Augmenting CT evaluation of primary small bowel malignancies: The role of cinematic rendering

Primary small bowel malignancies are rare, often presenting with nonspecific symptoms or as acute emergencies, which can delay diagnosis. Contrast-enhanced CT is the primary imaging modality in the emergency setting, but detection and characterization of small bowel tumors remain challenging. Cinematic rendering (CR) is a recently developed three-dimensional post-processing technique that produces photorealistic images from CT data, enhancing visualization of small bowel pathology. This pictorial review outlines the CT imaging features of major small bowel malignancies, including adenocarcinoma, carcinoid tumor, gastrointestinal stromal tumor, lymphoma, and sarcoma, and describes features that highlight the utility of CR in augmenting traditional imaging. CR offers improved visualization of mucosal abnormalities, tumor extent, vascular involvement, and textural differences, potentially increasing diagnostic confidence, supporting presurgical planning, and facilitating communication among clinicians and patients. By emphasizing the added value of CR, we aim to provide radiologists with practical guidance for identifying small bowel neoplasms and suggest that integrating advanced 3D visualization into routine CT evaluation can support timely diagnosis and management in acute care settings.