Computed Tomography (CT) is a widely utilized imaging modality in clinical settings. Using densely acquired rotational X-ray arrays, CT can capture 3D spatial features. However, it is confronted with challenged such as significant time consumption and high radiation exposure. CT reconstruction methods based on sparse-view X-ray images have garnered substantial attention from researchers as they present a means to mitigate costs and risks. In recent years, diffusion models, particularly the Latent Diffusion Model (LDM), have demonstrated promising potential in the domain of 3D CT reconstruction. Nonetheless, due to the substantial differences between the 2D latent representation of X-ray modalities and the 3D latent representation of CT modalities, the vanilla LDM is incapable of achieving effective alignment within the latent space. To address this issue, we propose the Consistent Latent Space Diffusion Model (CLS-DM), which incorporates cross-modal feature contrastive learning to efficiently extract latent 3D information from 2D X-ray images and achieve latent space alignment between modalities. Experimental results indicate that CLS-DM outperforms classical and state-of-the-art generative models in terms of standard voxel-level metrics (PSNR, SSIM) on the LIDC-IDRI and CTSpine1K datasets. This methodology not only aids in enhancing the effectiveness and economic viability of sparse X-ray reconstructed CT but can also be generalized to other cross-modal transformation tasks, such as text-to-image synthesis. We have made our code publicly available at https://anonymous.4open.science/r/CLS-DM-50D6/ to facilitate further research and applications in other domains.
Sparse-view computed tomography (CT) is a practical solution to reduce radiation dose, but the resulting ill-posed inverse problem poses significant challenges for accurate image reconstruction. Although deep learning and diffusion-based methods have shown promising results, they often lack physical interpretability or suffer from high computational costs due to iterative sampling starting from random noise. Recent advances in generative modeling, particularly Poisson Flow Generative Models (PFGM), enable high-fidelity image synthesis by modeling the full data distribution. In this work, we propose Residual Poisson Flow (ResPF) Generative Models for efficient and accurate sparse-view CT reconstruction. Based on PFGM++, ResPF integrates conditional guidance from sparse measurements and employs a hijacking strategy to significantly reduce sampling cost by skipping redundant initial steps. However, skipping early stages can degrade reconstruction quality and introduce unrealistic structures. To address this, we embed a data-consistency into each iteration, ensuring fidelity to sparse-view measurements. Yet, PFGM sampling relies on a fixed ordinary differential equation (ODE) trajectory induced by electrostatic fields, which can be disrupted by step-wise data consistency, resulting in unstable or degraded reconstructions. Inspired by ResNet, we introduce a residual fusion module to linearly combine generative outputs with data-consistent reconstructions, effectively preserving trajectory continuity. To the best of our knowledge, this is the first application of Poisson flow models to sparse-view CT. Extensive experiments on synthetic and clinical datasets demonstrate that ResPF achieves superior reconstruction quality, faster inference, and stronger robustness compared to state-of-the-art iterative, learning-based, and diffusion models.
Widely adopted evaluation metrics for sparse-view CT reconstruction--such as Structural Similarity Index Measure and Peak Signal-to-Noise Ratio--prioritize pixel-wise fidelity but often fail to capture the completeness of critical anatomical structures, particularly small or thin regions that are easily missed. To address this limitation, we propose a suite of novel anatomy-aware evaluation metrics designed to assess structural completeness across anatomical structures, including large organs, small organs, intestines, and vessels. Building on these metrics, we introduce CARE, a Completeness-Aware Reconstruction Enhancement framework that incorporates structural penalties during training to encourage anatomical preservation of significant structures. CARE is model-agnostic and can be seamlessly integrated into analytical, implicit, and generative methods. When applied to these methods, CARE substantially improves structural completeness in CT reconstructions, achieving up to +32% improvement for large organs, +22% for small organs, +40% for intestines, and +36% for vessels.
Medical image reconstruction from measurement data is a vital but challenging inverse problem. Deep learning approaches have achieved promising results, but often requires paired measurement and high-quality images, which is typically simulated through a forward model, i.e., retrospective reconstruction. However, training on simulated pairs commonly leads to performance degradation on real prospective data due to the retrospective-to-prospective gap caused by incomplete imaging knowledge in simulation. To address this challenge, this paper introduces imaging Knowledge-Informed Dynamic Optimal Transport (KIDOT), a novel dynamic optimal transport framework with optimality in the sense of preserving consistency with imaging physics in transport, that conceptualizes reconstruction as finding a dynamic transport path. KIDOT learns from unpaired data by modeling reconstruction as a continuous evolution path from measurements to images, guided by an imaging knowledge-informed cost function and transport equation. This dynamic and knowledge-aware approach enhances robustness and better leverages unpaired data while respecting acquisition physics. Theoretically, we demonstrate that KIDOT naturally generalizes dynamic optimal transport, ensuring its mathematical rationale and solution existence. Extensive experiments on MRI and CT reconstruction demonstrate KIDOT's superior performance.
Limited Angle Computed Tomography (LACT) often faces significant challenges due to missing angular information. Unlike previous methods that operate in the image domain, we propose a new method that focuses on sinogram inpainting. We leverage MR-SDEs, a variant of diffusion models that characterize the diffusion process with mean-reverting stochastic differential equations, to fill in missing angular data at the projection level. Furthermore, by combining distillation with constraining the output of the model using the pseudo-inverse of the inpainting matrix, the diffusion process is accelerated and done in a step, enabling efficient and accurate sinogram completion. A subsequent post-processing module back-projects the inpainted sinogram into the image domain and further refines the reconstruction, effectively suppressing artifacts while preserving critical structural details. Quantitative experimental results demonstrate that the proposed method achieves state-of-the-art performance in both perceptual and fidelity quality, offering a promising solution for LACT reconstruction in scientific and clinical applications.
Computed Tomography serves as an indispensable tool in clinical workflows, providing non-invasive visualization of internal anatomical structures. Existing CT reconstruction works are limited to small-capacity model architecture and inflexible volume representation. In this work, we present X-GRM (X-ray Gaussian Reconstruction Model), a large feedforward model for reconstructing 3D CT volumes from sparse-view 2D X-ray projections. X-GRM employs a scalable transformer-based architecture to encode sparse-view X-ray inputs, where tokens from different views are integrated efficiently. Then, these tokens are decoded into a novel volume representation, named Voxel-based Gaussian Splatting (VoxGS), which enables efficient CT volume extraction and differentiable X-ray rendering. This combination of a high-capacity model and flexible volume representation, empowers our model to produce high-quality reconstructions from various testing inputs, including in-domain and out-domain X-ray projections. Our codes are available at: https://github.com/CUHK-AIM-Group/X-GRM.
Cone-Beam Computed Tomography (CBCT) is essential in medical imaging, and the Feldkamp-Davis-Kress (FDK) algorithm is a popular choice for reconstruction due to its efficiency. However, FDK is susceptible to noise and artifacts. While recent deep learning methods offer improved image quality, they often increase computational complexity and lack the interpretability of traditional methods. In this paper, we introduce an enhanced FDK-based neural network that maintains the classical algorithm's interpretability by selectively integrating trainable elements into the cosine weighting and filtering stages. Recognizing the challenge of a large parameter space inherent in 3D CBCT data, we leverage wavelet transformations to create sparse representations of the cosine weights and filters. This strategic sparsification reduces the parameter count by $93.75\%$ without compromising performance, accelerates convergence, and importantly, maintains the inference computational cost equivalent to the classical FDK algorithm. Our method not only ensures volumetric consistency and boosts robustness to noise, but is also designed for straightforward integration into existing CT reconstruction pipelines. This presents a pragmatic enhancement that can benefit clinical applications, particularly in environments with computational limitations.
Score-based diffusion models have shown significant promise in the field of sparse-view CT reconstruction. However, the projection dataset is large and riddled with redundancy. Consequently, applying the diffusion model to unprocessed data results in lower learning effectiveness and higher learning difficulty, frequently leading to reconstructed images that lack fine details. To address these issues, we propose the ordered-subsets multi-diffusion model (OSMM) for sparse-view CT reconstruction. The OSMM innovatively divides the CT projection data into equal subsets and employs multi-subsets diffusion model (MSDM) to learn from each subset independently. This targeted learning approach reduces complexity and enhances the reconstruction of fine details. Furthermore, the integration of one-whole diffusion model (OWDM) with complete sinogram data acts as a global information constraint, which can reduce the possibility of generating erroneous or inconsistent sinogram information. Moreover, the OSMM's unsupervised learning framework provides strong robustness and generalizability, adapting seamlessly to varying sparsity levels of CT sinograms. This ensures consistent and reliable performance across different clinical scenarios. Experimental results demonstrate that OSMM outperforms traditional diffusion models in terms of image quality and noise resilience, offering a powerful and versatile solution for advanced CT imaging in sparse-view scenarios.
Dynamic computed tomography (CT) reconstruction faces significant challenges in addressing motion artifacts, particularly for nonperiodic rapid movements such as cardiac imaging with fast heart rates. Traditional methods struggle with the extreme limited-angle problems inherent in nonperiodic cases. Deep learning methods have improved performance but face generalization challenges. Recent implicit neural representation (INR) techniques show promise through self-supervised deep learning, but have critical limitations: computational inefficiency due to forward-warping modeling, difficulty balancing DVF complexity with anatomical plausibility, and challenges in preserving fine details without additional patient-specific pre-scans. This paper presents a novel INR-based framework, BIRD, for nonperiodic dynamic CT reconstruction. It addresses these challenges through four key contributions: (1) backward-warping deformation that enables direct computation of each dynamic voxel with significantly reduced computational cost, (2) diffeomorphism-based DVF regularization that ensures anatomically plausible deformations while maintaining representational capacity, (3) motion-compensated analytical reconstruction that enhances fine details without requiring additional pre-scans, and (4) dimensional-reduction design for efficient 4D coordinate encoding. Through various simulations and practical studies, including digital and physical phantoms and retrospective patient data, we demonstrate the effectiveness of our approach for nonperiodic dynamic CT reconstruction with enhanced details and reduced motion artifacts. The proposed framework enables more accurate dynamic CT reconstruction with potential clinical applications, such as one-beat cardiac reconstruction, cinematic image sequences for functional imaging, and motion artifact reduction in conventional CT scans.
Inspired by their success in solving challenging inverse problems in computer vision, implicit neural representations (INRs) have been recently proposed for reconstruction in low-dose/sparse-view X-ray computed tomography (CT). An INR represents a CT image as a small-scale neural network that takes spatial coordinates as inputs and outputs attenuation values. Fitting an INR to sinogram data is similar to classical model-based iterative reconstruction methods. However, training INRs with losses and gradient-based algorithms can be prohibitively slow, taking many thousands of iterations to converge. This paper investigates strategies to accelerate the optimization of INRs for CT reconstruction. In particular, we propose two approaches: (1) using a modified loss function with improved conditioning, and (2) an algorithm based on the alternating direction method of multipliers. We illustrate that both of these approaches significantly accelerate INR-based reconstruction of a synthetic breast CT phantom in a sparse-view setting.
Positron Emission Tomography (PET) imaging requires accurate attenuation correction (AC) to account for photon loss due to tissue density variations. In PET/MR systems, computed tomography (CT), which offers a straightforward estimation of AC is not available. This study presents a deep learning approach to generate synthetic CT (sCT) images directly from Time-of-Flight (TOF) non-attenuation corrected (NAC) PET images, enhancing AC for PET/MR. We first evaluated models pre-trained on large-scale natural image datasets for a CT-to-CT reconstruction task, finding that the pre-trained model outperformed those trained solely on medical datasets. The pre-trained model was then fine-tuned using an institutional dataset of 35 TOF NAC PET and CT volume pairs, achieving the lowest mean absolute error (MAE) of 74.49 HU and highest peak signal-to-noise ratio (PSNR) of 28.66 dB within the body contour region. Visual assessments demonstrated improved reconstruction of both bone and soft tissue structures from TOF NAC PET images. This work highlights the effectiveness of using pre-trained deep learning models for medical image translation tasks. Future work will assess the impact of sCT on PET attenuation correction and explore additional neural network architectures and datasets to further enhance performance and practical applications in PET imaging.
Sparse-view sampling in dual-energy computed tomography (DECT) significantly reduces radiation dose and increases imaging speed, yet is highly prone to artifacts. Although diffusion models have demonstrated potential in effectively handling incomplete data, most existing methods in this field focus on the image do-main and lack global constraints, which consequently leads to insufficient reconstruction quality. In this study, we propose a dual-domain virtual-mask in-formed diffusion model for sparse-view reconstruction by leveraging the high inter-channel correlation in DECT. Specifically, the study designs a virtual mask and applies it to the high-energy and low-energy data to perform perturbation operations, thus constructing high-dimensional tensors that serve as the prior information of the diffusion model. In addition, a dual-domain collaboration strategy is adopted to integrate the information of the randomly selected high-frequency components in the wavelet domain with the information in the projection domain, for the purpose of optimizing the global struc-tures and local details. Experimental results indicated that the present method exhibits excellent performance across multiple datasets.
Four-dimensional computed tomography (4D CT) reconstruction is crucial for capturing dynamic anatomical changes but faces inherent limitations from conventional phase-binning workflows. Current methods discretize temporal resolution into fixed phases with respiratory gating devices, introducing motion misalignment and restricting clinical practicality. In this paper, We propose X$^2$-Gaussian, a novel framework that enables continuous-time 4D-CT reconstruction by integrating dynamic radiative Gaussian splatting with self-supervised respiratory motion learning. Our approach models anatomical dynamics through a spatiotemporal encoder-decoder architecture that predicts time-varying Gaussian deformations, eliminating phase discretization. To remove dependency on external gating devices, we introduce a physiology-driven periodic consistency loss that learns patient-specific breathing cycles directly from projections via differentiable optimization. Extensive experiments demonstrate state-of-the-art performance, achieving a 9.93 dB PSNR gain over traditional methods and 2.25 dB improvement against prior Gaussian splatting techniques. By unifying continuous motion modeling with hardware-free period learning, X$^2$-Gaussian advances high-fidelity 4D CT reconstruction for dynamic clinical imaging. Project website at: https://x2-gaussian.github.io/.
X-ray imaging is indispensable in medical diagnostics, yet its use is tightly regulated due to potential health risks. To mitigate radiation exposure, recent research focuses on generating novel views from sparse inputs and reconstructing Computed Tomography (CT) volumes, borrowing representations from the 3D reconstruction area. However, these representations originally target visible light imaging that emphasizes reflection and scattering effects, while neglecting penetration and attenuation properties of X-ray imaging. In this paper, we introduce X-Field, the first 3D representation specifically designed for X-ray imaging, rooted in the energy absorption rates across different materials. To accurately model diverse materials within internal structures, we employ 3D ellipsoids with distinct attenuation coefficients. To estimate each material's energy absorption of X-rays, we devise an efficient path partitioning algorithm accounting for complex ellipsoid intersections. We further propose hybrid progressive initialization to refine the geometric accuracy of X-Filed and incorporate material-based optimization to enhance model fitting along material boundaries. Experiments show that X-Field achieves superior visual fidelity on both real-world human organ and synthetic object datasets, outperforming state-of-the-art methods in X-ray Novel View Synthesis and CT Reconstruction.
Directly reconstructing 3D CT volume from few-view 2D X-rays using an end-to-end deep learning network is a challenging task, as X-ray images are merely projection views of the 3D CT volume. In this work, we facilitate complex 2D X-ray image to 3D CT mapping by incorporating new view synthesis, and reduce the learning difficulty through view-guided feature alignment. Specifically, we propose a dual-view guided diffusion model (DVG-Diffusion), which couples a real input X-ray view and a synthesized new X-ray view to jointly guide CT reconstruction. First, a novel view parameter-guided encoder captures features from X-rays that are spatially aligned with CT. Next, we concatenate the extracted dual-view features as conditions for the latent diffusion model to learn and refine the CT latent representation. Finally, the CT latent representation is decoded into a CT volume in pixel space. By incorporating view parameter guided encoding and dual-view guided CT reconstruction, our DVG-Diffusion can achieve an effective balance between high fidelity and perceptual quality for CT reconstruction. Experimental results demonstrate our method outperforms state-of-the-art methods. Based on experiments, the comprehensive analysis and discussions for views and reconstruction are also presented.
Sparse-view 3D CT reconstruction aims to recover volumetric structures from a limited number of 2D X-ray projections. Existing feedforward methods are constrained by the limited capacity of CNN-based architectures and the scarcity of large-scale training datasets. In this paper, we propose an X-ray Large Reconstruction Model (X-LRM) for extremely sparse-view (<10 views) CT reconstruction. X-LRM consists of two key components: X-former and X-triplane. Our X-former can handle an arbitrary number of input views using an MLP-based image tokenizer and a Transformer-based encoder. The output tokens are then upsampled into our X-triplane representation, which models the 3D radiodensity as an implicit neural field. To support the training of X-LRM, we introduce Torso-16K, a large-scale dataset comprising over 16K volume-projection pairs of various torso organs. Extensive experiments demonstrate that X-LRM outperforms the state-of-the-art method by 1.5 dB and achieves 27x faster speed and better flexibility. Furthermore, the downstream evaluation of lung segmentation tasks also suggests the practical value of our approach. Our code, pre-trained models, and dataset will be released at https://github.com/caiyuanhao1998/X-LRM
Liver-vessel segmentation is an essential task in the pre-operative planning of liver resection. State-of-the-art 2D or 3D convolution-based methods focusing on liver vessel segmentation on 2D CT cross-sectional views, which do not take into account the global liver-vessel topology. To maintain this global vessel topology, we rely on the underlying physics used in the CT reconstruction process, and apply this to liver-vessel segmentation. Concretely, we introduce the concept of top-k maximum intensity projections, which mimics the CT reconstruction by replacing the integral along each projection direction, with keeping the top-k maxima along each projection direction. We use these top-k maximum projections to condition a diffusion model and generate 3D liver-vessel trees. We evaluate our 3D liver-vessel segmentation on the 3D-ircadb-01 dataset, and achieve the highest Dice coefficient, intersection-over-union (IoU), and Sensitivity scores compared to prior work.
Deep learning has emerged as a powerful tool for solving inverse problems in imaging, including computed tomography (CT). However, most approaches require paired training data with ground truth images, which can be difficult to obtain, e.g., in medical applications. We present TomoSelfDEQ, a self-supervised Deep Equilibrium (DEQ) framework for sparse-angle CT reconstruction that trains directly on undersampled measurements. We establish theoretical guarantees showing that, under suitable assumptions, our self-supervised updates match those of fully-supervised training with a loss including the (possibly non-unitary) forward operator like the CT forward map. Numerical experiments on sparse-angle CT data confirm this finding, also demonstrating that TomoSelfDEQ outperforms existing self-supervised methods, achieving state-of-the-art results with as few as 16 projection angles.
Emerging unsupervised implicit neural representation (INR) methods, such as NeRP, NeAT, and SCOPE, have shown great potential to address sparse-view computed tomography (SVCT) inverse problems. Although these INR-based methods perform well in relatively dense SVCT reconstructions, they struggle to achieve comparable performance to supervised methods in sparser SVCT scenarios. They are prone to being affected by noise, limiting their applicability in real clinical settings. Additionally, current methods have not fully explored the use of image domain priors for solving SVCsT inverse problems. In this work, we demonstrate that imperfect reconstruction results can provide effective image domain priors for INRs to enhance performance. To leverage this, we introduce Self-prior embedding neural representation (Spener), a novel unsupervised method for SVCT reconstruction that integrates iterative reconstruction algorithms. During each iteration, Spener extracts local image prior features from the previous iteration and embeds them to constrain the solution space. Experimental results on multiple CT datasets show that our unsupervised Spener method achieves performance comparable to supervised state-of-the-art (SOTA) methods on in-domain data while outperforming them on out-of-domain datasets. Moreover, Spener significantly improves the performance of INR-based methods in handling SVCT with noisy sinograms. Our code is available at https://github.com/MeijiTian/Spener.
A major challenge for medical X-ray CT imaging is reducing the number of X-ray projections to lower radiation dosage and reduce scan times without compromising image quality. However these under-determined inverse imaging problems rely on the formulation of an expressive prior model to constrain the solution space while remaining computationally tractable. Traditional analytical reconstruction methods like Filtered Back Projection (FBP) often fail with sparse measurements, producing artifacts due to their reliance on the Shannon-Nyquist Sampling Theorem. Consensus Equilibrium, which is a generalization of Plug and Play, is a recent advancement in Model-Based Iterative Reconstruction (MBIR), has facilitated the use of multiple denoisers are prior models in an optimization free framework to capture complex, non-linear prior information. However, 3D prior modelling in a Plug and Play approach for volumetric image reconstruction requires long processing time due to high computing requirement. Instead of directly using a 3D prior, this work proposes a BM3D Multi Slice Fusion (BM3D-MSF) prior that uses multiple 2D image denoisers fused to act as a fully 3D prior model in Plug and Play reconstruction approach. Our approach does not require training and are thus able to circumvent ethical issues related with patient training data and are readily deployable in varying noise and measurement sparsity levels. In addition, reconstruction with the BM3D-MSF prior achieves similar reconstruction image quality as fully 3D image priors, but with significantly reduced computational complexity. We test our method on clinical CT data and demonstrate that our approach improves reconstructed image quality.