Digital obstructive arterial disease can be detected by laser Doppler measurements with high sensitivity and specificity

Guillaume Mahe, David A. Liedl, Charlene McCarter, Roger Shepherd, Peter Gloviczki, Ian R. McPhail, Thom W Rooke, Paul W. Wennberg

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective This study was conducted to determine the sensitivity and specificity of laser Doppler flowmetry (LDF) measurements for digital obstructive arterial disease (DOAD) using angiography as the reference standard and to compare the accuracy of different classical tests used to assess DOAD. Diagnosis of vascular abnormalities at the digital level is challenging. Angiography is the gold standard for assessment of DOAD but is invasive and expensive to perform. Methods We performed a retrospective analysis of consecutive patients referred at Mayo Clinic (Rochester, Minn) for upper extremity arterial assessment during a 27-month period. Finger-brachial index, skin blood flow (in arbitrary units [a.u.]), and skin temperature (in degrees Celsius) were recorded in each digit on the pulp at baseline and after a thermal challenge test (hand placed in a thermal box at 47.0 C for 15 minutes). Angiogram analysis was blinded and performed by a radiologist using a vascularization scale ranging from 0 (no vessel) to 4 (normal). The receiver operating characteristic curve was used to define a specific cutoff point to detect DOAD. Twenty-two patients had LDF measurements and complete angiograms. Results A total of 185 digits were analyzed because some patients had only analysis of one hand. The best area under the curve (AUC) was 0.98 (range, 0.94-0.99) for postwarming skin blood flow, with a cutoff point of ≤206 a.u. This AUC was statistically different from AUCs of all the other tests (P <.01). Sensitivity and specificity were 93% (95% confidence interval, 85%-97%) and 96% (95% confidence interval, 90%-99%), respectively. Conclusions LDF combined with a thermal challenge is highly accurate, safe, and noninvasive means to detect DOAD.

Original languageEnglish (US)
JournalJournal of Vascular Surgery
Volume59
Issue number4
DOIs
StatePublished - 2014

Fingerprint

Arterial Occlusive Diseases
Lasers
Laser-Doppler Flowmetry
Angiography
Sensitivity and Specificity
Area Under Curve
Hot Temperature
Hand
Confidence Intervals
Skin
Skin Temperature
Upper Extremity
ROC Curve
Fingers
Blood Vessels
Arm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Digital obstructive arterial disease can be detected by laser Doppler measurements with high sensitivity and specificity. / Mahe, Guillaume; Liedl, David A.; McCarter, Charlene; Shepherd, Roger; Gloviczki, Peter; McPhail, Ian R.; Rooke, Thom W; Wennberg, Paul W.

In: Journal of Vascular Surgery, Vol. 59, No. 4, 2014.

Research output: Contribution to journalArticle

Mahe, Guillaume ; Liedl, David A. ; McCarter, Charlene ; Shepherd, Roger ; Gloviczki, Peter ; McPhail, Ian R. ; Rooke, Thom W ; Wennberg, Paul W. / Digital obstructive arterial disease can be detected by laser Doppler measurements with high sensitivity and specificity. In: Journal of Vascular Surgery. 2014 ; Vol. 59, No. 4.
@article{ac3e76a63272470bbb3bc4df43d4dbc0,
title = "Digital obstructive arterial disease can be detected by laser Doppler measurements with high sensitivity and specificity",
abstract = "Objective This study was conducted to determine the sensitivity and specificity of laser Doppler flowmetry (LDF) measurements for digital obstructive arterial disease (DOAD) using angiography as the reference standard and to compare the accuracy of different classical tests used to assess DOAD. Diagnosis of vascular abnormalities at the digital level is challenging. Angiography is the gold standard for assessment of DOAD but is invasive and expensive to perform. Methods We performed a retrospective analysis of consecutive patients referred at Mayo Clinic (Rochester, Minn) for upper extremity arterial assessment during a 27-month period. Finger-brachial index, skin blood flow (in arbitrary units [a.u.]), and skin temperature (in degrees Celsius) were recorded in each digit on the pulp at baseline and after a thermal challenge test (hand placed in a thermal box at 47.0 C for 15 minutes). Angiogram analysis was blinded and performed by a radiologist using a vascularization scale ranging from 0 (no vessel) to 4 (normal). The receiver operating characteristic curve was used to define a specific cutoff point to detect DOAD. Twenty-two patients had LDF measurements and complete angiograms. Results A total of 185 digits were analyzed because some patients had only analysis of one hand. The best area under the curve (AUC) was 0.98 (range, 0.94-0.99) for postwarming skin blood flow, with a cutoff point of ≤206 a.u. This AUC was statistically different from AUCs of all the other tests (P <.01). Sensitivity and specificity were 93{\%} (95{\%} confidence interval, 85{\%}-97{\%}) and 96{\%} (95{\%} confidence interval, 90{\%}-99{\%}), respectively. Conclusions LDF combined with a thermal challenge is highly accurate, safe, and noninvasive means to detect DOAD.",
author = "Guillaume Mahe and Liedl, {David A.} and Charlene McCarter and Roger Shepherd and Peter Gloviczki and McPhail, {Ian R.} and Rooke, {Thom W} and Wennberg, {Paul W.}",
year = "2014",
doi = "10.1016/j.jvs.2013.10.076",
language = "English (US)",
volume = "59",
journal = "Journal of Vascular Surgery",
issn = "0741-5214",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Digital obstructive arterial disease can be detected by laser Doppler measurements with high sensitivity and specificity

AU - Mahe, Guillaume

AU - Liedl, David A.

AU - McCarter, Charlene

AU - Shepherd, Roger

AU - Gloviczki, Peter

AU - McPhail, Ian R.

AU - Rooke, Thom W

AU - Wennberg, Paul W.

PY - 2014

Y1 - 2014

N2 - Objective This study was conducted to determine the sensitivity and specificity of laser Doppler flowmetry (LDF) measurements for digital obstructive arterial disease (DOAD) using angiography as the reference standard and to compare the accuracy of different classical tests used to assess DOAD. Diagnosis of vascular abnormalities at the digital level is challenging. Angiography is the gold standard for assessment of DOAD but is invasive and expensive to perform. Methods We performed a retrospective analysis of consecutive patients referred at Mayo Clinic (Rochester, Minn) for upper extremity arterial assessment during a 27-month period. Finger-brachial index, skin blood flow (in arbitrary units [a.u.]), and skin temperature (in degrees Celsius) were recorded in each digit on the pulp at baseline and after a thermal challenge test (hand placed in a thermal box at 47.0 C for 15 minutes). Angiogram analysis was blinded and performed by a radiologist using a vascularization scale ranging from 0 (no vessel) to 4 (normal). The receiver operating characteristic curve was used to define a specific cutoff point to detect DOAD. Twenty-two patients had LDF measurements and complete angiograms. Results A total of 185 digits were analyzed because some patients had only analysis of one hand. The best area under the curve (AUC) was 0.98 (range, 0.94-0.99) for postwarming skin blood flow, with a cutoff point of ≤206 a.u. This AUC was statistically different from AUCs of all the other tests (P <.01). Sensitivity and specificity were 93% (95% confidence interval, 85%-97%) and 96% (95% confidence interval, 90%-99%), respectively. Conclusions LDF combined with a thermal challenge is highly accurate, safe, and noninvasive means to detect DOAD.

AB - Objective This study was conducted to determine the sensitivity and specificity of laser Doppler flowmetry (LDF) measurements for digital obstructive arterial disease (DOAD) using angiography as the reference standard and to compare the accuracy of different classical tests used to assess DOAD. Diagnosis of vascular abnormalities at the digital level is challenging. Angiography is the gold standard for assessment of DOAD but is invasive and expensive to perform. Methods We performed a retrospective analysis of consecutive patients referred at Mayo Clinic (Rochester, Minn) for upper extremity arterial assessment during a 27-month period. Finger-brachial index, skin blood flow (in arbitrary units [a.u.]), and skin temperature (in degrees Celsius) were recorded in each digit on the pulp at baseline and after a thermal challenge test (hand placed in a thermal box at 47.0 C for 15 minutes). Angiogram analysis was blinded and performed by a radiologist using a vascularization scale ranging from 0 (no vessel) to 4 (normal). The receiver operating characteristic curve was used to define a specific cutoff point to detect DOAD. Twenty-two patients had LDF measurements and complete angiograms. Results A total of 185 digits were analyzed because some patients had only analysis of one hand. The best area under the curve (AUC) was 0.98 (range, 0.94-0.99) for postwarming skin blood flow, with a cutoff point of ≤206 a.u. This AUC was statistically different from AUCs of all the other tests (P <.01). Sensitivity and specificity were 93% (95% confidence interval, 85%-97%) and 96% (95% confidence interval, 90%-99%), respectively. Conclusions LDF combined with a thermal challenge is highly accurate, safe, and noninvasive means to detect DOAD.

UR - http://www.scopus.com/inward/record.url?scp=84897086790&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84897086790&partnerID=8YFLogxK

U2 - 10.1016/j.jvs.2013.10.076

DO - 10.1016/j.jvs.2013.10.076

M3 - Article

C2 - 24406090

AN - SCOPUS:84897086790

VL - 59

JO - Journal of Vascular Surgery

JF - Journal of Vascular Surgery

SN - 0741-5214

IS - 4

ER -