Good morning!
try the 6x setting if you like but for me it didn´t make much improvement compared to 4x. Also my videocard is on the edge of good performance with 4x. My game is heavily modded (I use almost all improved skin mods, better smoke etc).
When i leave port i have around 20 fps.
Switch to 6x and check performance maybe your card can handle it.
Another quality improvment setting is "anisotropic texture filtering", also accessable with the tool. Change it to "8x + quality" and do some testing. But it´s not such a booster like AA.
Don´t forget to set both back to default (application controlled) if you want to play another game, some games have their own options for AA and that anisotropic stuff.
Have to go to the dentist now, ugh