SAVER: Stochastic Adaptive Variance-Driven Exploration and Reconstruction for Low-Dose Computed Tomography

Computed tomography (CT) plays a crucial role in medical diagnosis, but minimizing radiation exposure while maintaining image quality remains a critical challenge. Low-dose CT (LDCT) protocols reduce radiation risks but inevitably suffer from severe noise and artifacts that compromise diagnostic accuracy. While existing deep learning methods have achieved promising results, there remains a continuous quest for generative paradigms that intrinsically capture global-to-local structural dependencies to better preserve fine anatomical details. To this end, we propose DeVAR, a novel generative framework that applies visual autoregressive modeling (VAR) to LDCT denoising for the first time. Conditioned on global context provided by LDCT prefix tokens, DeVAR progressively generates discrete token maps of the target normal-dose CT (NDCT) via next-scale prediction. Because quantization inherently discards high-frequency information, we introduce a residual refiner to capture subtle anatomical structures beyond the capacity of a discrete codebook. Finally, empowered by a dual-representation hybrid training strategy, our hybrid NDCT decoder seamlessly integrates continuous and discrete latents to reconstruct high-fidelity, detail-preserved images. Extensive experiments on two public datasets demonstrate that DeVAR consistently achieves superior qualitative and quantitative performance compared to state-of-the-art LDCT denoising methods.

In X-ray tomography, reconstruction quality generally improves with larger numbers of projections. However, more projections increase experiment costs, acquisition time and the radiation dose imparted to the sample. One mitigation to these trade-offs is to adopt a sequential design of experiments, in which each subsequent measurement is determined as a function of previously acquired data in order to maximize information gain. In practice, a widely used heuristic to maximize information is to align beams with the edges of the sample. A key challenge, however, is that the true sample is unknown, so identifying edge-aligned beams typically requires reconstructing the sample based on available measurements. This work proposes a novel sequential design method that identifies edge-aligned measurements directly from the sinogram, bypassing any reconstruction, thereby improving computational efficiency and reducing the experimental design's susceptibility to reconstruction errors. Our method dynamically selects the next set of measurement beams by maximizing an acquisition function that balances exploration and exploitation over the domain of all possible measurements, improving reconstruction quality while reducing measurement redundancy.

Computed tomography (CT) is a critical imaging modality for clinical diagnosis, but reducing radiation dose inevitably introduces severe noise and structured artifacts that degrade image quality. Existing deep learning-based low-dose CT (LDCT) reconstruction methods are typically optimized for fixed dose levels or specific anatomical regions, limiting their robustness and generalization in realistic clinical settings. We propose GenDiff, a generalizable diffusion-based framework for LDCT reconstruction that jointly models continuous radiation dose and anatomical information within a unified reconstruction network. The proposed framework integrates a Dose-Anatomy Encoder to learn acquisition-aware embeddings, a dose- and anatomy-conditioned cold diffusion backbone for iterative refinement, a physics-consistency update to enforce fidelity to the CT forward model, and a Structural Prior Refinement Module (SPRM) that preserves anatomical structures while suppressing dose-dependent artifacts. Extensive experiments on multi-anatomy clinical datasets, including unseen ultra-low-dose conditions as well as out-of-distribution phantom and animal datasets, demonstrate that GenDiff consistently outperforms state-of-the-art convolutional neural network and diffusion-based reconstruction methods. The proposed approach achieves superior reconstruction quality while maintaining strong robustness across different dose levels, anatomical regions, and acquisition domains, making it a promising solution for practical low-dose CT imaging.