Abstract

Purpose: Hyperspectral imaging (HSI) is a noninvasive spectroscopy technique for determining superficial tissue oxygenation. The HyperView™ system is a hand-held camera that enables perfusion image acquisition. The evaluation of superficial tissue oxygenation is warranted in the evaluation of patients with peripheral arterial disease. The aim was to determine the reliability of repeated HSI measurements. Methods: In this prospective cohort study, HSI was performed on 50 healthy volunteers with a mean age of 26.4 ± 2.5 years, at the lower extremity. Two independent observers performed HSI during two subsequent measurement sessions. Short term test–retest reliability and intra- and inter-observer reliability were determined, and generalizability and decision studies were performed. Transcutaneous oxygen pressure (TcPo2) measurements were also performed. Results: The short term test–retest reliability was good for the HSI values determined at the lower extremity, ranging from 0.72 to 0.90. Intra- and inter-observer reliability determined at different days were poor to moderate for both HSI (0.24 to 0.71 and 0.30 to 0.58, respectively) and TcPo2 (0.54 and 0.56, and 0.51 and 0.31, respectively). Reliability can be increased to >0.75 by averaging two measurements on different days. Conclusion: This study showed good short term test–retest reliability for HSI measurements, however low intra- and inter-observer reliability was observed for tissue oxygenation measurements with both HSI and TcPo2 performed at separate days in young healthy volunteers. Reliability of HSI can be improved when determined as a mean of two measurements taken on different days.

Highlights

  • Diagnostic techniques to determine perfusion and oxygenation in the lower extremities can potentially improve clinical decision making in patients with chronic limb threatening ischemia (CLTI) or patients with diabetic foot ulcers [1]

  • This study investigated the reliability of the HyperViewTM system for tissue oxygenation measurements of the lower extremity in healthy volunteers

  • This study showed good short term test–retest reliability, but low intra- and inter-observer reliability for superficial tissue oxygenation measurements with both Hyperspectral imaging (HSI) and TcPo2 performed on separate days in healthy volunteers

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Summary

Introduction

Diagnostic techniques to determine perfusion and oxygenation in the lower extremities can potentially improve clinical decision making in patients with chronic limb threatening ischemia (CLTI) or patients with diabetic foot ulcers [1]. Assessment of impaired tissue perfusion and/or oxygenation can be used for timely treatment to solve symptoms such as (rest) pain and non-healing foot ulcers. Transcutaneous oxygen pressure (TcPo2) measurement is the most commonly used technique for tissue perfusion [1, 3,4,5,6,7,8]. This technique is time consuming, operator dependent, and the level of high-quality evidence remains low [2, 9, 10]

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