Preprint · Jul 8, 2026
Beyond muscle size: The additive value of ultrasound-derived echogenicity and texture as a biomarker of age-related physical function differences
By Oranchuk DJ, Milner J, Harris‐Love MO
Ultrasound-derived measures of muscle thickness and echogenicity are increasingly used to assess skeletal muscle size and quality; however, comparatively little is known about the reliability and physiological relevance of newer ultrasound texture features. This study will examine the test-retest reliability of ultrasound-derived muscle thickness, corrected echogenicity, and Grey-Level Co-occurrence Matrix (GLCM) texture features in the quadriceps and forearm flexor muscles of healthy younger and older adults while evaluating the influence of imaging orientation and anatomical location. The study will additionally investigate age-related differences in muscle morphology and quality and examine associations between ultrasound-derived muscle characteristics, muscle strength, rapid force production, physical function, and body composition. Hierarchical regression analyses will determine whether texture features provide additional explanatory value beyond conventional ultrasound measures. Establishing reliable imaging protocols and evaluating the clinical relevance of ultrasound texture analysis will support its broader application in aging research, rehabilitation, and future studies of sarcopenia and musculoskeletal health.