CE-Boost Enhancement Combined with Subtraction Reconstruction Improves Distal Bronchial Artery Visualization on CTA

<title>Abstract</title> <p>Objective To evaluate the value of flexible subtraction combined with CE-Boost technology in bronchial artery CTA. Materials and Methods 81 patients who underwent pulmonary artery–bronchial artery CTA were retrospectively enrolled. Using the same raw data, three image sets were reconstructed: conventional iterative reconstruction (Group A), single CE-Boost (Group B), and double CE-Boost (Group C). Objective parameters (BA diameter, noise, SNR, CNR) and subjective image quality (5-point scale) were compared. Results No significant difference in BA diameter was found among groups (P &gt; 0.05). As CE-Boost superposition increased, noise increased (P &lt; 0.001), SNR showed no significant change (P = 0.714), and CNR significantly improved (P &lt; 0.001). Subjective scores were highest in Group C (P &lt; 0.001), with good inter-observer agreement (Kappa &gt; 0.8). A total of 146 BAS were identified, with variable origins and consistent anatomical courses. Conclusion Flexible subtraction combined with CE-Boost significantly improves image quality and vascular visualization in bronchial artery CTA without distorting vascular morphology. Double overlay offers the best performance, though the trade-off with increased noise should be considered.</p>