{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T23:26:07Z","timestamp":1783985167106,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["1S63719N"],"award-info":[{"award-number":["1S63719N"]}],"id":[{"id":"10.13039\/501100003130","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":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Peripheral arterial disease (PAD) is a chronic occlusive disease that restricts blood flow in the lower limbs, causing partial or complete blockages of the blood flow. While digital subtraction angiography (DSA) has traditionally been the preferred method for assessing blood flow in the lower limbs, advancements in wide beam Computed Tomography (CT), allowing successive acquisition at high frame rate, might enable hemodynamic measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To quantify the arterial blood flow in stenotic below\u2010the\u2010knee (BTK) arteries. To this end, we propose a novel method for contrast bolus tracking and assessment of quantitative hemodynamic parameters in stenotic arteries using\u00a04D\u2010CT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty patients with suspected PAD underwent 4D\u2010CT angiography in addition to the clinical run\u2010off computed tomography angiography (CTA). From these dynamic acquisitions, the BTK arteries were segmented and the region of maximum blood flow was extracted. Time attenuation curves (TAC) were estimated using 2D spatio\u2010temporal B\u2010spline regression, enforcing both spatial and temporal smoothness. From these curves, quantitative hemodynamic parameters, describing the shape of the propagating contrast bolus were automatically extracted. We evaluated the robustness of the proposed TAC fitting method with respect to interphase delay and imaging noise and compared it to commonly used approaches. Finally, to illustrate the potential value of 4D\u2010CT, we assessed the correlation between the obtained hemodynamic parameters and the presence of\u00a0PAD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>280 out of 292 arteries were successfully segmented, with failures mainly due to a delayed contrast arrival. The proposed method led to physiologically plausible hemodynamic parameters and was significantly more robust compared to 1D temporal regression. A significant correlation between the presence of proximal stenoses and several hemodynamic parameters was found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The proposed method based on spatio\u2010temporal bolus tracking was shown to lead to stable and physiologically plausible estimation of quantitative hemodynamic parameters, even in the case of stenotic arteries. These parameters may provide valuable information in the evaluation of PAD and contribute to its\u00a0diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16755","type":"journal-article","created":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T11:36:35Z","timestamp":1695728195000},"page":"6844-6856","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Quantitative hemodynamic assessment of stenotic below\u2010the\u2010knee arteries using spatio\u2010temporal bolus tracking on 4D\u2010CT angiography"],"prefix":"10.1002","volume":"50","author":[{"given":"Pieter Thomas","family":"Boonen","sequence":"first","affiliation":[{"name":"Department of Radiology Vrije Universiteit Brussel (VUB)  Jette Brussels Belgium"},{"name":"Department of Electronics and Informatics (ETRO) Vrije Universiteit Brussel (VUB)  Elsene Brussels Belgium"},{"name":"imec  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico","family":"Buls","sequence":"additional","affiliation":[{"name":"Department of Radiology Vrije Universiteit Brussel (VUB)  Jette Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert","family":"van Gompel","sequence":"additional","affiliation":[{"name":"Department of Radiology Vrije Universiteit Brussel (VUB)  Jette Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannes","family":"Devos","sequence":"additional","affiliation":[{"name":"Department of Radiology Vrije Universiteit Brussel (VUB)  Jette Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannick","family":"de Brucker","sequence":"additional","affiliation":[{"name":"Department of Radiology Vrije Universiteit Brussel (VUB)  Jette Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Leiner","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitri","family":"Aerden","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Vrije Universiteit Brussel (VUB)  Jette Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"de Mey","sequence":"additional","affiliation":[{"name":"Department of Radiology Vrije Universiteit Brussel (VUB)  Jette Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jef","family":"Vandemeulebroucke","sequence":"additional","affiliation":[{"name":"Department of Electronics and Informatics (ETRO) Vrije Universiteit Brussel (VUB)  Elsene Brussels Belgium"},{"name":"imec  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2013.09.003"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.303849"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61249-0"},{"issue":"16","key":"e_1_2_7_5_1","first-page":"1660","article-title":"Associations between conventional cardiovascular risk factors and risk of peripheral artery disease in men","volume":"308","author":"Joosten MM","year":"2012","journal-title":"JAMA, Tech Rep"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30255-4"},{"key":"e_1_2_7_7_1","unstructured":"VlayenJ KirstenHH OlivierD et\u00a0al.Revascularization for lower limb peripheral arterial disease.Good Clinical Practice (GCP) Brussels: Belgian Health Care Knowledge Centre (KCE). 2014. 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