Hybrid US/SWL-OAI imaging. A Representative US and MSOT images from a healthy volunteer (HV; no clinical PAD symptoms and normal ABI) (top row) and a chronic limb threatening ischemia patient (CLTI; Fontaine III: rest pain, mostly in the feet and IV: necrosis and/or gangrene of the limb) (bottom row). Pink Illustration: sketch of a healthy (top) and fibrotic (bottom) skeletal muscle. Blue boxes show the polygonal region of interest (ROI) within the muscle tissue. Created with BioRender.com. B Receiver operating characteristic (ROC) curve with area under curve (AUC) and 95% confidence interval (CI) to distinguish between HV and CLTI for n = 193 subjects ((n = 59 HV/ n = 58 CLTI) using the combination of hybrid US/OAI, age, depth and gender. C ROC with AUC and 95% CI to differentiate aTASC 1 from aTASC 3 for n = 193 subjects (n = 59 aTASC1/ n = 18 aTASC3) using the combination of hybrid US/OAI, age, depth and gender.