VascuSR: Iterative Anatomy-Aware Diffusion for CT Super-Resolution

High-resolution volumetric medical imaging is critical for clinical diagnosis, yet acquisition is often limited by scanner hardware, scan time, and for CT, radiation dose. Medical 3D Super-Resolution (Med3DSR) offers a computational alternative, but existing methods commonly rely on per-subject optimization, pretrained priors, or coordinate-based implicit representations, which compromise anatomical fidelity and limit efficiency. To address these limitations, we present MedGSSR, a fully end-to-end feed-forward framework that represents volumes as an explicit 3D Gaussian field for Med3DSR. Unlike coordinate-based implicit functions, our explicit 3D Gaussian representation naturally enhances signal continuity and local high-frequency fidelity. Specifically, MedGSSR explicitly decouples the reconstruction process into coarse-grained structural preservation and fine-grained textural refinement through the proposed Pyramid Anatomical Encoder and a Hierarchical Gaussian Projector. To support arbitrary-scale super-resolution, we introduce sub-voxel Gaussian decomposition and a Differentiable Gaussian Voxelizer that directly queries the continuous 3D intensity field, reducing discretization artifacts. Extensive experiments on MRI and CT benchmarks demonstrate that MedGSSR significantly outperforms state-of-the-art methods. Notably, our framework exhibits robust generalizability across unseen datasets without requiring per-subject optimization, enabling fast inference and high-fidelity volumetric super-resolution in practical clinical settings. Our project webpage, including code, is at https://william2ai.github.io/medgssr

Three-dimensional (3D) medical image enhancement, including denoising and super-resolution, is critical for clinical diagnosis in CT, PET, and MRI. Although diffusion models have shown remarkable success in 2D medical imaging, scaling them to high-resolution 3D volumes remains computationally prohibitive due to lengthy diffusion trajectories over high-dimensional volumetric data. We observe that in conditional enhancement, strong anatomical priors in the degraded input render dense noise schedules largely redundant. Leveraging this insight, we propose a sparse voxel-space diffusion framework that trains and samples on a compact set of uniformly subsampled timesteps. The network predicts clean data directly on the data manifold, supervised in velocity space for stable gradient scaling. A lightweight Structure-aware Trajectory Modulation (STM) module recalibrates time embeddings at each network block based on local anatomical content, enabling structure-adaptive denoising over the shared sparse schedule. Operating directly in voxel space, our framework preserves fine anatomical detail without lossy compression while achieving up to $10\times$ training acceleration. Experiments on four datasets spanning CT, PET, and MRI demonstrate state-of-the-art performance on both denoising and super-resolution tasks. Our code is publicly available at: https://github.com/mirthAI/sparse-3d-diffusion.

The effectiveness of super resolution (SR) models hinges on their ability to recover high frequency structure without introducing artifacts. Diffusion based approaches have recently advanced the state of the art in SR. However, most diffusion based SR pipelines operate purely in the spatial domain, which may yield high frequency details that are not well supported by the underlying low resolution evidence. On the other hand, unlike supervised SR models that may inject dataset specific textures, single image SR relies primarily on internal image statistics and can therefore be less prone to dataset-driven hallucinations; nevertheless, ambiguity in the LR observation can still lead to inconsistent high frequency details. To tackle this problem, we introduce BATDiff, an unsupervised Bivariate A trous Wavelet Diffusion model designed to provide structured cross scale guidance during the generative process. BATDiff employs an a Trous wavelet transform that constructs an undecimated multiscale representation in which high frequency components are progressively revealed while the full spatial resolution is preserved. As the core inference mechanism, BATDiff includes a bivariate cross scale module that models parent child dependencies between adjacent scales. It improves high frequency coherence and reduces mismatch artifacts in diffusion based SR. Experiments on standard benchmarks demonstrate that BATDiff produces sharper and more structurally consistent reconstructions than existing diffusion and non diffusion baselines, achieving improvements in fidelity and perceptual quality.