Adaptive Texture-aware Masking for Self-Supervised Learning in 3D Dental CBCT Analysis

Metal artifacts generated by dental implants significantly degrade cone-beam computed tomography (CBCT) volumes, obscuring critical anatomical structures and compromising diagnostic precision. To address this, an unsupervised deep learning framework has been proposed for Metal Artifact Reduction (MAR) utilizing a Cycle-Consistent Adversarial Network (CycleGAN) optimized for high-fidelity restoration. Unlike supervised methods that rely on unattainable voxel-aligned paired datasets, the proposed approach leverages an unpaired dataset of approximately 4,000 images, curated from the public ToothFairy dataset. The architecture integrates U-Net-based generators and PatchGAN discriminators, specifically tuned to mitigate generative hallucinations and preserve morphological integrity. Quantitative benchmarking on a held-out test set demonstrates a 34.6% improvement in the Blind/Referenceless Image Spatial Quality Evaluator (BRISQUE) score, a substantial reduction in Fréchet Inception Distance (FID) from 207.03 to 157.04, and a superior Structural Similarity Index Measure (SSIM) of 0.9105. The framework achieves real-time efficiency with a 3.03 ms inference time per slice, effectively suppressing artifacts while preserving anatomical detail. Expert validation confirms high fidelity; however, to ensure reliability in extreme cases, the architecture is recommended as a clinical decision-support tool under human-in-the-loop oversight. By enhancing diagnostic clarity via a scalable software pipeline, this study provides a robust solution for high-fidelity dental implant imaging.

Recent breakthroughs in self-supervised learning (SSL), such as the Latent-Euclidean Joint-Embedding Predictive Architecture (LeJEPA), alongside successes in integrating visual encoders with language models, have driven the demand for adaptable, high-capacity vision encoders in Computed Tomography (CT). In this work, we explore 2D slice-based architectures as a flexible alternative to native 3D models for processing volumetric CT data. Using the CT-RATE dataset, we trained DALE-CT (Depth-Aware Latent-Euclidean Computed Tomography), a 2D model family built entirely from scratch using LeJEPA, and compared its performance against a continually pre-trained DINOv2 baseline. To enhance representation quality, we developed a novel 3D depth-aware pre-training strategy anchored by dense auxiliary supervision from both automated anatomical masks and human-annotated abnormalities. Under linear probe evaluation with Multiple Instance Learning (MIL) for multi-abnormality detection, the frozen backbone of this dual-supervised model (DALE-CT-2S) achieves a Macro AUROC of 0.833. This performance demonstrates near-parity with state-of-the-art 3D vision-language models, achieved entirely from scratch with significantly less data and no textual supervision. To ensure reproducibility, all training code, evaluation scripts, and model weights have been made publicly available.

Self-supervised learning has enabled large-scale pre-training on 2D natural images, producing general-purpose visual representations that transfer effectively across tasks. However, many medical imaging modalities, such as CT scans, are inherently three-dimensional and differ fundamentally from natural images in both structure and semantics. Volumetric modalities capture spatial continuity, organ anatomy, and intensity-based tissue properties (e.g., Hounsfield Units), which are not adequately modeled by 2D pre-training. To bridge this gap, we introduce CoralBay, a self-distillation framework that extends DINO by using a hierarchical 3D Swin backbone and applying self-distillation to concatenated multi-scale features, enabling data-efficient self-supervised learning of rich spatial representations that encode both global semantics and fine-grained local structure. As a result, CoralBay transfers effectively to a wide range of downstream radiological tasks, demonstrating strong and consistent performance across diverse anatomical targets. In addition, we contribute to the open-source \eva framework by introducing a public, reproducible 3D radiology leaderboard that unifies multiple datasets and establishes a standardized benchmark for evaluating volumetric representation learning methods.