The effectiveness of post-processing head and neck CT angiography using contrast enhancement boost technique.

Background and Purpose: This study aimed to investigate the potential of contrast enhancement (CE)-boost technique in the head and neck computed tomography (CT) angiography in terms of the objective and subjective image quality.
Materials and Methods: Consecutive patients who underwent head and neck CT angiography between May 2022 and July 2022 were included. The CE-boost images were generated by combining the subtracted iodinated image and contrast-enhanced image. The objective image analysis was compared for each image with and without CE-boost technique using the CT attenuation, image noise, signal-to-noise-ratio (SNR), contrast-to-noise-ratio (CNR), and image sharpness (full width at half width maximum, FWHM). The subjective image analysis was evaluated by two independent experienced radiologists in the following aspects: the overall image quality, motion artifact, vascular delineation, and vessel sharpness.
Results: A total of 65 patients (mean age, 59.48 ± 13.71 years; range, 24-87 years; 36 women) were included. The CT attenuation of the vertebrobasilar arteries was significantly (p < 0.001) higher in the images obtained using CE-boost technique than in conventional images. Image noise was significantly (p < 0.001) lower for CE-boost images (6.09 ± 1.93) than for conventional images (7.79 ± 1.73). Moreover, CE-boost technique yielded higher SNR (64.43 ± 17.17 vs. 121.37 ± 38.77, p < 0.001) and CNR (56.90 ± 18.79 vs. 116.65 ± 57.44, p < 0.001) than conventional images. CE-boost resulted in shorter FWHM than conventional images (p < 0.001). Higher subjective image quality scores were also demonstrated by the CE-boost than images without CE-boost technique.
Conclusions: In both objective and subjective image analysis, the CE-boost technique provided higher image quality without increasing the flow rate and concentration of contrast media in the head and neck CT angiography. Furthermore, the vessel completeness and delineation were superior in CE-boost images than in conventional images.
Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: The co-authors (J. K. Ryu and H. Shim) are employee Canon Medical Systems Korea, Seoul, Korea that is the subsidiary in Korea of Canon Medical Systems Corporation, Otawara-si, Japan. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
(Copyright: © 2023 Otgonbaatar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)