{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:36:19Z","timestamp":1791513379400,"version":"4.3.4"},"reference-count":49,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Type 2 diabetes is a major cause of incidences and the progression of peripheral artery disease (PAD). Bone marrow edema (BME) is an important finding suggestive of underlying bone inflammation in non-traumatic diabetic patients with PAD. Our aim was to evaluate the presence, severity, and clinical implications of BME detected by virtual non-calcium application (VNCa) of dual-energy CT angiography (DE-CTA). (2) Methods: A consecutive series of 76 diabetic patients (55 men; mean age 71.6 \u00b1 11.2 yrs) submitted to lower limb DE-CTA for PAD evaluation and revascularization planning, which were retrospectively analyzed. VNCa images were independently and blindly revised for the presence, location, and severity of BME by two radiologists with 10 years of experience. BME and non-BME groups were evaluated in terms of PAD clinical severity and 6-month secondary major amputation rate. (3) Results: BME was present in 17 (22%) cases, while 59 (78%) patients were non-BME. The BME group showed a significantly higher incidence of major amputation (p &lt; 0.001) and a significantly higher number of patients with advanced clinical stages of PAD compared to the non-BME group (p = 0.024). (4) Conclusions: Lower limb DE-CTA with VNCa application is a useful tool in the detection of BME in diabetic patients with PAD, simultaneously enabling the evaluation of the severity and location of the arterial disease for revascularization planning. BME presence could be a marker of clinically severe PAD and a possible risk factor for revascularization failure.<\/jats:p>","DOI":"10.3390\/jcm13061536","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T04:19:02Z","timestamp":1709785142000},"page":"1536","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The Clinical Utility of Lower Extremity Dual-Energy CT Angiography in the Detection of Bone Marrow Edema in Diabetic Patients with Peripheral Artery Disease"],"prefix":"10.3390","volume":"13","author":[{"given":"Chiara","family":"Floridi","sequence":"first","affiliation":[{"name":"Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60126 Ancona, Italy"},{"name":"Division of Interventional Radiology, Department of Radiological Sciences, University Hospital \u201cAzienda Ospedaliera Universitaria delle Marche\u201d, 60126 Ancona, Italy"},{"name":"Division of Radiology, Department of Radiological Sciences, University Hospital \u201cAzienda Ospedaliera Universitaria delle Marche\u201d, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7133-8509","authenticated-orcid":false,"given":"Laura Maria","family":"Cacioppa","sequence":"additional","affiliation":[{"name":"Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60126 Ancona, Italy"},{"name":"Division of Interventional Radiology, Department of Radiological Sciences, University Hospital \u201cAzienda Ospedaliera Universitaria delle Marche\u201d, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Valeri","sequence":"additional","affiliation":[{"name":"Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolo","family":"Rossini","sequence":"additional","affiliation":[{"name":"Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzia","family":"Rosati","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiological Sciences, University Hospital \u201cAzienda Ospedaliera Universitaria delle Marche\u201d, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Vento","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, Aortic Team, Lancisi Cardiovascular Center, 60122 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Felicioli","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiological Sciences, University Hospital \u201cAzienda Ospedaliera Universitaria delle Marche\u201d, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Macchini","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiological Sciences, University Hospital \u201cAzienda Ospedaliera Universitaria delle Marche\u201d, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Candelari","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiological Sciences, University Hospital \u201cAzienda Ospedaliera Universitaria delle Marche\u201d, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Carotti","sequence":"additional","affiliation":[{"name":"Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60126 Ancona, Italy"},{"name":"Division of Radiology, Department of Radiological Sciences, University Hospital \u201cAzienda Ospedaliera Universitaria delle Marche\u201d, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Giovagnoni","sequence":"additional","affiliation":[{"name":"Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60126 Ancona, Italy"},{"name":"Division of Radiology, Department of Radiological Sciences, University Hospital \u201cAzienda Ospedaliera Universitaria delle Marche\u201d, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.25259\/JCIS_77_2020","article-title":"Diagnostic Accuracy of Color Doppler and Calcium Scoring versus Dual-Energy Computed Tomography Angiography in the Assessment of Peripheral Arterial Diseases 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