-standard. The repeatability and acceptability of the depth camera system was assessed in people with obesity at a clinic.

RESULTS

There was evidence of a fixed systematic difference between the depth camera system and the gold standard but excellent correlation between volume estimates (r²=0.997), with little evidence of proportional bias. The depth camera system was highly repeatable - low typical error (0.192L), high intraclass correlation coefficient (>0.999) and low technical error of measurement (0.64%). Depth camera based 3D surface imaging was also acceptable to people with obesity.

CONCLUSION

It is feasible (valid, repeatable and acceptable) to use a low cost, flexible 3D surface imaging system to monitor the body size and shape of people with obesity in a clinical setting.

Validity and intraobserver reliability of three-dimensional scanning compared with conventional anthropometry for children and adolescents from a population-based cohort study

BACKGROUND

Conventional anthropometric measurements are time consuming and require well trained medical staff. To use three-dimensional whole body laser scanning in daily clinical work, validity, and reliability have to be confirmed.

METHODS

We compared a whole body laser scanner with conventional anthropometry in a group of 473 children and adolescents from the Leipzig Research Centre for Civilization Diseases (LIFE-Child). Concordance correlation coefficients (CCC) were calculated separately for sex, weight, and age to assess validity. Overall CCC (OCCC) was used to analyze intraobserver reliability.

RESULTS

Body height and the circumferences of waist, hip, upper arm, and calf had an "excellent" (CCC ≥ 0.9); neck and thigh circumference, a "good" (CCC ≥ 0.7); and head circumference, a "low" (CCC < 0.5) degree of concordance over the complete study population. We observed dependencies of validity on sex, weight, and age. Intraobserver reliability of both techniques is "excellent" (OCCC ≥ 0.9).

CONCLUSION

Scanning is faster, requires less intensive staff training and provides more information. It can be used in an epidemiologic setting with children and adolescents but some measurements should be considered with caution due to reduced agreement with conventional anthropometry.

Comparison of 3D laser-based photonic scans and manual anthropometric measurements of body size and shape in a validation study of 123 young Swiss men

Background

Manual anthropometric measurements are time-consuming and challenging to perform within acceptable intra- and inter-individual error margins in large studies. Three-dimensional (3D) laser body scanners provide a fast and precise alternative: within a few seconds the system produces a 3D image of the body topography and calculates some 150 standardised body size measurements.

Objective

The aim was to enhance the small number of existing validation studies and compare scan and manual techniques based on five selected measurements. We assessed the agreement between two repeated measurements within the two methods, analysed the direct agreement between the two methods, and explored the differences between the techniques when used in regressions assessing the effect of health related determinants on body shape indices.

Methods

We performed two repeated body scans on 123 volunteering young men using a Vitus Smart XXL body scanner. We manually measured height, waist, hip, buttock, and chest circumferences twice for each participant according to the WHO guidelines. The participants also filled in a basic questionnaire.

Results

Mean differences between the two scan measurements were smaller than between the two manual measurements, and precision as well as intra-class correlation coefficients were higher. Both techniques were strongly correlated. When comparing means between both techniques we found significant differences: Height was systematically shorter by 2.1 cm, whereas waist, hip and bust circumference measurements were larger in the scans by 1.17–4.37 cm. In consequence, body shape indices also became larger and the prevalence of overweight was greater when calculated from the scans. Between 4.1% and 7.3% of the probands changed risk category from normal to overweight when classified based on the scans. However, when employing regression analyses the two measurement techniques resulted in very similar coefficients, confidence intervals, and p-values.

Conclusion

For performing a large number of measurements in a large group of probands in a short time, body scans generally showed good feasibility, reliability, and validity in comparison to manual measurements. The systematic differences between the methods may result from their technical nature (contact vs. non-contact).

Reliability of 3D laser-based anthropometry and comparison with classical anthropometry

Anthropometric quantities are widely used in epidemiologic research as possible confounders, risk factors, or outcomes. 3D laser-based body scans (BS) allow evaluation of dozens of quantities in short time with minimal physical contact between observers and probands. The aim of this study was to compare BS with classical manual anthropometric (CA) assessments with respect to feasibility, reliability, and validity. We performed a study on 108 individuals with multiple measurements of BS and CA to estimate intra- and inter-rater reliabilities for both. We suggested BS equivalents of CA measurements and determined validity of BS considering CA the gold standard. Throughout the study, the overall concordance correlation coefficient (OCCC) was chosen as indicator of agreement. BS was slightly more time consuming but better accepted than CA. For CA, OCCCs for intra- and inter-rater reliability were greater than 0.8 for all nine quantities studied. For BS, 9 of 154 quantities showed reliabilities below 0.7. BS proxies for CA measurements showed good agreement (minimum OCCC > 0.77) after offset correction. Thigh length showed higher reliability in BS while upper arm length showed higher reliability in CA. Except for these issues, reliabilities of CA measurements and their BS equivalents were comparable.

Body shape and size in 6-year old children: assessment by three-dimensional photonic scanning

Background:

Body shape and size are typically described using measures such as body mass index (BMI) and waist circumference, which predict disease risks in adults. However, this approach may underestimate the true variability in childhood body shape and size.

Objective:

To use a comprehensive three-dimensional photonic scan approach to describe variation in childhood body shape and size.

Subjects/Methods:

At age 6 years, 3350 children from the population-based 2004 Pelotas birth cohort study were assessed by three-dimensional photonic scanner, traditional anthropometry and dual X-ray absorptiometry. Principal component analysis (PCA) was performed on height and 24 photonic scan variables (circumferences, lengths/widths, volumes and surface areas).

Results:

PCA identified four independent components of children's body shape and size, which we termed: Corpulence, Central:peripheral ratio, Height and arm lengths, and Shoulder diameter. Corpulence showed strong correlations with traditional anthropometric and body composition measures (r>0.90 with weight, BMI, waist circumference and fat mass; r>0.70 with height, lean mass and bone mass); in contrast, the other three components showed weak or moderate correlations with those measures (all r<0.45). There was no sex difference in Corpulence, but boys had higher Central:peripheral ratio, Height and arm lengths and Shoulder diameter values than girls. Furthermore, children with low birth weight had lower Corpulence and Height and arm lengths but higher Central:peripheral ratio and Shoulder diameter than other children. Children from high socio-economic position (SEP) families had higher Corpulence and Height and arm lengths than other children. Finally, white children had higher Corpulence and Central:peripheral ratio than mixed or black children.

Conclusions:

Comprehensive assessment by three-dimensional photonic scanning identified components of childhood body shape and size not captured by traditional anthropometry or body composition measures. Differences in these novel components by sex, birth weight, SEP and skin colour may indicate their potential relevance to disease risks.

Lung function in children in relation to ethnicity, physique and socioeconomic factors

Can ethnic differences in spirometry be attributed to differences in physique and socioeconomic factors?Assessments were undertaken in 2171 London primary schoolchildren on two occasions 1 year apart, whenever possible, as part of the Size and Lung function In Children (SLIC) study. Measurements included spirometry, detailed anthropometry, three-dimensional photonic scanning for regional body shape, body composition, information on ethnic ancestry, birth and respiratory history, socioeconomic circumstances, and tobacco smoke exposure.Technically acceptable spirometry was obtained from 1901 children (mean (range) age 8.3 (5.2-11.8) years, 46% boys, 35% White, 29% Black-African origin, 24% South-Asian, 12% Other/mixed) on 2767 test occasions. After adjusting for sex, age and height, forced expiratory volume in 1 s was 1.32, 0.89 and 0.51 z-score units lower in Black-African origin, South-Asian and Other/mixed ethnicity children, respectively, when compared with White children, with similar decrements for forced vital capacity (p<0.001 for all). Although further adjustment for sitting height and chest width reduced differences attributable to ethnicity by up to 16%, significant differences persisted after adjusting for all potential determinants, including socioeconomic circumstances.Ethnic differences in spirometric lung function persist despite adjusting for a wide range of potential determinants, including body physique and socioeconomic circumstances, emphasising the need to use ethnic-specific equations when interpreting results.