ReCo-Diff: Residual-Conditioned Deterministic Sampling for Cold Diffusion in Sparse-View CT

Diffusion-based sparse-view CT (SVCT) imaging has achieved remarkable advancements in recent years, thanks to its more stable generative capability. However, recovering reliable image content and visually consistent textures is still a crucial challenge. In this paper, we present a Progressively Texture-aware Diffusion (PTD) model, a coarse-to-fine learning framework tailored for SVCT. Specifically, PTD comprises a basic reconstructive module PTD$_{\textit{rec}}$ and a conditional diffusion module PTD$_{\textit{diff}}$. PTD$_{\textit{rec}}$ first learns a deterministic mapping to recover the majority of the underlying low-frequency signals (i.e., coarse content with smoothed textures), which serves as the initial estimation to enable fidelity. Moreover, PTD$_{\textit{diff}}$ aims to reconstruct high-fidelity details for coarse prediction, which explores a dual-domain guided conditional diffusion to generate reliable and consistent textures. Extensive experiments on sparse-view CT reconstruction demonstrate that our PTD achieves superior performance in terms of structure similarity and visual appeal with only a few sampling steps, which mitigates the randomness inherent in general diffusion models and enables a better trade-off between visual quality and fidelity of high-frequency details.

Computed Tomography (CT) is a widely used imaging modality in medical and industrial applications. To limit radiation exposure and measurement time, there is a growing interest in sparse-view CT, where the number of projection views is significantly reduced. Deep neural networks have shown great promise in improving reconstruction quality in sparse-view CT, especially generative diffusion models. However, these methods struggle to scale to large 3D volumes due to several reasons: (i) the high memory and computational requirements of 3D models, (ii) the lack of large 3D training datasets, and (iii) the inconsistencies across slices when using 2D models independently on each slice. We overcome these limitations and scale diffusion-based sparse-view CT reconstruction to large 3D volumes by combining conditional diffusion with explicit data consistency. We propose Conditional Diffusion Posterior Alignment (CDPA) to enable scalable 3D sparse-view CT reconstruction. A 2D U-Net diffusion model is conditioned on an initial 3D reconstruction to improve inter-slice consistency, combined with data-consistency alignment to match measured projections. Experiments on synthetic and real Cone Beam CT (CBCT) data show state-of-the-art performance, with ablations that confirm the synergistic effects of the proposed pipeline. Finally, we show that the same principles also strengthen fast denoising U-Nets, yielding near-diffusion quality at a fraction of the computational cost.

Sparse-view CT reduces radiation dose and scanning time by acquiring fewer projection views, but angular undersampling makes reconstruction severely ill-posed, causing streak artifacts, structural blurring, and loss of fine details. Existing supervised methods are often tied to specific sampling settings, whereas generative methods may introduce anatomically inconsistent hallucination-like structures under severe undersampling. We propose Lucid, a sparsity-adaptive, consistency-guided reconstruction framework based on a Flow Matching generative prior for sparse-view CT. Lucid is trained only on high-quality CT images to learn a continuous transport between a Gaussian distribution and the high-quality CT image distribution, independent of view sampling. During inference, the sampling sparsity level is explicitly incorporated to adapt the generative trajectory of a single pretrained model. Specifically, Lucid constructs a degradation-matched initial state by sparsity-weighted fusion of the sparse-view FBP image and Gaussian noise, performs sparsity-modulated Flow Matching updates, and applies projection-domain data-consistency correction after each prior update. Experiments under multiple sparse-view settings show that Lucid achieves stable reconstruction performance across different sampling densities, improves image quality and structural fidelity, and reduces the risk of hallucination-like structures in generative sparse-view CT reconstruction.