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High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model
Published on: March 16, 2022
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Stratification of Microvascular Disease Severity in the Foot Using Spatial Frequency Domain Imaging.
Samuel Jett1, Mallory R Thompson2, Shubhangi Awasthi2
1Modulated Imaging Inc, Irvine, CA, USA.
Journal of Diabetes Science and Technology
|July 5, 2021
Summary
Microvascular disease (MVD) in diabetes impairs limb oxygenation. Spatial frequency domain imaging (SFDI) shows promise in detecting MVD, unlike standard ankle-brachial index (ABI) or toe-brachial index (TBI) tests.
Area of Science:
- Vascular Medicine
- Diabetic Complications
- Medical Imaging
Background:
- Microvascular disease (MVD) affects small vessels, impairing tissue oxygenation and perfusion.
- MVD is a common, under-monitored diabetes complication, increasing risks for ulceration, amputation, and adverse limb outcomes, especially with peripheral artery disease (PAD).
- Current vascular assessments lack standard microvascular evaluation.
Purpose of the Study:
- To evaluate the efficacy of spatial frequency domain imaging (SFDI) in assessing microvascular disease (MVD) in patients with or at risk for lower extremity peripheral artery disease (PAD).
- To compare SFDI-derived parameters with standard ankle-brachial index (ABI) and toe-brachial index (TBI) for MVD detection.
Main Methods:
- Assessed 299 limbs from 153 patients clinically evaluated for lower extremity PAD.
- Utilized ankle-brachial index (ABI), toe-brachial index (TBI), and spatial frequency domain imaging (SFDI) for patient assessment.
- Compared measurements against MVD status defined by diabetes, neuropathy, and retinopathy severity.
Main Results:
- SFDI parameters, specifically HbT1 and StO2, showed significant differences across MVD severity groups (P < .001).
- A logistic regression model using HbT1 and StO2 effectively differentiated severe MVD from mild MVD (P = .001, AUC = 0.844).
- Neither ABI nor TBI significantly differentiated these MVD populations.
Conclusions:
- Standard PAD assessments (ABI, TBI) are insufficient for detecting MVD in at-risk populations.
- SFDI-derived HbT1 and StO2 show potential as reliable tools for evaluating MVD.
- Further prospective studies are needed to confirm the role of MVD assessment in routine clinical practice for patients at risk of lower extremity complications.
