The impact of post-processing images of abdominal CT small vessels using contrast enhancement boost technique: a retrospective study.

BACKGROUND

Accurate visualization of small abdominal arteries is crucial for diagnosis, preoperative evaluation, and treatment planning, especially in hepatobiliary and pancreatic diseases. However, due to their small calibers and rapid contrast transit, consistent delineation of these vessels remains challenging in conventional computed tomography (CT) angiography. Recent advancements in image postprocessing, such as contrast enhancement boost (CE-Boost) techniques, offer opportunities to improve vascular conspicuity without additional radiation or contrast agent. This study aimed to evaluate the efficacy of CE-Boost technology in improving image quality and vascular delineation for small abdominal vessels in multiphase contrast-enhanced CT examinations.

METHODS

This retrospective analysis included 100 patients undergoing triphasic abdominal CT between July to November 2024. Raw datasets were reconstructed using an adaptive iterative denoising algorithm to generate conventional images (Group A). Subsequent application of flexible subtraction CE-Boost technology produced optimized images (Group B). Quantitative analysis measured CT attenuation values and noise levels (standard deviation) in four arterial branches (common hepatic, left gastric, splenic, and superior mesenteric arteries) and adjacent erector spinae musculature. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated for vascular structures. Two blinded radiologists independently scored image quality using a 5-point Likert scale, with interobserver agreement assessed via Cohen's kappa.

RESULTS

CE-Boost-processed images (Group B) demonstrated significantly improved image quality compared to conventional processing (Group A). Quantitative analysis showed higher CT attenuation values in Group B across all evaluated arterial branches: common hepatic artery [median 362.50 256.00 Hounsfield units (HU), P<0.001], left gastric artery (333.87±77.27 230.38±53.90 HU, P<0.001), splenic artery (median 374.50 257.17 HU, P<0.001), and superior mesenteric artery (median 380.67 269.00 HU, P<0.001). Mean increases ranged from 48 to 62 HU. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) improved by 39-54% across target vessels (all P<0.001). Subjective scoring also favored Group B, with higher overall image quality scores {median: 5 [interquartile range (IQR): 4-5] 4 (IQR: 4-5), P<0.001}, and strong interobserver agreement (κ=0.776 for Group B, κ=0.723 for Group A, both P<0.001). These results indicate superior vascular enhancement and diagnostic visibility using CE-Boost processing.

CONCLUSIONS

CE-Boost technology significantly enhances the visualization of small abdominal vasculature through advanced postprocessing optimization. The technique improves objective image quality metrics (CT attenuation, SNR, CNR) while maintaining diagnostic noise levels, and demonstrates high clinical utility for vascular mapping. These advancements in image processing workflows may facilitate more accurate anatomical assessment and diagnostic interpretation of small vessel pathologies.