Correlation of quiescent-interval single-shot (QISS) magnetic resonance angiography (MRA), computed tomography angiography (CTA) and digital subtraction angiography (DSA) for peripheral arterial disease (PAD) assessment

Silva Breznik; Ales Slanic; Jernej Lucev

doi:10.2478/raon-2026-0019

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Correlation of quiescent-interval single-shot (QISS) magnetic resonance angiography (MRA), computed tomography angiography (CTA) and digital subtraction angiography (DSA) for peripheral arterial disease (PAD) assessment

Radiology and Oncology

AHEAD OF PRINT

By: Silva Breznik, Ales Slanic and Jernej Lucev

Open Access

|Apr 2026

Abstract

Background

Cross-sectional imaging methods such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are widely used for the assessment of peripheral arteries in patients with chronic limbthreatening ischemia (CLTI) or claudication. Given the limitations of CTA in evaluating heavily calcified vessels, we aimed to determine whether quiescent-interval single-shot (QISS) MRA provides better diagnostic agreement with digital subtraction angiography (DSA).

Patients and methods

In this retrospective study, 25 patients who underwent lower limb QISS MRA between April 2022 and April 2024 were included. Thirteen patients also underwent CTA, and 19 underwent DSA.

Results

The mean patient age was 67 ± 12 years (range: 32–86), and 20 were male. CLTI was present in 12 patients (48%), and medial arterial calcification was noted in 7 patients (28%). A total of 450 segments were evaluated by QISS MRA, 229 by CTA, and 149 by DSA. Agreement for ≥ 50% stenosis/occlusion was moderate for QISS MRA vs. CTA (κ = 0.41) and QISS MRA vs. DSA (κ = 0.49), and moderate for CTA vs. DSA (κ = 0.57). In below-the-knee arteries, QISS MRA showed substantial agreement with DSA (κ = 0.61) and high sensitivity (86.2%).

Conclusions

In this small, exploratory cohort QISS MRA showed promising performance for segment-based assessment of peripheral arterial disease (PAD), particularly in below-the-knee arteries in patients with medial arterial calcification, and outperformed CTA for the detection of ≥ 50% stenosis relative to DSA. Larger studies are needed to further establish its clinical utility.

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Articles in this issue

DOI: https://doi.org/10.2478/raon-2026-0019 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Submitted on: Nov 7, 2025

Accepted on: Feb 16, 2026

Published on: Apr 16, 2026

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

arterial cross-sectional imaging,

atherosclerosis,

arterial calcification,

Related subjects:

Haematology, oncology,

Radiology

© 2026 Silva Breznik, Ales Slanic, Jernej Lucev, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

AHEAD OF PRINT