{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T10:23:13Z","timestamp":1779877393507,"version":"3.53.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T00:00:00Z","timestamp":1673827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81870614"],"award-info":[{"award-number":["81870614"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["12171396"],"award-info":[{"award-number":["12171396"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although diabetic and atherosclerotic vascular diseases have different pathophysiological mechanisms, the screening methods currently used for diabetic lower\u2010extremity vascular diseases are mainly based on the evaluation methods used for atherosclerotic vascular diseases. Thus, assessment of microvascular perfusion is of great importance in early detection of lower\u2010extremity ischemia in diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This cross\u2010sectional study aimed to develop a quantitative model for evaluating lower\u2010extremity perfusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We recruited 57 participants (14 healthy participants and 43 diabetes patients, of which 16 had lower\u2010extremity arterial disease [LEAD]). All participants underwent technetium\u201099\u00a0m sestamibi (99mTc\u2010MIBI) scintigraphy and ankle\u2010brachial index (ABI) examination. We derived two key perfusion kinetics indices named activity perfusion index (API) and basal perfusion index (BPI). This study was registered in ClinicalTrials.gov (URL: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.ClinicalTrials.gov\">https:\/\/www.ClinicalTrials.gov<\/jats:ext-link>, NCT02752100).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The estimated limb perfusion values in our lower\u2010extremity perfusion assessment (LEPA) model showed excellent consistency with the actual measured data. Diabetes patients showed reduced lower\u2010extremity perfusion in comparison with the control group (BPI: 106.21\u00a0\u00b1\u00a011.99\u00a0vs. 141.56\u00a0\u00b1\u00a017.38, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05; API: 12.34\u00a0\u00b1\u00a03.27\u00a0vs. 14.56\u00a0\u00b1\u00a03.12, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). Using our model, the reductions in lower\u2010extremity perfusion could be detected early in approximately 96.30% of diabetes patients. Patients with LEAD showed more severe reductions in lower\u2010extremity perfusion than diabetes patients without LEAD (BPI: 47.85\u00a0\u00b1\u00a020.30\u00a0vs. 106.21\u00a0\u00b1\u00a011.99, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05; API: 7.06\u00a0\u00b1\u00a01.70\u00a0vs. 12.34\u00a0\u00b1\u00a03.27, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). Discriminant analysis using API and BPI could successfully screen all diabetes patients with LEAD with a sensitivity of 100% and specificity of 80.77%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We established a LEPA model that could successfully assess lower\u2010extremity microvascular perfusion in diabetes patients. This model has important application value for the recognition of early\u2010stage LEAD in patients with diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16214","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T05:54:57Z","timestamp":1673243697000},"page":"3019-3026","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Quantitative model for assessment of lower\u2010extremity perfusion in patients with diabetes"],"prefix":"10.1002","volume":"50","author":[{"given":"Qian","family":"Zhang","sequence":"first","affiliation":[{"name":"Center for Hypertension and Metabolic Diseases Department of Hypertension and Endocrinology Chongqing Institute of Hypertension Daping Hospital Army Medical University  Chongqing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Liu","sequence":"additional","affiliation":[{"name":"Center for Hypertension and Metabolic Diseases Department of Hypertension and Endocrinology Chongqing Institute of Hypertension Daping Hospital Army Medical University  Chongqing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Li","sequence":"additional","affiliation":[{"name":"Center for Hypertension and Metabolic Diseases Department of Hypertension and Endocrinology Chongqing Institute of Hypertension Daping Hospital Army Medical University  Chongqing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yushuang","family":"Liu","sequence":"additional","affiliation":[{"name":"Center for Hypertension and Metabolic Diseases Department of Hypertension and Endocrinology Chongqing Institute of Hypertension Daping Hospital Army Medical University  Chongqing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbo","family":"He","sequence":"additional","affiliation":[{"name":"Center for Hypertension and Metabolic Diseases Department 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