Clinical Nutrition Open Science 50 (2023) 40e45

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Clinical Nutrition Open Science

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Short Communication

Improved precision of 3-dimensional optical imaging for

anthropometric measurement using non-rigid avatar
reconstruction and parameterized body model fitting
Grant M. Tinsley a, *, Patrick S. Harty a, b, Madelin R. Siedler a,
Matthew T. Stratton a, c, Christian Rodriguez a
a
Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock,
TX, USA
b
Department of Kinesiology, College of Science, Technology and Health, Lindenwood University, St. Charles, MO, USA
c
Department of Health, Kinesiology and Sport, University of South Alabama, Mobile, AL, USA

a r t i c l e i n f o s u m m a r y

Article history: Background: Three-dimensional optical imaging for digital

Received 25 May 2023 anthropometry and body composition estimation is increasingly
Accepted 13 July 2023 available to health professionals and individual consumers. The
Available online 18 July 2023
purpose of the present analysis was to examine the precision of a
scanner that employs non-rigid avatar reconstruction and
Keywords:
parameterized body model fitting.
3D scanning
Methods: Sixty-nine healthy adults (37 F, 32 M; [mean ±SD] age:
Anthropometry
Body composition 24.1±5.5 y; height: 169.2±13.9 cm; BMI: 26.0±5.2 kg/m2) were
Body fat evaluated through duplicate scans using a second-generation
Waist circumference prototype three-dimensional optical scanner. Test-retest preci-
sion was established using the intraclass correlation coefficient
(ICC), root-mean-square coefficient of variation (RMS-%CV), pre-
cision error (PE), and least significant change.
Results: Across 21 non-ankle body circumferences, PE ranged from
0.4 to 0.8 cm, RMS-%CV ranged from 0.4 to 1.4%, and ICC values
were 0.975e0.999. Compared to the first-generation scanner (PE:
0.8e1.0 cm; RMS-%CV: 0.8e1.2%), the errors of waist and hip cir-
cumferences were reduced by half (PE: 0.4e0.5 cm, RMS-%CV: 0.4
e0.6%). Estimated body fat percentage also demonstrated very
high reliability (PE: 0.2%, RMS-%CV: 0.7%, ICC: 0.999).
Conclusions: These findings support the improved precision of a
second-generation scanner reconstructing a non-rigid avatar

* Corresponding author. 3204 Main Street, Texas Tech University, Lubbock, TX 79409, USA.
E-mail address: grant.tinsley@ttu.edu (G.M. Tinsley).

https://doi.org/10.1016/j.nutos.2023.07.002
2667-2685/© 2023 The Author(s). Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism. This
is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
G.M. Tinsley, P.S. Harty, M.R. Siedler et al. Clinical Nutrition Open Science 50 (2023) 40e45

subject and parameterized body model fitting and demonstrate

the low measurement error that is achievable with this technology.
© 2023 The Author(s). Published by Elsevier Ltd on behalf of
European Society for Clinical Nutrition and Metabolism. This is an
open access article under the CC BY license (http://
creativecommons.org/licenses/by/4.0/).

Introduction

Three-dimensional optical imaging for digital anthropometry and body composition applications is
increasingly available to health professionals and individual consumers [1]. While a growing number of
investigations have reported the performance of specific commercially available scanners or phone
applications [2e5], the method-specific nature of these technologies necessitates continual evaluation
and refinement of hardware and software features [6].
We previously reported the precision of four commercially available three-dimensional optical
imaging technologies, including a first-generation at-home scanner [7]. This scanner employed three
assisted stereo sensors and structured light technology to capture and locally process light information
from subjects who were rotated on a motorized turntable while standing rigid. Since that time, this
technology has been redeveloped as a second-generation scanner using a single sensor and time-of-
flight scanning technology to capture light information from subjects rotating themselves in place
on any flooring. In contrast to the first-generation scanner, in which the subject was assumed to be
rigid during reconstruction of avatars, the second-generation scanner employs fully non-rigid recon-
struction of avatars. The purpose of the present analysis was to examine the precision of the second-
generation scanner and compare the performance to the first-generation scanner [7].

Materials and methods

Sixty-nine healthy adults were evaluated (37 F, 32 M; 46 non-Hispanic White, 13 Hispanic, 5 non-
Hispanic Black, 5 Asian; [mean ±SD] age: 24.1±5.5 y; height: 169.2±13.9 cm; BMI: 26.0±5.2 kg/m2).
Multiple scans were performed using the second-generation prototype scanner (Prism Labs, Inc., Los
Angeles, CA, USA). Each scan involved the participant rotating in place approximately 1.7 meters in
front of the scanner. Following each scan, advanced machine learning procedures were used to pre-
process data through binary segmentation and obtaining frame-to-frame correspondences. A
parameterized body model was fitted to each avatar produced by fully non-rigid reconstruction to
normalize the avatar's pose to a canonical pose and ensure consistent measurement locations
(Figures 1-2). Additionally, body fat percentage was estimated through a proprietary algorithm using
avatar measurements. Data from the first two consecutive scans for each participant were used in the
present analysis. This data collection was approved by the Texas Tech University Institutional Review
Board (IRB2021-198). All participants read and signed the university-approved informed consent
document prior to participation.
Test-retest precision was established using the intraclass correlation coefficient (ICC; model 2,1),
root-mean-square coefficient of variation (RMS-%CV; i.e., the relative technical error of measurement),
precision error (PE; i.e., the absolute technical error of measurement), and least significant change
(LSC; i.e., 2.77  PE). The maximum absolute difference (i.e., absolute value of largest between-scan
difference observed in the entire dataset) was also evaluated. Data were analyzed using R (v. 4.1.2).

Results

Across all 23 body circumferences, PE values were 0.8 cm, with corresponding LSC values 1.6 cm
(Table 1). Except for ankle circumferences, which demonstrated slightly higher relative errors, all sites
exhibited ICC values >0.97 and RMS-%CV <1.5%. Maximum absolute differences between scans were
2.5 cm, except for the upper chest measurement, which demonstrated a slightly higher value of 3.9 cm.

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G.M. Tinsley, P.S. Harty, M.R. Siedler et al. Clinical Nutrition Open Science 50 (2023) 40e45

Figure 1. Avatars from 3-Dimensional Optical Imaging. Representative avatars from the first-generation scanner (A), second-
generation scanner (B), and second-generation scanner after normalization to a canonical pose (C) are displayed.

The waist-to-hip ratio was calculated for each scan, with high reliability observed between scans
(ICC: 0.995, RMS-%CV: 0.6%, PE: 0.005 arbitrary units (au), LSC: 0.01 au, maximum absolute difference:
0.02 au). Body fat percentage estimates also demonstrated high reliability (ICC: 0.999, RMS-%CV: 0.7%,
PE: 0.2%, LSC: 0.6%, maximum absolute difference: 0.8%).

Figure 2. Circumference Sites. Lines displayed on the avatars correspond to the measurement sites evaluated in the present study.

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G.M. Tinsley, P.S. Harty, M.R. Siedler et al. Clinical Nutrition Open Science 50 (2023) 40e45

Table 1
Precision of circumference measurements

Circumferencea Mean SD PE RMS- ICC LSC MAD

(cm) (cm) (cm) %CV (cm) (cm)

Ankle (Left) 22.7 1.1 0.4 1.6 0.898 1.0 1.1

Ankle (Right) 22.9 1.0 0.5 2.2 0.761 1.4 2.0
Arm (Left, Lower) 27.5 3.3 0.4 1.3 0.988 1.0 1.5
Arm (Right, Lower) 28.6 3.4 0.4 1.4 0.986 1.1 1.8
Calf (Left) 38.2 2.5 0.4 1.1 0.975 1.1 1.4
Calf (Right) 38.5 2.5 0.4 0.9 0.980 1.0 1.3
Chest 98.7 11.2 0.6 0.6 0.997 1.6 2.5
Chest (Lower) 90.0 11.9 0.5 0.6 0.998 1.4 2.0
Chest (Upper) 103.0 10.9 0.8 0.8 0.995 2.2 3.9
Hip 105.5 9.7 0.4 0.4 0.998 1.2 1.6
Lower Thigh (Left) 48.7 4.3 0.4 0.9 0.991 1.2 2.1
Lower Thigh (Right) 48.7 4.5 0.6 1.2 0.983 1.6 2.0
Mid Arm (Left) 29.5 4.0 0.4 1.3 0.991 1.1 1.3
Mid Arm (Right) 30.7 4.2 0.4 1.4 0.989 1.2 1.8
Neck 40.1 4.7 0.4 1.0 0.993 1.1 1.3
Shoulder 116.3 10.7 0.4 0.4 0.998 1.2 2.2
Stomach 91.0 13.5 0.4 0.5 0.999 1.2 1.3
Thigh (Left) 61.2 5.5 0.4 0.6 0.995 1.1 1.3
Thigh (Right) 61.1 5.6 0.5 0.9 0.991 1.5 1.9
Upper Thigh (Left) 67.9 5.8 0.4 0.6 0.994 1.2 1.9
Upper Thigh (Right) 67.8 5.9 0.6 0.9 0.990 1.6 2.1
Waist 85.1 13.2 0.5 0.6 0.999 1.4 1.7
Waist (Navy) 85.4 12.6 0.5 0.6 0.999 1.3 2.0

Abbreviations: PE e precision error, RMS-%CV e root-mean-square coefficient of variation, ICC e intraclass correlation coeffi-
cient (model 2,1), LSC e least significant change, MAD e maximum absolute difference.
a
Refer to Figure 1 for measurement locations.

Discussion

We previously established precision of the first-generation scanner in 179 healthy adults, within the
same laboratory used in the present investigation and using the same statistical procedures [7]. Several
measurement sites are shared between the first- and second-generation scanners e including cir-
cumferences of the arms, chest, hip, neck, thighs, and waist e which allowed for direct comparison of
scanner performance. As compared to the first-generation scanner, nearly all PE and RMS-%CV values
were reduced with the second-generation scanner. Additionally, all ICC values were higher for the
second-generation scanner. For the shared measurement sites, the first-generation scanner's PE values
ranged from 0.5 to 1.0 cm, RMS-%CV values ranged from 0.7 to 1.6%, and ICC values ranged from 0.983 to
0.995 [7]. In comparison, values for the second-generation scanner ranged from 0.4 to 0.6 cm (PE),
0.4e1.4% (RMS-%CV), and 0.989 to 0.999 (ICC).
The largest magnitude of improvement was seen for waist and hip circumferences, both of which
demonstrated half the magnitude of error with the second-generation scanner (waist: PE of 0.5 cm,
RMS-%CV of 0.6%; hip: PE of 0.4 cm, RMS-%CV of 0.4%) as compared to the first-generation scanner
(waist: PE of 1.0 cm, RMS-%CV of 1.2%; hip: PE of 0.8 cm, RMS-%CV of 0.8%). These improvements are
particularly notable due to the clinical importance of these circumferences, either as standalone
metrics or through joint use as the waist-to-hip ratio. Both waist circumference and waist-to-hip ratio
are positively associated with the risk of cardiovascular events and have been recommended as part of
cardiovascular disease risk assessments [8,9]. The notable reduction in error when assessing these
metrics with the second-generation scanner in the present study demonstrates the promise of evolving
3-dimensional imaging technologies for risk assessment and health monitoring [10].
While both hardware and software advances may have contributed to the improved precision of
circumference estimates observed in the present analysis, the procedures to obtain circumferences
from body avatars deserve particular attention. The first-generation scanner obtained all circumference
measurements directly from the reconstructed avatar without normalization procedures. In contrast,

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G.M. Tinsley, P.S. Harty, M.R. Siedler et al. Clinical Nutrition Open Science 50 (2023) 40e45

the second-generation scanner obtained measurements from the avatar normalized to a canonical
pose using a parameterized body model to ensure consistent measurement locations. The precision
improvements are also particularly noteworthy due to the non-rigid nature of the subjects during data
collection with the second-generation scanner, as compared to the relatively rigid nature of the sub-
jects during first-generation scans due to the utilization of a turntable.
Three-dimensional optical imaging has emerged as a promising technology for high-precision
estimation of anthropometric variables and subsequent estimation of body composition. Due to the
rapid evolution of hardware and software, continual evaluation is needed to verify putative techno-
logical improvements. The present study supports the improved precision of a second-generation
scanner utilizing non-rigid avatar reconstruction and parameterized body model fitting and demon-
strates the low measurement error that can be achieved with appropriate scanning and data analysis
procedures. As scanning technologies continue to mature, their potential utility in clinical practice and
mobile health applications should be recognized and leveraged to promote appropriate health
monitoring.

Statement of authorship

GMT and PSH designed the study; PSH, MRS, MTS, and CR collected the data; GMT analyzed the data
and wrote the manuscript; all authors reviewed and approved the final manuscript.

Funding sources

This research was financially supported in part by the Texas Chapter of the American College of
Sports Medicine. This sponsor played no role in the study design, data collection and analysis, or
manuscript preparation. A non-monetary research contract between the manufacturer of the three-
dimensional scanner used in the present analysis (Prism Labs, Inc.; contract number: C18221) and
Texas Tech University allowed for use of the prototype scanner and exchange of de-identified data.
Besides confirming the technical description of the scanning technology, the manufacturer played no
role in the present manuscript, including the statistical analysis, writing, and decision to publish.

Declaration of competing interest

The authors declare the following financial interests/personal relationships which may be
considered as potential competing interests: GMT has received in-kind support for his research lab-
oratory, in the form of equipment loan or donation, from manufacturers of body composition
assessment devices, including Size Stream LLC; Naked Labs, Inc.; Prism Labs, Inc.; RJL Systems;
MuscleSound; and Biospace, Inc. Separate from the present project, he has received a research grant
from the manufacturer of the scanner used in the present study (Prism Labs, Inc.; award number:
22e1034).

Acknowledgements

The authors wish to acknowledge Dale Keith, Jacob Green, Jake Boykin, Sarah White, Brielle
DeHaven, Ethan Tinoco, and Alex Brojanac for their assistance with data collection. The authors also
wish to acknowledge the personnel of Prism Labs, Inc. for technical support for the three-dimensional
scanner used in the present study.

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