UltraDiff: Differentiable Ray Tracing in Ultrasound for Shape Optimization

Acoustic shadows from bone and other highly attenuating tissues obscure clinically important structures in ultrasound. In fetal brain imaging, skull-induced artefacts disproportionately degrade the hemisphere closer to the transducer (proximal), limiting symmetric assessment of the two hemispheres. Existing correction methods require raw scanner data, impose restrictive assumptions on tissue properties, or rely on generative models that may hallucinate anatomy. We present RFlash, a physics-informed post-processing method that decomposes beamformed ultrasound images into explicit attenuation and scatter-intensity maps using a differentiable radiance-field formulation of image formation. Attenuation-adaptive re-rendering then removes the dependence of the signal at each depth on the intervening tissue, equivalent to virtually advancing the transducer into the tissue. Across 1,261 3D fetal brain volumes, 143 real 2D curvilinear abdominal scans, and 1,200 simulated 2D linear-probe liver scans, RFlash reduces shadow-related intensity differences more effectively than classical Hughes-Duck attenuation correction. For a gestational-age model trained on the distal hemisphere (further from the transducer) and applied to the proximal hemisphere, prediction error decreases by 5.1 days (40%) relative to the original images. The estimated attenuation maps also yield shadow-confidence maps that improve random-forest bone-shadow segmentation over the image alone and receive greater SHAP importance than an existing neural confidence-map baseline, suggesting greater physical consistency. RFlash requires neither hardware modification nor access to raw scanner data and supports 2D and 3D acquisitions with linear and curvilinear probes, making it widely applicable allowing clinicians to use our method on their already acquired scanners and images.

Conditional diffusion models can generate anatomically plausible medical ultrasound (US) images, but anatomical plausibility alone does not ensure realistic B-mode appearance. Most US pipelines adapt standard generative architectures and condition them on anatomical masks, or use guidance mechanisms that reinforce the same anatomical signal. However, B-mode US images are shaped by acquisition-dependent properties such as speckle texture, tissue contrast, and attenuation. Using a frozen US foundation model, we show that standard conditional diffusion baselines remain separated from real images in representation space. In this work, we propose Feature-Space Candidate Guidance (FSCG), a training-free sampling strategy to reduce this gap. At sampling time, FSCG applies local k-NN feature correction and selects the best of multiple stochastic candidates according to their feature-space energy. In this way, the mask defines the anatomy, while FSCG steers samples toward the real US domain. Across three different datasets, FSCG reduces average FID64 by 56%, FID192 by 57%, and nearest-neighbour feature distance by 47% over standard conditional diffusion sampling, outperforming alternative inference-time guidance baselines. The results suggest that domain-aware feature representations can reveal and reduce realism gaps in medical diffusion synthesis without retraining the generator. Our code is available at https://github.com/marinadominguez/FSCG.

Sonar is often the only modality suitable for high-resolution imaging underwater due to light attenuation and turbidity. Forward-looking imaging sonar provides measurements over range and horizontal angle but collapses vertical structure into a flat image, creating ambiguities that make 3D recovery challenging. A common use case for imaging sonar is underwater terrain mapping (bathymetry), yet current methods require many views, expensive multi-sensor setups, or significant training data, which limits use and adaptability to new environments. We present a training-free method that recovers bathymetry from a single sonar image in under 30 seconds via differentiable rendering, conditioned on a known seafloor tilt. To our knowledge, this is the first differentiable rendering approach for single-view height recovery in sonar. Our method implements differentiable sonar ray tracing and optimizes an explicit height field to reproduce the target image. On synthetic datasets, our approach outperforms a supervised CNN under distribution shift and remains close on rough terrain, while the CNN wins in-distribution. By modeling physically grounded priors of the sonar process, our method adapts across sensor configurations and environments without training data.