{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T11:50:20Z","timestamp":1770465020723,"version":"3.49.0"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:00:00Z","timestamp":1702339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Anatomy"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>There is a growing interest in muscle characteristics of the lumbar multifidus related to low back pain, but findings between studies are inconsistent. One of the issues explaining these conflicting findings might be the use of two\u2010dimensional measures of cross\u2010sectional area and thickness of the lumbar multifidus in most studies, which might be a suboptimal representation of the entire muscle volume. A three\u2010dimensional volumetric assessment, combined with standardized imaging and processing measurement protocols, is highly recommended to quantify spinal muscle morphology. Three\u2010dimensional freehand ultrasonography is a technique with large potential for daily clinical practice. It is achieved by combining conventional two\u2010dimensional ultrasound with a motion\u2010tracking system, recording the position and orientation of the ultrasound transducer during acquisition, resulting in a three\u2010dimensional reconstruction. This study investigates intra\u2010 and interprocessor reliability for the quantification of muscle volume of the lumbar multifidus based on three\u2010dimensional freehand ultrasound and its validity, in 31 patients with low back pain and 20 healthy subjects. Two processors manually segmented the lumbar multifidus on three\u2010dimensional freehand ultrasound images using Stradwin software following a well\u2010defined method. We assessed the concurrent validity of the measurement of multifidus muscle volume using three\u2010dimensional freehand ultrasound compared with magnetic resonance imaging in 10 patients with low back pain. Processing reliability and agreement were determined using intraclass correlation coefficients, Bland\u2013Altman plots, and calculation of the standard error of measurement and minimal detectable change, while validity was defined based on correlation analysis. The processing of three\u2010dimensional freehand ultrasound images to measure lumbar multifidus volume was reliable. Good to excellent intraclass correlation coefficients were found for intraprocessor reliability. For interprocessor reliability, the intraclass correlation coefficients were moderate to good, emphasizing the importance of processing guidelines and training. A single processor analysis is preferred in clinical studies or when small differences in muscle volume are expected. The correlation between magnetic resonance imaging and three\u2010dimensional freehand ultrasound measurements of lumbar multifidus volume was moderate to good but with a systematically smaller multifidus volume measured on three\u2010dimensional freehand ultrasound. These results provide opportunities for both researchers and clinicians to reliably assess muscle structure using three\u2010dimensional freehand ultrasound in patients with low back pain and to monitor changes related to pathology or interventions. To allow implementation in both research and clinical settings, guidelines on three\u2010dimensional freehand ultrasound processing and training were provided.<\/jats:p>","DOI":"10.1111\/joa.13988","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T05:59:26Z","timestamp":1702447166000},"page":"601-609","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["<scp>Three\u2010dimensional<\/scp> freehand ultrasonography to measure muscle volume of the lumbar multifidus: Reliability of processing technique and validity through comparison to magnetic resonance imaging"],"prefix":"10.1111","volume":"244","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6276-125X","authenticated-orcid":false,"given":"Sofie","family":"Rummens","sequence":"first","affiliation":[{"name":"Department of Development and Regeneration KU Leuven \u2013 University of Leuven  Leuven Belgium"},{"name":"Department of 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