A novel computer-aided diagnostic approach for detecting peripheral arterial disease in patients with diabetes
Peripheral arterial disease (PAD) is an important manifestation of systemic atherosclerosis, with diabetes being one of its most significant risk factors. Owing to medial arterial calcification (MAC), the ankle-brachial index (ABI) is not always a reliable tool for detecting PAD. Arterial Doppler fl...
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| Veröffentlicht in: | PloS one 2018-06, Vol.13 (6), p.e0199374-e0199374 |
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| creator | Buschmann, Eva Elina Li, Lulu Brix, Michèle Zietzer, Andreas Hillmeister, Philipp Busjahn, Andreas Bramlage, Peter Buschmann, Ivo |
| description | Peripheral arterial disease (PAD) is an important manifestation of systemic atherosclerosis, with diabetes being one of its most significant risk factors. Owing to medial arterial calcification (MAC), the ankle-brachial index (ABI) is not always a reliable tool for detecting PAD. Arterial Doppler flow parameters, such as systolic maximal acceleration (ACCmax) and relative pulse slope index (RPSI), may serve as effective surrogates to detect stenosis-induced flow alteration. In the present study, ACCmax and RPSI were prospectively evaluated in 166 patients (304 arteries) with clinical suspicion of PAD, including 76 patients with and 90 patients without diabetes. In the overall sample, the sensitivity of ACCmax (69%) was superior to that of ABI (58%) and RPSI (56%). In patients with diabetes, the sensitivity of ACCmax (57%), ABI (56%) and RPSI (57%) were similar, though a parallel test taking both ACCmax and RPSI into account further increased sensitivity to 68%. The specificity (98%) and accuracy (78%) of ACCmax were superior to those of ABI (83% and 70%, respectively), as were the specificity (95%) and accuracy (77%) of RPSI in patients with diabetes. The diagnostic properties of ACCmax and RPSI were superior to those of ABI for detecting PAD in patients with diabetes. Our acceleration algorithm (Gefäßtachometer®) provides a rapid, safe, noninvasive tool for identifying PAD in patients with diabetes. |
| doi_str_mv | 10.1371/journal.pone.0199374 |
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Owing to medial arterial calcification (MAC), the ankle-brachial index (ABI) is not always a reliable tool for detecting PAD. Arterial Doppler flow parameters, such as systolic maximal acceleration (ACCmax) and relative pulse slope index (RPSI), may serve as effective surrogates to detect stenosis-induced flow alteration. In the present study, ACCmax and RPSI were prospectively evaluated in 166 patients (304 arteries) with clinical suspicion of PAD, including 76 patients with and 90 patients without diabetes. In the overall sample, the sensitivity of ACCmax (69%) was superior to that of ABI (58%) and RPSI (56%). In patients with diabetes, the sensitivity of ACCmax (57%), ABI (56%) and RPSI (57%) were similar, though a parallel test taking both ACCmax and RPSI into account further increased sensitivity to 68%. The specificity (98%) and accuracy (78%) of ACCmax were superior to those of ABI (83% and 70%, respectively), as were the specificity (95%) and accuracy (77%) of RPSI in patients with diabetes. The diagnostic properties of ACCmax and RPSI were superior to those of ABI for detecting PAD in patients with diabetes. Our acceleration algorithm (Gefäßtachometer®) provides a rapid, safe, noninvasive tool for identifying PAD in patients with diabetes.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0199374</identifier><identifier>PMID: 29928037</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acceleration ; Aged ; Algorithms ; Angiography ; Ankle ; Ankle Brachial Index ; Area Under Curve ; Arteries ; Arteriosclerosis ; Atherosclerosis ; Biology and Life Sciences ; Calcification ; Calcification (ectopic) ; Cardiology ; Cardiovascular disease ; Care and treatment ; Diabetes ; Diabetes mellitus ; Diabetic Angiopathies - diagnosis ; Diabetic Angiopathies - diagnostic imaging ; Diabetic Angiopathies - physiopathology ; Diabetics ; Diagnosis ; Diagnosis, Computer-Assisted ; Diagnostic systems ; Female ; Flow alteration ; Franklin, Benjamin (1706-1790) ; Health aspects ; Hemodynamics ; Humans ; Internal medicine ; Laboratories ; Male ; Medical diagnosis ; Medical equipment ; Medical imaging ; Medicine and Health Sciences ; Middle Aged ; Patients ; Peripheral Arterial Disease - diagnosis ; Peripheral Arterial Disease - diagnostic imaging ; Peripheral Arterial Disease - physiopathology ; Peripheral vascular diseases ; Physiology ; Preventive medicine ; Pulse ; Research and Analysis Methods ; Risk analysis ; Risk factors ; ROC Curve ; Sensitivity ; Sensitivity and Specificity ; Stenosis ; Systole ; Tibial Arteries - diagnostic imaging ; Tibial Arteries - pathology ; Tibial Arteries - physiopathology ; Ultrasonic imaging ; Wavelet Analysis</subject><ispartof>PloS one, 2018-06, Vol.13 (6), p.e0199374-e0199374</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Buschmann et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Owing to medial arterial calcification (MAC), the ankle-brachial index (ABI) is not always a reliable tool for detecting PAD. Arterial Doppler flow parameters, such as systolic maximal acceleration (ACCmax) and relative pulse slope index (RPSI), may serve as effective surrogates to detect stenosis-induced flow alteration. In the present study, ACCmax and RPSI were prospectively evaluated in 166 patients (304 arteries) with clinical suspicion of PAD, including 76 patients with and 90 patients without diabetes. In the overall sample, the sensitivity of ACCmax (69%) was superior to that of ABI (58%) and RPSI (56%). In patients with diabetes, the sensitivity of ACCmax (57%), ABI (56%) and RPSI (57%) were similar, though a parallel test taking both ACCmax and RPSI into account further increased sensitivity to 68%. 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Our acceleration algorithm (Gefäßtachometer®) provides a rapid, safe, noninvasive tool for identifying PAD in patients with diabetes.</description><subject>Acceleration</subject><subject>Aged</subject><subject>Algorithms</subject><subject>Angiography</subject><subject>Ankle</subject><subject>Ankle Brachial Index</subject><subject>Area Under Curve</subject><subject>Arteries</subject><subject>Arteriosclerosis</subject><subject>Atherosclerosis</subject><subject>Biology and Life Sciences</subject><subject>Calcification</subject><subject>Calcification (ectopic)</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Care and treatment</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetic Angiopathies - diagnosis</subject><subject>Diabetic Angiopathies - diagnostic imaging</subject><subject>Diabetic Angiopathies - physiopathology</subject><subject>Diabetics</subject><subject>Diagnosis</subject><subject>Diagnosis, Computer-Assisted</subject><subject>Diagnostic systems</subject><subject>Female</subject><subject>Flow alteration</subject><subject>Franklin, Benjamin (1706-1790)</subject><subject>Health aspects</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Internal medicine</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical equipment</subject><subject>Medical imaging</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Peripheral Arterial Disease - diagnosis</subject><subject>Peripheral Arterial Disease - diagnostic imaging</subject><subject>Peripheral Arterial Disease - physiopathology</subject><subject>Peripheral vascular diseases</subject><subject>Physiology</subject><subject>Preventive medicine</subject><subject>Pulse</subject><subject>Research and Analysis Methods</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>ROC Curve</subject><subject>Sensitivity</subject><subject>Sensitivity and Specificity</subject><subject>Stenosis</subject><subject>Systole</subject><subject>Tibial Arteries - diagnostic imaging</subject><subject>Tibial Arteries - pathology</subject><subject>Tibial Arteries - physiopathology</subject><subject>Ultrasonic imaging</subject><subject>Wavelet 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novel computer-aided diagnostic approach for detecting peripheral arterial disease in patients with diabetes</title><author>Buschmann, Eva Elina ; Li, Lulu ; Brix, Michèle ; Zietzer, Andreas ; Hillmeister, Philipp ; Busjahn, Andreas ; Bramlage, Peter ; Buschmann, Ivo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c653t-179e81976ff7eb0eaa6fcb844e299c7c2b1ac9681cb43fee00299c98115d01f23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acceleration</topic><topic>Aged</topic><topic>Algorithms</topic><topic>Angiography</topic><topic>Ankle</topic><topic>Ankle Brachial Index</topic><topic>Area Under Curve</topic><topic>Arteries</topic><topic>Arteriosclerosis</topic><topic>Atherosclerosis</topic><topic>Biology and Life Sciences</topic><topic>Calcification</topic><topic>Calcification (ectopic)</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Care and 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Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Buschmann, Eva Elina</au><au>Li, Lulu</au><au>Brix, Michèle</au><au>Zietzer, Andreas</au><au>Hillmeister, Philipp</au><au>Busjahn, Andreas</au><au>Bramlage, Peter</au><au>Buschmann, Ivo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A novel computer-aided diagnostic approach for detecting peripheral arterial disease in patients with diabetes</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-06-21</date><risdate>2018</risdate><volume>13</volume><issue>6</issue><spage>e0199374</spage><epage>e0199374</epage><pages>e0199374-e0199374</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Peripheral arterial disease (PAD) is an important manifestation of systemic atherosclerosis, with diabetes being one of its most significant risk factors. Owing to medial arterial calcification (MAC), the ankle-brachial index (ABI) is not always a reliable tool for detecting PAD. Arterial Doppler flow parameters, such as systolic maximal acceleration (ACCmax) and relative pulse slope index (RPSI), may serve as effective surrogates to detect stenosis-induced flow alteration. In the present study, ACCmax and RPSI were prospectively evaluated in 166 patients (304 arteries) with clinical suspicion of PAD, including 76 patients with and 90 patients without diabetes. In the overall sample, the sensitivity of ACCmax (69%) was superior to that of ABI (58%) and RPSI (56%). In patients with diabetes, the sensitivity of ACCmax (57%), ABI (56%) and RPSI (57%) were similar, though a parallel test taking both ACCmax and RPSI into account further increased sensitivity to 68%. The specificity (98%) and accuracy (78%) of ACCmax were superior to those of ABI (83% and 70%, respectively), as were the specificity (95%) and accuracy (77%) of RPSI in patients with diabetes. The diagnostic properties of ACCmax and RPSI were superior to those of ABI for detecting PAD in patients with diabetes. Our acceleration algorithm (Gefäßtachometer®) provides a rapid, safe, noninvasive tool for identifying PAD in patients with diabetes.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29928037</pmid><doi>10.1371/journal.pone.0199374</doi><tpages>e0199374</tpages><orcidid>https://orcid.org/0000-0003-4970-2110</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_2057887619 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acceleration Aged Algorithms Angiography Ankle Ankle Brachial Index Area Under Curve Arteries Arteriosclerosis Atherosclerosis Biology and Life Sciences Calcification Calcification (ectopic) Cardiology Cardiovascular disease Care and treatment Diabetes Diabetes mellitus Diabetic Angiopathies - diagnosis Diabetic Angiopathies - diagnostic imaging Diabetic Angiopathies - physiopathology Diabetics Diagnosis Diagnosis, Computer-Assisted Diagnostic systems Female Flow alteration Franklin, Benjamin (1706-1790) Health aspects Hemodynamics Humans Internal medicine Laboratories Male Medical diagnosis Medical equipment Medical imaging Medicine and Health Sciences Middle Aged Patients Peripheral Arterial Disease - diagnosis Peripheral Arterial Disease - diagnostic imaging Peripheral Arterial Disease - physiopathology Peripheral vascular diseases Physiology Preventive medicine Pulse Research and Analysis Methods Risk analysis Risk factors ROC Curve Sensitivity Sensitivity and Specificity Stenosis Systole Tibial Arteries - diagnostic imaging Tibial Arteries - pathology Tibial Arteries - physiopathology Ultrasonic imaging Wavelet Analysis |
| title | A novel computer-aided diagnostic approach for detecting peripheral arterial disease in patients with diabetes |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-14T23%3A10%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20novel%20computer-aided%20diagnostic%20approach%20for%20detecting%20peripheral%20arterial%20disease%20in%20patients%20with%20diabetes&rft.jtitle=PloS%20one&rft.au=Buschmann,%20Eva%20Elina&rft.date=2018-06-21&rft.volume=13&rft.issue=6&rft.spage=e0199374&rft.epage=e0199374&rft.pages=e0199374-e0199374&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0199374&rft_dat=%3Cgale_plos_%3EA543865486%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2057887619&rft_id=info:pmid/29928037&rft_galeid=A543865486&rft_doaj_id=oai_doaj_org_article_27ca0d482b404449bc1d00bc1f090365&rfr_iscdi=true |