MULTIMODAL IMAGING TECHNIQUES IN SPORTS

Faculty of Exercise and Sport Science University of Verona MULTIMODAL IMAGING TECHNIQUES IN SPORTS Valentina Cavedon1,2,3, Francesco Piscitelli1,2,3, Christian Lovato2,3, Chiara Milanese1,2, Andrea Giachetti4,5, Carlo Zancanaro1,2,3 1 Faculty of Exercise and Sport Science, University of Verona, Italy 2 Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy 3 Doctoral program in Multimodal Imaging in Biomedicine, University of Verona, Italy. 4 Faculty of Education Sciences, University of Verona, Italy 5 Department of Computer Science, University of Verona, Italy Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona Introduction Anthropometry and body composition analysis have been largely applied in scientific research to identify different subgroups within a certain population. Moreover anthropometry and body composition analysis is frequently carried out in sport to assess changes in physiological status. Recent progress in both fields is changing the way these study are performed and open a lot of new possibilities. This study explored the opportunity of using multimodal imaging techniquesnamely, DXA and 3D body scanning, to simultaneously assess body composition and anthropometry in humans for application in sports science. Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona Materials & Methods DXA: dual-energy X-ray absorptiometry, currently represents the gold standard to estimate body composition (fat mass, lean mass, and bone mineral density) “…DXA was designed to measure bone mass and has been shown to be both accurate and precise when used for this purpose. However, DXA is increasingly being used to measure BC… Future research is needed to investigate the application of DXA in different fields (chronic diseases and sport medicine). DXA offers a quick and easy assessment of body fat, lean mass and BMD and is considered superior to many other methods. It is often used in clinical settings, as well as to compare various BC methods for assessing body fat in overweight and obese children…” # Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona The radiation received by the patient during the scan is less than that of an airline flight from California to New York and back. http://www.radiologyinfo.org/en/safety/index.cfm?pg=sfty_xray#part3 “…In conclusion, BC assessments by DXA are readily available, less expensive and less invasive compared with other diagnostic imaging techniques, such as MRI and CT. Scanning times… have decreased substantially with newer technology. DXA is a simple, safe and precise technique that can measure BMD and soft-tissue composition not only in the whole body but also in specific regions of the body. This makes it an important tool not only for assessing and managing osteoporosis, but also for studying how soft tissue composition changes in healthy and disease conditions...” # # Andreoli A. et al (2009) Body composition assessment by dual-energy X-ray absorptiometry (DXA). RadiolMed. 114:286-300 Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona Anthropometry is becoming fully digital: 3D body scanner can now acquire very accurate models of human subjects, allowing automatic or computer assisted measurement of body lengths, breadths, widths, diameters, volume and surface area. “…Three-dimensional (3D) whole-body scanning has recently been used in several large anthropometric surveys of military personnel and the general population, but has yet to be applied to athletes. Previously, only traditional anthropometric measurement techniques and equipment (e.g. girth tapes, stadiometers, etc.) have been used in anthropometric surveysofathletes…” * Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona “…Three-dimensionalwhole-bodyscanning uses… white light projected onto the body with the reflection captured by cameras as a series of points (typically between 500,000 and one million) with XYZ coordinates. Measurements can then be extracted from the scans usingmeasurementextractionsoftware…” * Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona “…they do offerseveraladvantages over traditional anthropometric measurement techniques that make them very attractive for athlete surveys. First, they allow for the capture of surface anthropometric data in a more time-efficient and non-invasive manner, making in-competition measurement more feasible. Second, they greatly expand the range of anthropometric dimensions for which data can be collected. Third, they provide an historical record of the anthropometry of an athlete at a given point in time, one that can be reassessed at any time without the need for the individual to be present…” * * Schranz N. et al. Three-dimensional anthropometric analysis: Differences between elite Australian rowers and the general population. Journal ofSportsSciences. (2010) 28(5):459-469 Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona The first AIM ofourresearchwasto compare measurements obtained with standard tape-based procedures with similar ones simulated with a custom made software tool on the digital models, obtaining comparable results for most of the analyzed measures. A sample of 12 subjects (6 male and 6 female), students at the University of Verona, were enrolled in this study. A set of 28 anthropometric measures was performed on each subject. Body sites were marked previously using a dermographic pen. Measurement were performed twice by one experienced anthropometristin accordancewith the protocolsoutlined in Lohmanet al. (1988). Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona All participants were then positioned in the standard pose in the center of the scanner over a mark on the floor. They were instructed to hold their breath (at end-tidal expiration) for the duration of the 5.5 s scan. All participants were scanned twice. Digital measurements were performed in two different occasion by 3 different anthropometrist ( 1 experienced antropometrist and 2 naives anthropometrists). Measurements were conducted on 3D images of subjects using a dedicated software on a VTK library. Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona Results Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona Results Comparison of item measurements taken by the experienced anthropometrist and any naive anthropometrists in the digital mode showed that digital anthropometry allows for accurate and reproducible measurements also when operators lack specific training. Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona The second research approach aims at developing a totally automatic analysis of body shape in order to obtain measurements from raw scanner data. Given the great amount of data made available by the body scanning technology, developing viable, automatic and robust procedures is essential. Computational geometry tools like remeshing and skeletonization algorithms, etc. have been applied to analyze the models and automatically extract from them shape parameters independently on pose variations and with sufficient robustness against acquisition noise or holes. Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona Being these parameters not directly comparable with tape-based methods, a possible validation approach we are testing is related to a direct correlation of the measurements with body composition data acquired with the DXA scanner. Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona In a preliminary study (25 obese woman, Age 30-50 years, BMI 30÷40) we found that several automatically extracted body measurements (obtained in the abdominal region) are highly correlated with trunk fat (r≥0.9 with maximum Anterior-Posterior diameter, maximum Mean Diameter and maximum of slice Area) Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona and total body fat (r=0.76 with maximum Anterior-Posterior diameter, r=0.89 with maximum Mean Diameter, r=0.88 with maximum of slice Area). Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Faculty of Exercise and Sport Science University of Verona The current results suggest thatresearchers and sportsscientists should take into account the new generation of 3D devices to perform anthropometric and body composition analysis. Clearly, further research with more subjects is warranted to verify these results and develop appropriate recommendations for application in sports science. Moreover future anthropometric surveys and talent identification programs should include 3D anthropometry analysis in their basic physical-based testing when recruiting potential athletes, as it may provide better markers for potential elite competitors. Laboratory of Anthropometry and Body Composition, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

MULTIMODAL IMAGING TECHNIQUES IN SPORTS