Case studies of laser Doppler imaging system for clinical diagnosis applications and management.

The laser Doppler perfusion imager (LDPI) is a recent development in the field of laser Doppler flowmetry. It has great potential in many medical applications for the non-invasive diagnosis of problems based on microvascular perfusion. Established applications include assessment of breast skin blood flow, wound healing, skin burn, and systemic sclerosis. This paper aims to enhance the usability of LPDI for diagnostics testing through the examination of two major issues. The first issue deals with the performance of the LDPI technique. Two case studies are used not only to highlight the potential applications of LDPI, but also to illustrate the general procedure/precautions needed for ensuring the consistency and quality of the captured perfusion images. The first case study deals with the perfusion across the proximal interphalangeal joints of patients with osteoarthritis. The results showed that LDPI could provide an objective and specific assessment of hyperaemia over the interphalangeal joints in patients with rheumatoid arthritis. The second case study deals with the blood flow on the stomach region during acupuncture. The results indicated that LDPI could provide an objective and specific assessment of the stimulation level on acupuncture point. The issues discussed in these case studies would be useful for the evolution of other novel LDPI applications and the standardization of the proper clinical procedure for the capturing of the LDP images. The second issue deals with the intelligent management of the LDPI results to facilitate the prescription of treatment based on analysis of similar cases previously encountered. The framework of an intelligent diagnostics assistant is proposed to automate the search and retrieval of relevant past cases based on the LDPI diagnosis. The paper uses skin burn as an example to discuss the considerations and techniques for the implementation of the proposed intelligent diagnostics system. This work constitutes initial efforts to increase the productivity of the doctors in diagnostics testing using LDPI.