CTForensics: A Comprehensive Dataset and Method for AI-Generated CT Image Detection
Authors: Yiheng Li, Zichang Tan, Guoqing Xu, Yichun Yeh, Yang Yang, Zhen Lei
Organizations: School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China · MAIS, Institute of Automation, Chinese Academy of Sciences, Beijing, China · Sangfor Technologies Inc., Shenzhen, China · CAIR, HKISI, Chinese Academy of Sciences, Beijing, China
Abstract
Recent advances in generative AI have made synthetic Computed Tomography (CT) images increasingly realistic, enabling promising applications in medical data augmentation while raising serious concerns about clinical safety and data trustworthiness. Detecting AI-generated CT images remains challenging for two key reasons: existing benchmarks cover only limited generation sources, and many detectors are adapted from natural-image forensics without explicitly modeling CT-specific imaging properties. In this paper, we introduce CTForensics, a dataset for detecting AI-generated CT images. CTForensics contains 75,990 2D CT images, including a dedicated test benchmark of 29,990 balanced authentic and generated samples from ten representative CT generative models spanning GAN-based and diffusion-based paradigms. We further propose the Enhanced Spatial-Frequency CT Forgery Detector (ESF-CTFD), a CT-oriented CNN framework built around a Wavelet-Enhanced Central Stem, Multi-Scale Spatial Aggregation, and a Frequency-Aware Prediction Block. The Wavelet-Enhanced Central Stem enhances local intensity correlations and high-frequency residuals, Multi-Scale Spatial Aggregation aligns anatomical features across resolutions with lightweight residual units, and the Frequency-Aware Prediction Block models global spectral artifacts. Extensive experiments on CTForensics show that ESF-CTFD achieves 96.01% mAcc and 99.96% mAP, outperforming existing methods and maintaining strong robustness under realistic perturbations with only a 0.99% average drop. Codes will be available at https://github.com/liyih/CTForensics.
The rapid advancements in generative AI technologies, such as Stable Diffusion, DALL-E, and Midjourney, have significantly transformed the creation of synthetic visual content. While these models enable innovation across industries, they also pose serious challenges, including misinformation, disinformation, and biased content generation. The increasing realism of AI-generated images makes their detection a pressing concern for researchers, policymakers, and industry stakeholders. In this paper, we present the findings of the Defactify 4.0 workshop, which introduced the Counter Turing Test (CT2) for AI-Generated Image Detection. The competition consisted of two key tasks: (1) binary classification of images as either AI-generated or real and (2) identification of the specific generative model responsible for an AI-generated image. To support both tasks, we employed the MS COCOAI dataset, a benchmark of 96000 real and synthetic images generated by five state-of-the-art models alongside real images from MS COCO. Participants employed diverse detection strategies, including convolutional neural networks (CNNs), Vision Transformers (ViTs), frequency-based analysis, contrastive learning, and multimodal techniques. The results demonstrated that while AI-generated images can be detected with high accuracy (F1-score > 0.83), identifying the exact model used remains significantly more challenging (highest F1-score: 0.4986). These findings highlight the need for improved model fingerprinting, adversarial robustness, and real-time detection mechanisms.
Recent advancements in synthetic data technology have opened a new era where images of remarkable quality are generated, blurring the lines between real-life images and those produced by Artificial Intelligence (AI). This evolution poses a significant challenge to ensuring the reliability and authenticity of data, underscoring the need for robust detection methods. In this paper, we present a robust approach aimed at addressing these pressing concerns. Our methodology revolves around leveraging fusion strategies, combining the strengths of multiple detection methods for identifying AI-generated images. Through extensive experimentation on the CIFAKE dataset, our model showcases remarkable performance, achieving an impressive accuracy rate of 97.32%. This accomplishment underscores the efficacy of our approach in accurately distinguishing between AI-generated images and real-life images, thus contributing to the advancement of data authentication techniques amidst the proliferation of synthetic data.
Xuan-Bach Mai, Hoang-Minh Nguyen-Huu, Quoc-Nghia Nguyen +3
The emergence of medical deepfakes, i.e., medical images manipulated by deep generative models, poses a significant threat to clinical workflows. However, existing detectors suffer from two critical limitations: poor generalization to unseen generative architectures for manipulation detection and lack of interpretability. In this context, we present HexMIL (Hierarchical EXplainable Multiple Instance Learning), a mask-free medical deepfake detector that simultaneously addresses both limitations using only binary volume-level supervision. HexMIL decomposes each CT volume into a two-level hierarchy of patches and slices, aggregated via independent Gated Attention modules whose weights are directly combined into a full-resolution 3D attention volume that localizes the manipulated sub-region without any pixel-level annotation. Unlike post-hoc methods such as Grad-CAM, HexMIL's attention weights constitute the exact forward computation driving the classification decision, providing ante-hoc and structurally faithful spatial attribution. We evaluate HexMIL on M3DSynth and CT-GAN datasets under a rigorous cross-generator generalization protocol, training on a single generative architecture and testing on unseen ones. HexMIL outperforms all baselines by +9.1 AUC and +9.4 F1 in out-of-domain classification, and achieves the best average IoU and Pointing Game score in localization. Project page: opontorno.github.io/hexmil.