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Updated: May 4, 2026
Doppler Optical Coherence Tomography of Retinal Circulation
Published on: September 18, 2012
Digital obstructive arterial disease can be detected by laser Doppler measurements with high sensitivity and
Guillaume Mahe1, David A Liedl2, Charlene McCarter2
1Gonda Vascular Center, Mayo Clinic, Rochester, Minn; L'Université Nantes Angers Le Mans, Institut National de la Santé et de la Recherche Médicale 1083/CNRS 6214, Faculty of Medicine, Angers, France.
Insights
Laser Doppler flowmetry (LDF) with a thermal challenge accurately detects digital obstructive arterial disease (DOAD). This noninvasive method shows high sensitivity and specificity, offering a safe alternative to angiography for diagnosing vascular issues.
Area of Science:
- Vascular Medicine
- Medical Diagnostics
- Biomedical Engineering
Background:
- Diagnosing digital obstructive arterial disease (DOAD) is challenging.
- Angiography, the gold standard, is invasive and costly.
- Noninvasive methods are needed for accurate DOAD assessment.
Purpose of the Study:
- To evaluate the sensitivity and specificity of laser Doppler flowmetry (LDF) for DOAD.
- To compare LDF accuracy against classical tests for DOAD.
- To use angiography as the reference standard for DOAD diagnosis.
Main Methods:
- Retrospective analysis of 22 patients undergoing upper extremity arterial assessment.
- Recorded skin blood flow (LDF) and temperature post-thermal challenge.
- Angiogram analysis by a blinded radiologist; ROC curve analysis for LDF cutoff.
Main Results:
- Postwarming skin blood flow using LDF achieved an AUC of 0.98 (95% CI, 0.94-0.99).
- Optimal cutoff for LDF was ≤206 arbitrary units, yielding 93% sensitivity and 96% specificity.
- LDF performance significantly outperformed other classical tests (P < .01).
Conclusions:
- Laser Doppler flowmetry combined with a thermal challenge is a highly accurate diagnostic tool for DOAD.
- This noninvasive approach is safe and effective for detecting digital arterial disease.
- LDF offers a valuable alternative to invasive angiography for DOAD assessment.
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.
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