{
  "abstract": "Peripheral artery disease (PAD) spans a continuum from large-vessel obstruction to distal microvascular dysfunction, yet routine non-invasive tests, including the ankle-brachial index (ABI), do not provide structurally resolved assessment of the foot microvascular bed and may be unreliable in the setting of medial arterial calcification or perioperative follow-up. Here we developed a clinic-oriented multispectral compound-scanning photoacoustic tomography system (MCPATS) for compression-free distal toe imaging, and an interpretable photoacoustic tomography distal microcirculation score, termed PACT-DMS, for phenotyping PAD-related distal vascular abnormalities. PACT-DMS was derived from anatomically standardized distal toe sections and integrated seven prespecified vascular features spanning trunk-vessel morphology, microvascular distribution and pulsation-related dynamics through a traceable linear support vector machine. In a prospective single-centre cohort of 45 participants, the bilateral fusion PACT-DMS model distinguished patients with PAD from healthy controls with an area under the receiver operating characteristic curve of 0.964 (95% CI, 0.907-1.000) and an accuracy of 91.1% (95% CI, 82.2%-97.8%) under subject-level leave-one-out cross-validation, supported by complementary robustness analyses. Exploratory analyses further showed that PACT-DMS identified abnormal distal vascular phenotypes in 6 of 9 clinically diagnosed PAD limbs with non-abnormal ABI and visualized distal vascular-bed changes before and after revascularization. These findings support MCPATS-enabled interpretable photoacoustic vascular phenotyping as a candidate adjunctive approach for distal microcirculatory assessment in PAD; larger multicentre studies with external validation and prespecified analysis protocols will be required to define its clinical role.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, Tsinghua University"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "name": "H. Deng"
    },
    {
      "name": "T. Yuwen"
    },
    {
      "name": "Z. Li"
    },
    {
      "name": "J. Xiang"
    },
    {
      "name": "Y. Bai"
    },
    {
      "name": "N. Zhang"
    },
    {
      "name": "W. Fu"
    },
    {
      "name": "X. Wang"
    },
    {
      "name": "J. Guo"
    },
    {
      "name": "W. Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "C. Ma"
    },
    {
      "name": "M.-Y. Liu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cge0by1he6qz5.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.02.26361270",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.02.26361270v1.full",
  "id": "cge0by1he6qz5",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.02.26361270v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "radiology and imaging"
    ],
    [
      "openalex",
      "2204|Photoacoustic and Ultrasonic Imaging"
    ]
  ],
  "openalex": "W7208720020",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.02.26361270v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-02",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cge0by1he6qz5.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:47Z",
      "native_id": "10.64898/2026.09.02.26361270",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.02.26361270v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:radiology and imaging",
      "subfield": "imaging"
    }
  ],
  "title": "Interpretable photoacoustic phenotyping of distal microcirculation for peripheral artery disease diagnosis with exploratory perioperative assessment",
  "title_text": "Interpretable photoacoustic phenotyping of distal microcirculation for peripheral artery disease diagnosis with exploratory perioperative assessment",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:47Z",
  "url": "https://research.draconitic.com/paper/cge0by1he6qz5",
  "venue": "medRxiv",
  "versions": []
}