FFAI: Flow Matching with Feedback Training and Adaptive Initialization for CT Reconstruction

Generative models, particularly Diffusion Models (DM), have shown strong potential for Computed Tomography (CT) reconstruction serving as expressive priors for solving ill-posed inverse problems. However, diffusion-based reconstruction relies on Stochastic Differential Equations (SDEs) for forward diffusion and reverse denoising, where such stochasticity can interfere with repeated data consistency corrections in CT reconstruction. Since CT reconstruction is often time-critical in clinical and interventional scenarios, improving reconstruction efficiency is essential. In contrast, Flow Matching (FM) models sampling as a deterministic Ordinary Differential Equation (ODE), yielding smooth trajectories without stochastic noise injection. This deterministic formulation is naturally compatible with repeated data consistency operations. Furthermore, we observe that FM-predicted velocity fields exhibit strong correlations across adjacent steps. Motivated by this, we propose an FM-based CT reconstruction framework (FMCT) and an efficient variant (EFMCT) that reuses previously predicted velocity fields over consecutive steps to substantially reduce the number of Neural network Function Evaluations (NFEs), thereby improving inference efficiency. We provide theoretical analysis showing that the error introduced by velocity reuse is bounded when combined with data consistency operations. Extensive experiments demonstrate that FMCT/EFMCT achieve competitive reconstruction quality while significantly improving computational efficiency compared with diffusion-based methods. The codebase is open-sourced at https://github.com/EFMCT/EFMCT.

Deep generative models have recently emerged as powerful priors for solving ill-posed inverse problems in CT, with diffusion-based approaches achieving state-of-the-art reconstruction performance. However, diffusion models typically rely on stochastic sampling procedures, long inference trajectories, and carefully tuned noise schedules, which can limit computational efficiency and numerical stability, especially at high spatial resolutions. In this work, we investigate Flow Matching as an alternative generative prior for CT reconstruction. We train a high-resolution Rectified Flow Matching model on 256x256 chest images from the Mayo Clinic Low-Dose CT dataset. To mitigate overfitting and limited anatomical variability, we employ a two-stage training strategy consisting of an initial phase with strong, anatomically informed data augmentation, followed by a fine-tuning phase with reduced or no augmentation to refine structural fidelity. The resulting model is capable of generating high-quality and anatomically coherent CT-like images, serving as a strong learned prior. We then evaluate multiple reconstruction methods specifically designed for Flow Matching models, including Plug-and-Play Flow, FlowDPS, Flower, and Flow-Priors (ICTM), and compare them against state-of-the-art diffusion-based reconstruction algorithms such as DDRM, DPS, and DiffPIR. Experimental results across several CT inverse problem settings show that Flow Matching-based approaches consistently outperform diffusion-based methods in terms of PSNR, SSIM, and perceptual quality, while requiring fewer sampling steps. Finally, we publicly release the trained Flow Matching model and accompanying code to facilitate reproducibility and future research. Overall, this work demonstrates that Flow Matching provides a stable, efficient, and effective alternative to diffusion models for high-resolution CT image reconstruction.

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.