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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 Cover

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

Open Access
|Apr 2026

Figures & Tables

FIGURE 1

(A) Computed tomography angiography (CTA) of the pelvis and lower extremities demonstrating diffuse arterial wall calcifications, most pronounced in the below-the-knee arteries, limiting accurate assessment of vessel patency due to blooming artefacts. The arrow indicates a heavily calcified proximal anterior tibial artery. (B) Non-contrast quiescent-interval single-shot magnetic resonance angiography (QISS MRA) of the same vessels in the same patient, demonstrating preserved arterial patency without interference from arterial wall calcifications, which are not visualized on QISS MRA. The arrow indicates two significant stenoses of the proximal anterior tibial artery.

FIGURE 2.

Carbon dioxide angiography (CO2 angiography) in the same patient as Figure 1, showing patency of the femoral arteries as seen on computed tomography angiography (CTA) and non-contrast quiescent-interval single-shot magnetic resonance angiography (QISS MRA). The arrow indicates two significant stenoses of the anterior tibial artery.

Kappa values by arterial segment

Arterial segmentQISS MRA vs. CTA κQISS MRA vs. DSA κCTA vs. DSA κ
Pelvic arteries0.400.51NA
Femoropopliteal arteries0.290.230.55
Below-the-knee arteries0.420.610.32

Results of agreement quiescent-interval slice-selective magnetic resonance angiography (QISS MRA), computer tomography angiography (CTA) and digital subtraction angiography (DSA)

Comparisonκ Value95% CIp-valueAgreement level
QISS MRA vs. CTA0.410.31–0.52< 0.001Moderate
QISS MRA vs. DSA0.490.37–0.60< 0.001Moderate
CTA vs. DSA0.570.34–0.80< 0.001MODERATE

Segment-based diagnostic performance of QISS MRA and CTA for detection of significant (≥ 50%) stenosis/occlusion using DSA as the reference standard

Modality / territoryPaired segments (n)TPTNFPFNSensitivity (%)Specificity (%)PPV (%)NPV (%)Accuracy (%)
QISS MRA – all segments121376413784.183.174.090.183.5
QISS MRA – below-the-knee7225367486.283.778.190.084.7
CTA – all segments393313260.091.250.093.987.2
CTA – below-the-knee16014110.093.30.093.387.5
DOI: https://doi.org/10.2478/raon-2026-0019 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Submitted on: Nov 7, 2025
Accepted on: Feb 16, 2026
Published on: Apr 16, 2026
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 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.

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