Effects of contrast enhancement boost postprocessing technique in combination with different reconstruction algorithms on the image quality of abdominal CT angiography

Objectives: To investigate whether contrast-enhancement-boost (CE-boost) in combination with hybrid iterative reconstruction (Hybrid IR, also named HIR [AIDR 3D, adaptive iterative dose reduction three dimensional]) and model-based iterative reconstruction (MBIR [FIRST, forward projected model-based IR solution]) algorithms can improve the image quality of abdominal CT angiography (CTA).Methods: This retrospective study included 50 patients who underwent abdominal CTA. Both arterial and portal phases were reconstructed using three different algorithms [filtered-back projection (FBP), AIDR 3D, and FIRST] separately. CE-boost was performed additionally to generate AIDR 3D-boost and FIRST-boost images. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the arteries and portal system were compared among the five datasets (FBP, AIDR 3D, FIRST, AIDR 3D-boost, FIRST-boost). In subjective analyses, two radiologists independently ordered images (5, best; 1, worst) based on the visual image quality of distal arterial or portal venous branches. The Friedman and the Dunn-Bonferroni post-hoc tests were used for statistical analysis.Results: FIRST-boost arterial and portal images had the lowest noise compared with FBP, AIDR 3D, FIRST, and AIDR 3D-boost images (all P < 0.05), and significantly higher SNR and CNR than FBP, AIDR 3D, and FIRST images (all P < 0.05). AIDR 3D-boost images showed lower noise, and higher SNR and CNR than FBP and AIDR 3D images (all P < 0.05). FIRST-boost images had higher subjective grading scores than FBP, AIDR 3D, and AIDR 3D-boost images (all P < 0.05).Conclusion: The postprocessing technique CE-boost can improve the image quality of abdominal CTA images. MBIR in combination with CE-boost (FIRST-boost) images had the best image quality compared with the other four image datasets.