Tomography

Grounding radiology report descriptions to 3D CT volumes is essential for verifiable clinical interpretation, yet remains challenging due to the semantic-spatial gap between free-text narratives and volumetric anatomy. Existing report-assisted and vision-language grounding methods typically rely on phrase-level alignment or dense pixel supervision, resulting in limited lesion-wise correspondence and suboptimal localization accuracy. We propose GLeVE, a graph-guided lesion grounding framework with anatomical prior verification and octree-based autoregressive refinement. GLeVE treats each lesion description as an atomic semantic unit and encodes organ attribution, attributes, and inter-lesion relations through relation-aware graph reasoning to produce discriminative lesion-wise queries. Anatomy-aware proposal generation with region-level verification enforces one-to-one text-lesion alignment, while hierarchical octree refinement progressively improves boundary delineation. Experiments on AbdomenAtlas 3.0 demonstrate consistent gains over classical multimodal foundation models and report-supervised baselines in both segmentation accuracy and lesion-level localization.

Computed tomography (CT) is a central to three-dimensional medical imaging, yet CT-based artificial intelligence remains fragmented across task-specific models for segmentation, classification, registration, and report analysis. Here we present FlexiCT, a family of CT foundation models trained by agglomerative continual pretraining on 266,227 CT volumes from 56 publicly available datasets, forming a large-scale public resource for CT representation learning. FlexiCT uses agglomerative pretraining across three stages: two-dimensional axial pretraining, three-dimensional anatomical pretraining and report-guided semantic alignment. This training strategy supports slice-level, volume-level and vision-language analysis. Across five downstream task families (segmentation, classification, registration, vision-language understanding and clinical retrieval), FlexiCT matches or exceeds prior task-specific approaches on multiple benchmarks. Its embeddings further organize CT scans along gradients associated with various tumor stages, suggesting that CT foundation models can capture imaging features relevant to disease phenotype characterization. Project page and code are available at: https://ricklisz.github.io/flexict.github.io and https://github.com/ricklisz/FlexiCT.

This work introduces a continuous soft near-orthogonality score and a resolution-aware saturated coverage objective for projection selection in region-of-interest focused cone-beam CT, grounded in Tuy's completeness theory. Replacing the binary hit-or-miss model of classical Tuy completeness with a graded, differentiable formulation preserves a direct link to achievable feature sizes while enabling both efficient approximate and exact optimisation. We establish that the underlying discrete decision problems are NP-complete via polynomial-time reductions from Set Cover, motivating a submodular greedy algorithm with proven $(1-1/\mathrm{e})$ approximation guarantees and a mixed-integer linear program (MILP) that provides certified optimality bounds. The MILP serves as a quality certificate for the greedy solution rather than a competing optimiser. The primary empirical finding confirms this relationship: across a systematic benchmark spanning six target regions, multiple projection budgets, and four controlled occlusion conditions, the pooled median greedy-to-MILP objective ratio was 0.998, with a substantial fraction of cases certified globally optimal. A binary formulation is included as a diagnostic baseline; it strengthens hard directional completeness but is weaker on the continuous coverage scale. We additionally introduce Effective Spatial Resolution (ESR), a physically interpretable trajectory-level diagnostic that maps directional sampling gaps to achievable feature sizes. ESR correlates reliably with matched reconstruction quality across projection budgets and occlusion levels, providing a practical bridge between the selection stage and the image domain without requiring reconstruction.

Panoramic radiograph (PR) is fundamentally used in routine dental care, but it inherently provides only a two-dimensional (2D) projection of complex three-dimensional (3D) craniofacial anatomy. Most existing learning-based methods attempt to computationally recover this 3D information by directly regressing native cone-beam computed tomography (CBCT) volumes from PR. However, this direct mapping requires the model to simultaneously learn common anatomical structures and patient-specific morphological variations. This entangled formulation makes the ill-posed 2D-to-3D inverse problem highly ambiguous, often producing over-smoothed reconstructions with blurred anatomical boundaries. To address this, we propose HyDAR-Pano3D, a two-stage framework that reformulates PR-to-CBCT reconstruction as a disentangled anatomical recovery problem. In Stage 1, a dual-encoder network integrates radiographic features with SAM-derived semantic priors to reconstruct an arch-normalized canonical volume. In Stage 2, an Anatomical Restoration Network predicts a prior-constrained structured deformation field to map this canonical volume back to the native space, restoring individual morphological variations. Experiments on three large-scale datasets show that HyDAR-Pano3D significantly outperforms baseline methods ($p < 0.05$), achieving a 25.76 dB PSNR, 85.70% SSIM, and an 83.83% overall anatomical Dice score. The synthesized volumes successfully support downstream segmentation of whole teeth (82.4% Dice) and the inferior alveolar canal (72.2% Dice), demonstrating that our disentangled approach preserves clinically relevant structures to enable robust anatomy-aware assessment when CBCT data is unavailable.

Cone-beam CT (CBCT) is routinely acquired during radiotherapy for patient setup, but its quantitative reliability is degraded by scatter, noise, and reconstruction artifacts, limiting Hounsfield Unit (HU) accuracy. We propose EPC-3D-Diff, a novel conditional 3D latent diffusion framework for volumetric CBCT to CT synthesis that introduces a projection domain equivariance loss derived from acquisition physics. Unlike common image domain equivariance, we exploit the fact that an in plane rotation of the volume corresponds to an angular shift in its projections. During training, we enforce this relationship by forward projecting rotated synthesized CT volumes and matching them to appropriately angle shifted projections of the paired target CT, yielding a physics consistent equivariance constraint integrated into the diffusion objective. To capture full 3D context efficiently, conditional diffusion is performed in a compact latent space learnt by a lightweight 3D autoencoder, preserving axial depth while downsampling in plane resolution for stable training. We validate on a paired head CBCT/CT phantom dataset, including repeat scans, and paired clinical data using patient wise splits, and perform single and mixed domain training, ablations, and comparisons with diffusion and CycleGAN. EPC-3D-Diff generalizes well and achieved substantial improvements, +7.4 dB (phantom) and +1.8 dB (clinical data) in PSNR compared to state of the art methods, alongside improved SSIM and HU accuracy, within tissue boundaries. Overall, EPC-3D-Diff improves robustness and physics consistency, supporting HU aware synthesis for downstream radiotherapy workflows. The open source code for EPC-3D-Diff is available at https://github.com/ALZAHRAALTALIB/EPC-3D-Diff.

In recent years, there has been a notable increase in the level of attention that is given to algorithms based on deep learning in the context of medical image segmentation. Nevertheless, the reliability of the field has been hindered due to the absence of a standardized methodology for performance analysis and the utilization of different datasets in previous research. The primary objective of the research is to comprehensively evaluate contemporary segmentation frameworks combined with state-of-the-art pre-trained backbones in order to accurately predict COVID-19 lesions in CT images. Moreover, this evaluation can serve as a point of reference for the segmentation of images in various other imaging scenarios. In order to accomplish this, we integrate four distinct deep learning architectures, namely Unet, PSPNet, Linknet, and FPN, with six pre-trained encoders, including VGG 19, DenseNet 121, Inception ResNet V2, MobileNet V2, SeresNet 101, and EfficientNet B0. This approach enables the development of diverse testing architectures. In the context of image segmentation, our research encompassed both binary and multi-class experimentation. The findings derived from our analysis of three distinct COVID-19 CT segmentation datasets indicate that deep learning architectures yield precise and efficient segmentation outcomes. Significantly, a maximum F1-Score of 98% was attained for binary class segmentation, while multi-class segmentation yielded F1-Scores of 75% and 77% across two separate datasets. The utilization of artificial intelligence and deep learning enhances the diagnostic process for pandemic diseases across multiple dimensions.

COVID-19 was a significant challenge that led to the loss of numerous lives daily. Not only a certain country was involved in this outbreak, but even the world has suffered because of the coronavirus. Imaging techniques using computed tomography (CT) and X-rays of the lungs are the most useful tools for the COVID-19 or any other pandemic disease screening process. Technology today has revolutionized the world by using artificial intelligence to replace manual processes with automated machines, which enable the system to imitate the human brain by making wise decisions based on experience. Motivated by this, our work proposes to use convolutional neural networks (CNN) based models for designing a computer-aided diagnosis (CAD) system that differentiates between COVID-19 and healthy lung pictures. We used two different sets of X-ray images of the lungs in addition to two different sets of CT scans and the classification is done using a variety of networks that have been pre-trained such as VGG (16, 19), Densenet (121), Resnet (50, 50 V2, 101 V2), Mobile net (V2), Xception Inception (V3, Resnet V2), Efficient net (B0) and Nasnet (Large). On the X-ray and CT image datasets, Resnet and VGG architecture have shown the ability to properly differentiate COVID-19 from normal images, with an average accuracy of 95 to 98 percent respectively. Our acquired results on the classification datasets are competitive and superior to previously reported findings in the literature.

Medical vision-language models (VLMs) have rapidly advanced as general-purpose multimodal assistants, yet their deployment in 3D Computed Tomography (CT) analysis remains constrained by a persistent mismatch between optimization objectives and clinical rigor. Current Reinforcement Learning (RL) paradigms still rely on lexical proxy signals that induce \textit{Evaluation Hallucinations}'', where models optimize linguistic fluency rather than factual clinical correctness, leading to diagnostically critical errors. To bridge this gap, we introduce the \textbf{Clinical Abnormality Benchmarking Substrate (CABS)}, a structured system that decomposes radiology reports into verifiable clinical semantic units. Using CABS, we identify a \textit{Mechanistic Divergence}'' in standard RL, where surface-similarity rewards drive policy gradients to bypass medical facts. We therefore propose \textbf{Trajectory-Integral Feedback GRPO (TIF-GRPO)}, a novel framework integrating control-theoretic principles into policy optimization. By formulating clinical reasoning as a pseudo-temporal trajectory for anomaly discovery, TIF-GRPO regulates anatomy-aware rewards via an integral feedback loop that penalizes persistent omissions as cumulative state errors and suppresses hallucinations as excessive control effort. Experiments on 3D CT benchmarks demonstrate that our approach significantly enhances abnormality detection and clinical faithfulness, establishing a new paradigm for fine-grained regulation in medical VLMs. Our project is available at \href{https://github.com/ZJU4HealthCare/TIF-GRPO}{GitHub}.

Computed tomography (CT) metal artifact reduction (MAR) aims to reduce the severe streaking artifacts induced by metallic implants and other high-density objects. Effective MAR generally requires both accurate artifact localization and artifact removal. Sinogram-domain methods can exploit explicit geometric cues, such as metal traces, to identify metal-corrupted measurements, while requiring raw projection data, which is often unavailable in clinical and practical scenarios. Image-domain methods are more flexible and widely applicable, yet they usually lack comparable geometric guidance, limiting their ability to localize artifacts and leading to suboptimal results. To address this limitation, we propose GraphMAR, a geometry-aware learning framework for explicit artifact identification and spatially adaptive MAR in the image domain. The key idea is to introduce graph-based geometric modeling as an image-domain analogue of sinogram metal traces. Specifically, we first construct a geometric graph from the metal mask and derive a geometric density graph that coarsely localizes artifact-prone regions according to inter-implant geometry. We then design GraphMoE, a graph-routed mixture-of-experts module that builds a polar-coordinate artifact graph in feature space and adaptively routes different experts to different spatial regions for MAR. By aligning the learned routing maps with the geometric density graph, GraphMAR provides explicit and interpretable artifact localization while enabling region-adaptive artifact reduction. Experiments on both simulated and real-world datasets demonstrate that GraphMAR achieves superior MAR performance compared with existing methods. To the best of our knowledge, this is the first work to introduce graph-based modeling for CT MAR and to enable explicit artifact identification in the image domain, improving both restoration quality and interpretability.

Accurate segmentation and statistical shape modeling of hand anatomy have significant implications for medical diagnostics, ergonomics, and biomechanics. This study proposes an AI-assisted reconstruction pipeline for segmenting and analyzing hand anatomy from 1,271 elbow-to-hand (e2h-CT) computed tomography scans. A Pix2Pix-based conditional generative adversarial network is first employed to remove plaster cast and background artifacts from CT volumes. The cleaned scans are then processed in 3D Slicer to extract skin and bone masks, which are converted into closed-surface mesh models. Segmented bone meshes are used to construct skeletal representations, enabling implicit skinning to align all hand models into a standardized anatomical configuration. Subsequently, non-rigid registration is performed on the hand skin surfaces using the Geodesic Based Coherent Point Drift++ (GBCPD++) algorithm to establish point-wise correspondence across subjects. Principal Component Analysis (PCA) is then applied to the registered models to quantify anatomical shape variability. The Pix2Pix preprocessing stage achieved a Dice coefficient of 0.9856 and an IoU of 0.9720 on the held-out test set. Statistical modeling was performed on a subset of 90 scans in which the fingers were fully visible and anatomically separated. The resulting statistical shape distributions demonstrate strong agreement with the U.S. Army Anthropometric Survey (ANSUR II), supporting the anatomical validity of the reconstructed models. The proposed methodology demonstrates significant potential for advancing biomechanical modeling, ergonomic optimization, prosthetic design, and precision medical diagnostics.

Automated segmentation of liver lesions on non-contrast computed tomography (NCCT) is clinically important but fundamentally challenging, particularly in low-resource settings across Africa and Asia where contrast agents are frequently unavailable. Progress has been limited by the absence of annotated NCCT benchmarks. Here we describe the TriALS challenge for automated liver lesion segmentation under contrast-limited conditions, supported by a multi-centre dataset of 150 cases with four-phase CT acquisitions (600 volumes) from Egyptian and Chinese institutions. Algorithms were evaluated on 70 cases from three institutions, including an independent external cohort. The top-performing method achieved a mean venous-phase Dice of 0.754, consistent with human-level performance, yet dropped to 0.57 on NCCT. On external validation, the leading method outperformed off-the-shelf models by up to 28% in Dice on NCCT. Algorithm performance was most strongly predicted by training data scale and pre-training strategy. A cross-year comparison exposed a persistent perceptual barrier on NCCT that scaling pre-training alone cannot overcome. Data, annotations, and code are available at https://github.com/xmed-lab/TriALS.

Recent progress in deep learning has significantly advanced CT image analysis, particularly for segmentation tasks. However, these advances are largely confined to image-level pattern recognition, with most methods lacking explicit anatomical or contextual reasoning. Large vision-language models introduce linguistic context into image analysis, yet most approaches typically focus on a single task, which is insufficient for clinical workflow analysis that requires multiple fine-grained types of analysis, such as anatomy detection and segmentation. In this paper, we propose a unified autoregressive framework that integrates language-guided visual reasoning into CT interpretation. Our method introduces task-routing tokens that trigger detection and segmentation heads conditioned on the hidden states of a large vision-language model, enabling coherent generation of visual outputs (e.g., masks and bounding boxes) and textual reasonings. To progressively enhance localisation accuracy and semantic clarity, we further design a "closer-look" mechanism that allows the model to perform progressive coarse-to-fine visits to regions of interest under refined fields of view. To support model training and evaluation, we curated a new multimodal CT dataset containing pixel-wise masks, bounding boxes, spatial prompts, and structured descriptions for visual objects constructed through an AI-assisted annotation process with human verification. Experiments on public benchmarks demonstrate consistent improvements over the SoTA, achieving up to 1.0% Dice on BTCV and 1.7% Dice on MosMed+, while additionally providing appearance reasoning outputs. The code and dataset will be available.

Ovarian cancer is the most lethal gynecologic malignancy: around 60% of patients are diagnosed at an advanced stage, with an associated 5-year survival rate of about 30%. Early identification of non-responders to neoadjuvant chemotherapy remains a key unmet need, as it could prevent ineffective therapy and avoid delays in optimal surgical management. This work proposes a non-invasive deep learning framework to predict neoadjuvant chemotherapy response from pre-treatment contrast-enhanced CT by leveraging automatically derived 3D lesion masks. The approach encodes axial slices with a partially fine-tuned pretrained image encoder and aggregates slice-level representations into a volumetric embedding through an attention-based module. Training combines classification loss with supervised contrastive regularization and hard-negative mining to improve separation between ambiguous responders and non-responders. The method was developed on a retrospective single-center cohort from the European Institute of Oncology (Milan, IT), including 280 eligible patients (147 responder, 133 non-responder). On the test cohort, the model achieved a ROC-AUC of 0.73 (95% CI: 0.58-0.86) and an F1-score of 0.70 (95% CI: 0.56-0.82). Overall, these results suggest that the proposed architecture learns clinically relevant predictive patterns and provides a robust foundation for an imaging-based stratification tool.

Purpose: Mechanical thrombectomy (MT) improves stroke outcomes, but is limited by a lack of local treatment access. Widespread distribution of reinforcement learning (RL)-based robotic systems can be used to alleviate this challenge through autonomous navigation, but current RL methods require live device tip coordinate tracking to function. This paper aims to develop and evaluate a real-time catheter tip tracking pipeline under fluoroscopy, addressing challenges such as low contrast, noise, and device occlusion. Methods: A multi-threaded pipeline was designed, incorporating frame reading, preprocessing, inference, and post-processing. Deep learning segmentation models, including U-Net, U-Net+Transformer, and SegFormer, were trained and benchmarked using two-class and three-class formulations. Post-processing involved two-step component filtering, one-pixel medial skeletonization, and greedy arc-length path following with contour fall-back. Results: On manually-labeled moderate complexity fluoroscopic video data, the two-class SegFormer achieved a mean absolute error of 4.44 mm, outperforming U-Net (4.60 mm), U-Net+Transformer (6.20 mm) and all three-class models (5.19-7.74 mm). On segmentation benchmarks, the system exceeded state-of-the-art CathAction results with improvements of up to +5% in Dice scores for three-segmentation. Conclusion: The results demonstrate that the proposed multi-threaded tracking framework maintains stable performance under challenging imaging conditions, outperforming prior benchmarks, while providing a reliable and efficient foundation for RL-based autonomous MT navigation.

This work studies lung tumor growth prediction from sparse and irregular longitudinal computed tomography (CT) observations with measurement variability. A Bayesian physics-informed neural network is developed by combining Gompertz growth dynamics with low-dimensional Bayesian inference in the log-volume domain. The framework employs a two-stage inference strategy combining maximum a posteriori (MAP) estimation and Hamiltonian Monte Carlo (HMC) sampling to estimate posterior predictive distributions and uncertainty intervals. The method was evaluated on longitudinal data from the National Lung Screening Trial (30 patients). Results show that the model captures heterogeneous tumor growth patterns while maintaining reasonable prediction accuracy under limited observations. Compared with deterministic modeling approaches, the proposed approach additionally provides calibrated uncertainty estimates. The inferred posterior parameter correlations were consistent with expected biological growth behavior. The proposed framework achieved a cohort-level log-space RMSE of approximately 0.20 together with well-calibrated 95% credible interval coverage across 30 patients. These findings suggest that Bayesian physics-informed modeling may be useful for uncertainty-aware tumor growth assessment when only limited longitudinal follow-up scans are available.

Radiation therapy (RT) requires precise dose delivery over multiple fractions, with CT fundamental for treatment planning due to its electron density information. Repeated CT acquisitions impose radiation exposure and logistical burdens, MRI lacks electron density, and cone-beam CT (CBCT) requires correction for dose calculation. Synthetic CT (sCT) generation addresses these by converting MRI or CBCT into CT-equivalent images with accurate Hounsfield Unit (HU) values, enabling MRI-only RT and CBCT-based adaptive workflows. Building on SynthRAD2023, SynthRAD2025 benchmarked sCT methods on 2,362 patients from five European centers across head and neck, thorax, and abdomen. Two tasks: MRI-to-CT (890 cases) and CBCT-to-CT (1,472 cases), evaluated via image similarity (MAE, PSNR, MS-SSIM), segmentation (Dice, HD95), and dosimetric metrics from photon and proton plans. With 803 participants and 12/13 valid submissions, Task 1 top performance reached MAE $64.8\pm21.3$ HU, PSNR $\sim$30 dB, MS-SSIM $\sim$0.936, Dice 0.79, photon $γ_{2\%/2\text{mm}}>98\%$, proton $γ\approx85\%$. Task 2 improved: MAE $48.3\pm13.4$ HU, PSNR 32.6 dB, MS-SSIM 0.968, Dice 0.86, photon $γ>99\%$, proton $γ\approx89\%$. Strong image--segmentation correlations ($ρ=0.78$--$0.79$) but moderate dose correlations confirmed image quality is insufficient as a dosimetric surrogate. Head-and-neck cases were most consistent; thoracic and abdominal cases showed greater variability. Residual errors at tissue interfaces propagate along beam paths, affecting proton dose more than photon. SynthRAD2025 demonstrates that deep learning yields clinically relevant sCTs, especially for CBCT-to-CT, while identifying persistent MRI-to-CT challenges and underscoring dose-based evaluation as essential for clinical validation.

Metal artifacts in computed tomography (CT) severely degrade image quality, compromising diagnostic accuracy and radiotherapy planning, especially in cancer patients with high-density implants. We propose H3D-MarNet, a two-stage framework for artifact-aware CT domain transformation from kilo-voltage CT (kVCT) to mega-voltage CT (MVCT). In the first stage, a wavelet-based preprocessing module suppresses metal-induced artifacts through frequency-aware denoising while preserving anatomical structures. In second stage, Domain-TransNet performs kVCT-to-MVCT domain transformation using a hybrid volumetric learning architecture. Domain-TransNet integrates a CNN-based encoder to capture fine-grained local anatomical details and a transformer-based encoder to model long-range volumetric dependencies. The complementary representations are fused through an attention-based feature fusion mechanism to ensure spatial and contextual coherence across slices. A multi-stage, attention-guided decoder, supported by deep supervision, progressively reconstructs artifact-suppressed MVCT volumes. Extensive experiments demonstrate that H3D-MarNet achieves 28.14 dB PSNR and 0.717 SSIM on artifact-affected slices from full dataset, indicating effective metal artifact suppression and anatomical preservation, highlighting its potential for reliable CT modality transformation in clinical radiotherapy workflows.

Multi-window CT imaging captures complementary pathological information across anatomical structures of differing densities, yet existing deep learning methods fuse representations only at later stages, missing cross-density interactions. We propose a cross-window knowledge distillation framework in which student encoders learn latent clinical priors from a teacher trained on the most informative window. Evaluated retrospectively on three cohorts - COPD-CT-DF (n=719), RSNA PE (n=1,433), and an in-house CTEPD dataset (n=161) - distillation improved per-window AUC by 10.1-16.5 percentage points on COPD-CT-DF (0.75-0.81 to 0.90-0.94; all P<0.001), with ensemble AUC reaching 0.9960. Similar gains were observed on RSNA PE (0.80-0.83 to 0.90-0.92) and CTEPD (AUC 0.7481 vs. 0.6264). Cross-window distillation internalises pathological signatures invisible to supervised approaches, offering a generalisable solution for multi-window pulmonary CT analysis.

Recent advances in 3D medical vision-language models have enabled joint reasoning over volumetric images and text, showing strong performance in medical visual question-answering (VQA) and report generation. Despite this progress, it remains unclear whether these models learn spatially grounded anatomy from 3D volumes or rely primarily on learned priors and language correlations. This uncertainty stems from the lack of systematic evaluation of semantic-spatial reasoning in volumetric medical VLMs for clinically reliable decision support. To address this gap, we introduce CT-SpatialVQA, a benchmark designed to evaluate semantic-spatial reasoning in 3D CT data. The benchmark comprises 9077 clinically grounded question-answer (QA) pairs derived directly from 1601 radiology reports and CT volumes, which are validated via a robust LLM-assisted pipeline with a 95% human consensus agreement rate. Our dataset requires explicit anatomical localization, laterality awareness, structural comparison, and 3D inter-structure relational reasoning. We also introduce a standardized evaluation protocol and benchmark eight 3D medical VLMs, finding severe degradation on semantic-spatial reasoning tasks, averaging 34% accuracy and often below random, highlighting the need for deeper integration of volumetric evidence for trustworthy clinical use.

We report the design and results of the third autoPET challenge (MICCAI 2024), which benchmarked automated lesion segmentation in whole-body PET/CT under a compositional generalization setting. Training data comprised 1,014 [18F]-FDG PET/CT studies from the University Hospital Tübingen and 597 [18F]/[68Ga]-PSMA PET/CT studies from the LMU University Hospital Munich, constituting the largest publicly available annotated PSMA PET/CT dataset to date. The held-out test set of 200 studies covered four tracer-center combinations, two of which represented unseen compositional pairings. A complementary data-centric award category isolated the contribution of data handling strategies by restricting participants to a fixed baseline model. Seventeen teams submitted 27 algorithms, predominantly nnU-Net-based 3D networks with PET/CT channel concatenation. The top-ranked algorithm achieved a mean DSC of 0.66, FNV of 3.18 mL, and FPV of 2.78 mL across all four test conditions, improving DSC by 8% and reducing the false-negative volume by 5 mL relative to the provided baseline. Ranking was stable across bootstrap resampling and alternative ranking schemes for the top tier. Beyond the benchmark, we provide an in-depth analysis of segmentation performance at the patient and lesion level. Three main conclusions can be drawn: (1) in-domain multitracer PET/CT segmentation is sufficient and probably approaching reader agreement; (2) compositional generalization to unseen tracer-center combinations remains an open problem mainly driven by systematic volume overestimation; (3) heterogeneity and case difficulty drive performance variation substantially more than the choice of algorithm among top-ranked teams.

We introduce iTRIALSPACE, a programmable evaluation framework for controlled assessment of lung CT models. Standard benchmarks are static retrospective collections that entangle lesion size, lobe prevalence, anatomy, and acquisition context, making it difficult to determine what structurally drives model accuracy. iTRIALSPACE addresses this limitation by composing real clinical CTs and lesion profiles into controlled virtual lesion trials through a four-stage pipeline: multidataset nodule profiling, explicit trial specification, anatomy-aware mask insertion, and ControlNet-conditioned CT synthesis. The framework is built on a unified 54-attribute nodule-profile dataset spanning 13,140 annotated nodules from seven public CT sources and instantiated as 13 trial modes. We evaluate iTRIALSPACE in a 55,469-sample Virtual Lesion Study spanning three medical VLMs, four spatialguidance conditions, and three clinical tasks. Across all 13 modes, the synthetic substrate remains within the real-to-real FID baseline, and synthetic performance rankings transfer strongly to real clinical data ($ρ$ = 0.93, p < 10$^{-15}$). Controlled trial modes expose findings unavailable to fixed-distribution benchmarks, including shortcut-driven size prediction collapse under lobe-equalized sampling and hostto-donor variance ratios of 8.9x and 3.3x in twin-cross analysis. These results position iTRIALSPACE as an auditable evaluation infrastructure for controlled, falsifiable testing beyond static retrospective benchmarks.

Computed tomography (CT) is indispensable for clinical diagnosis and image-guided interventions but exposes patients to ionizing radiation, motivating the development of safer imaging alternatives. Ultrasound (US) is non-ionizing and widely accessible; however, it is highly operator dependent and lacks quantitative tissue characterization, often leading to diagnostic uncertainty and unnecessary CT examinations. This work presents a 3D ultrasound-derived pseudo-CT (UD-pCT) framework that generates CT-like anatomical reference volumes inferred from US, without aiming to reproduce physically accurate Hounsfield Units. Paired 3D kidney US and CT volumes from the TRUSTED dataset are first spatially aligned using a landmark-based multimodal registration pipeline, creating high-quality paired inputs for supervised training of an adversarial framework. The proposed Bottleneck Transformer Residual U-Net3D (BT-ResUNet3D) model employs a 3D residual encoder-decoder generator augmented with a transformer bottleneck, enabling effective modeling of fine-grained local anatomical structures as well as long-range volumetric dependencies, while a 3D Conditional PatchGAN discriminator enforces local structural realism in the synthesized pseudo-CT volumes. Quantitative evaluation using PSNR and SSIM demonstrates that the proposed method outperforms established baselines in structural fidelity and perceptual image quality. The UD-pCT volumes provide real-time anatomical reference for operator guidance, potentially reducing acquisition variability and unnecessary CT use. A limitation of this study is the relatively small paired dataset, which may limit the generalizability of the proposed model.

Channel-gain maps provide the channel gain between any two locations in a geographical region. They find numerous applications, from resource allocation and interference control to path planning for autonomous vehicles. Channel-gain map estimation (CGME) is considerably more challenging than conventional radio map estimation (RME) because channel-gain maps are functions over a 6-dimensional input space. This calls for specialized methods, which currently rely on the (inaccurate) radio tomographic model or require a prohibitively large number of measurements since they do not exploit any spatial structure. This paper overcomes this issue by leveraging spatial patterns that channel-gain maps exhibit across environments, as dictated by the laws of physics and typical environmental characteristics (e.g. building materials and layouts). Adopting a metalearning perspective, a transformer-based estimator is proposed to implicitly learn this common structure from measurements collected in multiple environments. This enables CGME in new environments from significantly fewer measurements (five times less in our experiments). To maximize learning efficiency, the transformer is composed with a feature map that enforces the invariances of CGME, such as those following from reciprocity. Numerical experiments corroborate the merits of the proposed estimator relative to existing methods.

Cone Beam Computed Tomography (CBCT) is pivotal for 3D diagnostic imaging in dentistry. However, the development of robust AI models for volumetric analysis is often constrained by the scarcity of large, annotated datasets. Self-supervised learning (SSL), particularly Masked Image Modeling (MIM), offers a promising pathway to leverage unlabeled data. A limitation of standard MIM is its reliance on random masking, which fails to prioritize diagnostically critical regions in dental CBCT volumes, such as subtle pathological changes and intricate anatomical boundaries. To address this, we propose ATMask, a novel adaptive masking strategy. Instead of applying random masks or employing computationally intensive attention modules, ATMask computes an inter-slice texture variation map to identify regions with high structural or textural complexity. These high-variation areas are then selectively masked during pre-training, compelling the model to learn richer contextual representations essential for inferring complex 3D morphological transitions. Furthermore, we contribute the first large-scale CBCT dataset, curated from both public and private sources, comprising 6,314 scans, for the dental AI model pretraining. Extensive experiments on three downstream dental CBCT tasks demonstrate that our ATMask enables more data-efficient and powerful representation learning than standard random masking and other advanced SSL baselines. The dataset and code will be released.

High-fidelity circuit execution on noisy intermediate-scale quantum devices is bottlenecked by compilation pipelines that disregard complex, correlated noise. To address this, this methodology article proposes a quantum machine learning control (QMLC) framework for generative quantum circuit synthesis from gate-set tomography (GST) data that bypasses the traditional two-step pipeline of characterizing native quantum gates via GST followed by unitary decomposition algorithms. Instead, a generative concept space is directly learnt from GST data, enabling conditional synthesis of quantum circuits on a desired output distribution. Our approach tokenizes GST germ circuits and embeds them into a structured latent space using a curriculum-learning-motivated strategy, starting with short circuits and progressively incorporating longer ones with diverse output statistics. The embedded sequences are processed by a set-vision transformer with permutation-invariant pooling, producing k-seed vectors that represent the learned concept space of the quantum device. Aggregating data across multiple circuits makes this latent representation inherently context-aware, capturing the shared physical noise environment (e.g., crosstalk, drift) that isolated gate metrics miss. We propose an unconditional diffusion model to sample from the concept space. During inference, a user provides a target measurement distribution, and the model generates a corresponding circuit. To ensure fidelity and robustness, the output is denoised using a diffusion model that operates on the target conditional covariance matrix. This end-to-end framework is a step towards context-aware, hardware-native circuit synthesis directly from raw GST data, which offers a new paradigm for integrating quantum control and compilation. The QMLC framework is particularly suited for near-term quantum devices with complex calibration procedures.

The deployment of artificial intelligence in medical imaging is hindered by high computational complexity and resource-intensive processing of volumetric data. Although chest computed tomography (CT) volumes offer richer diagnostic information than projection radiography, their use in AI-based diagnosis remains limited due to the computational burden of processing uncompressed volumetric images (typically stored in NIfTI or DICOM format). Addressing the growing need for low-resource deployment and efficient electronic data transfer, we investigate the utilization of JPEG-compressed chest CT volumes for thoracic abnormality detection. We propose Feature Attention Style Transfer (FAST), a novel distillation framework that transfers both activation patterns and structural relationships from high-fidelity CT representations to a spatiotemporal visual encoder operating on compressed inputs. By combining Gram-matrix-based attention style preservation with dual-attention feature alignment, FAST enables robust feature extraction from degraded volumes. Furthermore, we introduce Structured Factorized Projection (SFP), leveraging Block Tensor Train decomposition as a parameter-efficient alternative to dense projection layers, reducing projection-head parameters by almost half. Our contrastive learning pipeline, CT-Lite, integrates these components with a SigLIP-based multimodal alignment objective. Experiments on CT-RATE, NIDCH, and Rad-ChestCT demonstrate that CT-Lite achieves AUROC within 5-7% of the uncompressed-input baseline across all three datasets, despite operating on compressed inputs with significantly fewer parameters, paving the way for AI-based clinical evaluation under resource constraints.

Accurate synthesis of computed tomography (CT) images from magnetic resonance imaging (MRI) is clinically valuable for cranial applications such as attenuation correction, radiotherapy planning, and image-guided interventions. However, heterogeneity across MRI field strengths and acquisition protocols limits the generalizability of existing methods. In this study, we formulate cranial CT synthesis as a modular, structurally coupled problem and propose a deep learning framework to improve robustness across heterogeneous MRI conditions. The model is designed to adapt to variations in field strength and imaging protocols while preserving anatomical consistency. Experiments on multi-site datasets demonstrate improved performance and generalization compared with conventional approaches. The proposed method enables reliable CT synthesis across heterogeneous MRI settings, supporting broader clinical translation.

While 3D Gaussian splatting (3DGS) offers explicit and efficient scene representations for cone-beam computed tomography reconstruction, conventional photometric optimization inherently suffers from spectral bias under ultra sparse-view conditions, leading to over-smoothing and a loss of high-frequency anatomical details. Since wavelet transforms provide rich high-frequency information and have been widely utilized to enhance sparse reconstruction, this work integrates wavelet multi-resolution analysis with 3DGS. To circumvent the mathematical mismatch between the strict non-negativity of physical X-ray attenuation and the bipolar nature of high-frequency wavelet coefficients, we propose Residual Gaussian Splatting (RGS). Methodologically, we introduce a spectrally-decoupled Gaussian representation that stratifies the volumetric field into a geometric base component and a residual detail component. This decomposition systematically transforms explicit high-frequency fitting into a physically consistent, implicit residual compensation task. Furthermore, we devise a spectral-spatial collaborative optimization strategy to coordinate the interplay between geometric anchoring and texture refinement, effectively preventing spectral crosstalk. Extensive experiments on clinical datasets demonstrate that RGS enables the reconstructed images to capture highly refined geometric textures. It successfully resolves the trade-off between artifact suppression and detail preservation, yielding superior visual fidelity in complex trabecular and vascular structures compared to existing neural rendering baselines.

The use of CT imaging is important for screening, diagnosis, therapy planning, and prognosis of lung cancers. Unfortunately, due to differences in imaging protocols and scanner models, CT images acquired by different means may show large differences in noise statistics, contrast, and texture. In this study, we develop a novel conditional MeanFlow pipeline for CT image reconstruction. We introduce a conditional MeanFlow network that models the enhancement trajectory by predicting image-conditioned flow fields given intermediate image states. The image enhancement network is trained with a MeanFlow consistency loss along with the image reconstruction loss. In order to provide an adaptive refinement process in terms of spatial location of enhancements, we integrate a regional reinforcement learning-driven policy network into our approach. The policy network receives information about the MeanFlow rollouts and provides predictions in terms of tile-wise refinement budgets, stopping criteria, and total budget allocation of enhancement processes. Our policy network is trained through reinforcement learning in a policy gradient framework, where the goal of the training reward is to maximize improvement of enhancements while minimizing unnecessary computations and avoiding instabilities. In this way, our approach combines conditional flow-based enhancement with reinforcement learning-based spatial enhancement control. This allows our approach to focus more attention on enhancing difficult areas while stabilizing areas already showing sufficient quality. Our results show high accuracy in the tumor ROI, with the average radiomic feature CCC being 0.96, an average PSNR of 31.30 $\pm$ 4.16, and average SSIM of 0.94 $\pm$ 0.07. Moreover, there is an improvement in the overall quality of images, with an average PSNR of 34.23 $\pm$ 1.71 and average SSIM of 0.95 $\pm$ 0.01.

Thoracic Computed Tomography (CT) scans offer detailed insights into the intricate branching network of the airway tree, which is essential for understanding various respiratory diseases. Airway bifurcations, where airway branches split, are crucial landmarks for understanding lung physiology, disease mechanisms and lesion localization. Despite the significance of bifurcation analysis, a notable lack of datasets annotated for this task hinders the development of advanced automated specialized detection or segmentation tools. In this paper, we introduce BifDet, the first publicly-available dataset specialized for 3D airway bifurcation detection, filling a critical gap in existing resources. Our dataset comprises carefully annotated CT scans from the ATM22 open-access cohort with bifurcation bounding boxes covering the parent and daughter branches. As a use-case for demonstrating the potential of BifDet, we fine-tune and evaluate RetinaNet and DETR for 3D airway bifurcations detection on CT scans. We provide detailed pipelines, including preprocessing steps and specific implementation design choices. Results are detailed over various categories of minimal bounding box sizes to serve as baseline to benchmark future research.

Chest computed tomography (CT) is central to the detection and management of thoracic disease, yet the growing scale and complexity of volumetric imaging increasingly exceed what can be addressed by scan-level prediction alone. Clinically useful AI for CT must not only recognize disease across the whole volume, but also localize abnormalities and provide interpretable visual evidence. Existing vision-language foundation models typically compress scans and reports into global image-text representations, limiting their ability to preserve spatial evidence and support clinically meaningful interpretation. Here we developed EXACT, an explainable anomaly-aware foundation model for three-dimensional chest CT that learns spatially resolved representations from paired clinical scans and radiology reports. EXACT was pre-trained on 25,692 CT-reports pairs using anatomy-aware weak supervision, jointly learning organ segmentation and multi-instance anomaly localization without manual voxel-level annotations. The resulting organ-specific anomaly-aware maps assign each voxel a disease-specific anomaly score confined to its corresponding anatomy, jointly encoding lesion extent and organ-level context. In retrospective multinational and multi-center evaluations, EXACT showed broad and consistent improvements across clinically relevant CT tasks, spanning multi-disease diagnosis, zero-shot anomaly localization, downstream adaptation, and visually grounded report generation, outperforming existing three-dimensional medical foundation models. By transforming routine clinical CT scans and free-text reports into explainable voxel-level representations, EXACT establishes a scalable paradigm for trustworthy volumetric medical AI.

Computed Tomography (CT) is a widely used imaging modality in medical and industrial applications. To limit radiation exposure and measurement time, there is a growing interest in sparse-view CT, where the number of projection views is significantly reduced. Deep neural networks have shown great promise in improving reconstruction quality in sparse-view CT, especially generative diffusion models. However, these methods struggle to scale to large 3D volumes due to several reasons: (i) the high memory and computational requirements of 3D models, (ii) the lack of large 3D training datasets, and (iii) the inconsistencies across slices when using 2D models independently on each slice. We overcome these limitations and scale diffusion-based sparse-view CT reconstruction to large 3D volumes by combining conditional diffusion with explicit data consistency. We propose Conditional Diffusion Posterior Alignment (CDPA) to enable scalable 3D sparse-view CT reconstruction. A 2D U-Net diffusion model is conditioned on an initial 3D reconstruction to improve inter-slice consistency, combined with data-consistency alignment to match measured projections. Experiments on synthetic and real Cone Beam CT (CBCT) data show state-of-the-art performance, with ablations that confirm the synergistic effects of the proposed pipeline. Finally, we show that the same principles also strengthen fast denoising U-Nets, yielding near-diffusion quality at a fraction of the computational cost.

Accurate prognostication and risk estimation are essential for guiding clinical decision-making and optimizing patient management. While radiologist-assessed features from CT scans provide valuable indicators of disease severity and outcomes, interpreting such images requires expert knowledge, and translating rich visual information into textual summaries inevitably leads to information loss. In this work, we propose a vision-language framework for 3D CT image understanding that leverages large-scale open-sourced CT images paired with radiology reports through visual instruction tuning. This pre-training enables the model to learn clinically meaningful visual-textual representations, which can then be adapted to downstream survival prediction tasks. By incorporating a survival prediction head on top of the pre-trained model, our approach improves survival prediction from CT images and clinical data while generating clinically meaningful language responses to predefined questions. Experimental results demonstrate that our method outperforms baseline methods in survival prediction, particularly, when clinical data alone is less predictive. The code will be released upon acceptance.

Automated medical report generation for 3D PET/CT imaging is fundamentally challenged by the high-dimensional nature of volumetric data and a critical scarcity of annotated datasets, particularly for low-resource languages. Current black-box methods map whole volumes to reports, ignoring the clinical workflow of analyzing localized Regions of Interest (RoIs) to derive diagnostic conclusions. In this paper, we bridge this gap by introducing VietPET-RoI, the first large-scale 3D PET/CT dataset with fine-grained RoI annotation for a low-resource language, comprising 600 PET/CT samples and 1,960 manually annotated RoIs, paired with corresponding clinical reports. Furthermore, to demonstrate the utility of this dataset, we propose HiRRA, a novel framework that mimics the professional radiologist diagnostic workflow by employing graph-based relational modules to capture dependencies between RoI attributes. This approach shifts from global pattern matching toward localized clinical findings. Additionally, we introduce new clinical evaluation metrics, namely RoI Coverage and RoI Quality Index, that measure both RoI localization accuracy and attribute description fidelity using LLM-based extraction. Extensive evaluation demonstrates that our framework achieves SOTA performance, surpassing existing models by 19.7% in BLEU and 4.7% in ROUGE-L, while achieving a remarkable 45.8% improvement in clinical metrics, indicating enhanced clinical reliability and reduced hallucination. Our code and dataset are available on GitHub.

Lung cancer remains one of the leading causes of cancer-related mortality worldwide. Conventional computed tomography (CT) imaging, while essential for detection and staging, has limitations in distinguishing benign from malignant lesions and providing interpretable diagnostic insights. To address this challenge, this study proposes a dual-modal artificial intelligence framework that integrates CT radiology with hematoxylin and eosin (H&E) histopathology for lung cancer diagnosis and subtype classification. The system employs convolutional neural networks to extract radiologic and histopathologic features and incorporates clinical metadata to improve robustness. Predictions from both modalities are fused using a weighted decision-level integration mechanism to classify adenocarcinoma, squamous cell carcinoma, large cell carcinoma, small cell lung cancer, and normal tissue. Explainable AI techniques including Grad-CAM, Grad-CAM++, Integrated Gradients, Occlusion, Saliency Maps, and SmoothGrad are applied to provide visual interpretability. Experimental results show strong performance with accuracy up to 0.87, AUROC above 0.97, and macro F1-score of 0.88. Grad-CAM++ achieved the highest faithfulness and localization accuracy, demonstrating strong correspondence with expert-annotated tumor regions. These results indicate that multimodal fusion of radiology and histopathology can improve diagnostic performance while maintaining model transparency, suggesting potential for future clinical decision support systems in precision oncology.

Reported chest CT segmentation performance can be strongly inflated when train and test partitions mix slices from the same study. We present CTSCAN, a reproducible multi-source chest CT benchmark and research stack designed to measure what survives under patient-disjoint evaluation. The current four-class artifact aggregates 89 cases from PleThora, MedSeg SIRM, and LongCIU, and we show that the original slice-PNG workflow induces near-complete case reuse across train, validation, and test. Using the playground environment, we run a multi-seed protocol sweep with the same FPN plus EfficientNet-B0 control configuration under slice-mixed and case-disjoint evaluation. Across 3 seeds and 12 epochs per seed, the slice-mixed protocol reaches 0.6665 foreground Dice and 0.5031 foreground IoU, whereas the case-disjoint protocol reaches 0.2066 Dice and 0.1181 IoU. Removing patient reuse therefore reduces foreground Dice by 0.4599 absolute (69.00% relative) and foreground IoU by 0.3850 absolute (76.52% relative). CTSCAN packages the corrected benchmark with deterministic split manifests, explicit weak-supervision controls, a scripted multi-seed protocol sweep, and reproducible figure generation, providing a reusable basis for patient-disjoint chest CT evaluation.

Lung cancer remains the leading cause of cancer-related mortality worldwide, with survival outcomes critically dependent on early and accurate detection. When low-dose computed tomography (LDCT) findings are indeterminate, clinicians typically defer diagnosis pending follow-up CT imaging obtained up to 12 months later, inevitably delaying treatment for patients with malignant nodules. To address this clinical gap, we propose Nodule-Aligned Multimodal (Latent) Diffusion (NAMD), a novel generative framework that synthesizes one-year follow-up nodule CT images conditioned on the baseline CT scan, quantitative nodule biomarkers, and patient-level Electronic Health Records (EHR), enabling timely prediction of nodule malignant progression without requiring actual follow-up scans. NAMD introduces two key contributions: (i) a nodule-aligned latent space regularized so that embedding distances reflect clinically meaningful biomarker changes, and (ii) an LLM-driven multimodal conditioning mechanism encoding heterogeneous EHR data into the diffusion backbone. Evaluated on the National Lung Screening Trial (NLST), our method's synthetic follow-up images achieve an AUROC of 0.805 and an AUPRC of 0.346 for lung nodule malignancy prediction, outperforming both the baseline LDCT performance without virtual follow-up generation, and existing state-of-the-art conditional generation methods, while maintaining competitive image quality. These findings suggest that NAMD enables earlier and more accurate lung cancer diagnosis by capturing clinically meaningful features of nodule progression.

A long-term goal in CT imaging is to achieve fast and accurate 3D reconstruction from sparse-view projections, thereby reducing radiation exposure, lowering system cost, and enabling timely imaging in clinical workflows. Recent feed-forward approaches have shown strong potential toward this overarching goal, yet their results still suffer from artifacts and loss of fine details. In this work, we introduce Iterative Latent Volumes (ILV), a feed-forward framework that integrates data-driven priors with classical iterative reconstruction principles to overcome key limitations of prior feed-forward models in sparse-view CBCT reconstruction. At its core, ILV constructs an explicit 3D latent volume that is repeatedly updated by conditioning on multi-view X-ray features and the learned anatomical prior, enabling the recovery of fine structural details beyond the reach of prior feed-forward models. In addition, we develop and incorporate several key architectural components, including an X-ray feature volume, group cross-attention, efficient self-attention, and view-wise feature aggregation, that efficiently realize its core latent volume refinement concept. Extensive experiments on a large-scale dataset of approximately 14,000 CT volumes demonstrate that ILV significantly outperforms existing feed-forward and optimization-based methods in both reconstruction quality and speed. These results show that ILV enables fast and accurate sparse-view CBCT reconstruction suitable for clinical use. The project page is available at: https://sngryonglee.github.io/ILV/.

Recent advances in generative AI have made synthetic Computed Tomography (CT) images increasingly realistic, enabling promising applications in medical data augmentation while raising serious concerns about clinical safety and data trustworthiness. Detecting AI-generated CT images remains challenging for two key reasons: existing benchmarks cover only limited generation sources, and many detectors are adapted from natural-image forensics without explicitly modeling CT-specific imaging properties. In this paper, we introduce CTForensics, a dataset for detecting AI-generated CT images. CTForensics contains 75,990 2D CT images, including a dedicated test benchmark of 29,990 balanced authentic and generated samples from ten representative CT generative models spanning GAN-based and diffusion-based paradigms. We further propose the Enhanced Spatial-Frequency CT Forgery Detector (ESF-CTFD), a CT-oriented CNN framework built around a Wavelet-Enhanced Central Stem, Multi-Scale Spatial Aggregation, and a Frequency-Aware Prediction Block. The Wavelet-Enhanced Central Stem enhances local intensity correlations and high-frequency residuals, Multi-Scale Spatial Aggregation aligns anatomical features across resolutions with lightweight residual units, and the Frequency-Aware Prediction Block models global spectral artifacts. Extensive experiments on CTForensics show that ESF-CTFD achieves 96.01% mAcc and 99.96% mAP, outperforming existing methods and maintaining strong robustness under realistic perturbations with only a 0.99% average drop. Codes will be available at https://github.com/liyih/CTForensics.

Undersampled CT volumes minimize acquisition time and radiation exposure but introduce artifacts degrading image quality and diagnostic utility. Reducing these artifacts is critical for high-quality imaging. We propose a computationally efficient hybrid deep-learning framework that combines the strengths of 2D and 3D models. First, a 2D U-Net operates on individual slices of undersampled CT volumes to extract feature maps. These slice-wise feature maps are then stacked across the volume and used as input to a 3D decoder, which utilizes contextual information across slices to predict an artifact-free 3D CT volume. The proposed two-stage approach balances the computational efficiency of 2D processing with the volumetric consistency provided by 3D modeling. The results show substantial improvements in inter-slice consistency in coronal and sagittal direction with low computational overhead. This hybrid framework presents a robust and efficient solution for high-quality 3D CT image post-processing. The code of this project can be found on github: https://github.com/J-3TO/2D-3DCNN_sparseview/.

While foundation models in radiology are expected to be applied to various clinical tasks, computational cost constraints remain a major challenge when training on 3D-CT volumetric data. In this study, we propose TotalFM, a radiological foundation model that efficiently learns the correspondence between 3D-CT images and linguistic expressions based on the concept of organ separation, utilizing a large-scale dataset of 140,000 series. By automating the creation of organ volume and finding-sentence pairs through segmentation techniques and Large Language Model (LLM)-based radiology report processing, and by combining self-supervised pre-training via VideoMAE with contrastive learning using volume-text pairs, we aimed to balance computational efficiency and representation capability. In zero-shot organ-wise lesion classification tasks, the proposed model achieved higher F1 scores in 83% (5/6) of organs compared to CT-CLIP and 64% (9/14) of organs compared to Merlin. These results suggest that the proposed model exhibits high generalization performance in a clinical evaluation setting using actual radiology report sentences. Furthermore, in zero-shot finding-wise lesion classification tasks, our model achieved a higher AUROC in 83% (25/30) of finding categories compared to Merlin. We also confirmed performance comparable to existing Vision-Language Models (VLMs) in radiology report generation tasks. Our results demonstrate that the organ-separated learning framework can serve as a realistic and effective design guideline for the practical implementation of 3D-CT foundation models. The source code and pretrained models are publicly available at https://github.com/jichi-labo/TotalFM.

Multi-source stationary computed tomography (CT) has recently attracted attention for its ability to achieve rapid image reconstruction, making it suitable for time-sensitive clinical and industrial applications. However, practical systems are often constrained by ultra-sparse-view sampling, which significantly degrades reconstruction quality. Traditional methods struggle under ultra-sparse-view settings, where interpolation becomes inaccurate and the resulting reconstructions are unsatisfactory. To address this challenge, this study proposes Diffusion-Refined Neural Attenuation Fields (Diff-NAF), an iterative framework tailored for multi-source stationary CT under ultra-sparse-view conditions. Diff-NAF combines a Neural Attenuation Field representation with a dual-branch conditional diffusion model. The process begins by training an initial NAF using ultra-sparse-view projections. New projections are then generated through an Angle-Prior Guided Projection Synthesis strategy that exploits inter view priors, and are subsequently refined by a Diffusion-driven Reuse Projection Refinement Module. The refined projections are incorporated as pseudo-labels into the training set for the next iteration. Through iterative refinement, Diff-NAF progressively enhances projection completeness and reconstruction fidelity under ultra-sparse-view conditions, ultimately yielding high-quality CT reconstructions. Experimental results on multiple simulated 3D CT volumes and real projection data demonstrate that Diff-NAF achieves the best performance under ultra-sparse-view conditions.

Laryngeal cancer imaging research lacks standardised public datasets to enable reproducible deep learning (DL) model development. We present LaryngealCT, a curated benchmark of 1,029 computed tomography (CT) scans aggregated from six collections from The Cancer Imaging Archive (TCIA). Uniform 1 mm isotropic volumes of interest encompassing the larynx were extracted using a weakly supervised parameter search framework validated by clinical experts. Six 3D DL architectures (custom 3D CNN, ResNet18,50,101, DenseNet121 and MedicalNet-pretrained ResNet50) were benchmarked on (i) early (Tis,T1,T2) vs. advanced (T3,T4) and (ii) T4 vs. non-T4 classification tasks. On the independent test set, the 3D CNN achieved the strongest overall performance across global and per-class metrics (Accuracy 0.854, F1-macro 0.841) in early vs. advanced classification. In the T4 task, AU-ROC values exceeded 0.82 for most models, but sensitivity for T4 disease remained limited (less than or equal to 0.412), with ResNet101 showing the most promising calibrated T4 recall (0.706. Model explainability assessed using GradCAMpp with thyroid cartilage overlays for T4 classification task revealed anatomically plausible peri-cartilage activations, although spatial overlap was modest. Through open-source data, pretrained models, and integrated explainability tools, LaryngealCT offers a reproducible foundation for AI-driven research to support future clinical decision-making in laryngeal oncology.

With the growing volume of CT examinations, there is an increasing demand for automated tools such as organ segmentation, abnormality detection, and report generation to support radiologists in managing their clinical workload. Multi-label classification of 3D Chest CT scans remains a critical yet challenging problem due to the complex spatial relationships inherent in volumetric data and the wide variability of abnormalities. Existing methods based on 3D convolutional neural networks struggle to capture long-range dependencies, while Vision Transformers often require extensive pre-training on large-scale, domain-specific datasets to perform competitively. In this work, we propose a 2.5D alternative by introducing a new graph-based framework that represents 3D CT volumes as structured graphs, where axial slice triplets serve as nodes processed through spectral graph convolution, enabling the model to reason over inter-slice dependencies while maintaining complexity compatible with clinical deployment. Our method, trained and evaluated on 3 datasets from independent institutions, achieves strong cross-dataset generalization, and shows competitive performance compared to state-of-the-art visual encoders. We further conduct comprehensive ablation studies to evaluate the impact of various aggregation strategies, edge-weighting schemes, and graph connectivity patterns. Additionally, we demonstrate the broader applicability of our approach through transfer experiments on automated radiology report generation and abdominal CT data.

X-ray micro-computed tomography (micro-CT) provides non-destructive three-dimensional (3D) imaging of porous material microstructures. In situ experiments, including mechanical loading and reactive transport, increasingly require dynamic four-dimensional (4D) imaging with volumes repeatedly acquired during experiments. However, rapid acquisition typically requires fewer projections, shorter exposures, or reduced fields of view, producing reconstructions with noise, blur, and artifacts that obscure pores, microcracks, and interfaces. To address this challenge, this study introduces InSituRes, a physics-informed same-grid volumetric enhancement framework for fast dynamic X-ray micro-CT imaging of temporally evolving materials. InSituRes maps fast-acquisition volumes to higher-quality long-acquisition reconstructions using paired scans of the same specimens. The model integrates 3D convolutional feature extraction with slice-wise transformer attention to capture local and broader in-plane context. A learnable forward degradation model approximates rapid acquisition effects, including spatial blurring, intensity scaling differences, and signal-dependent noise. During training, reconstructed volumes should match high-quality reference scans and reproduce observed fast acquisition data after propagation through the forward model, imposing a physics-guided consistency constraint. Experiments on unseen micro-CT datasets demonstrate improved reconstruction fidelity and enhanced visibility of fine microstructural features relative to conventional interpolation and learning-based enhancement approaches. The framework supports quantitative interpretation of fast 4D X-ray micro-CT scans of evolving materials.

Low-dose computed tomography (CT) denoising is crucial for reduced radiation exposure while ensuring diagnostically acceptable image quality. Despite significant advancements driven by deep learning (DL) in recent years, existing DL-based methods, typically trained on a specific dose level and anatomical region, struggle to handle diverse noise characteristics and anatomical heterogeneity during varied scanning conditions, limiting their generalizability and robustness in clinical scenarios. In this paper, we propose FoundDiff, a foundational diffusion model for unified and generalizable LDCT denoising across various dose levels and anatomical regions. FoundDiff employs a two-stage strategy: (i) dose-anatomy perception and (ii) adaptive denoising. First, we develop a dose- and anatomy-aware contrastive language-image pre-training model (DA-CLIP) to achieve robust dose and anatomy perception by leveraging specialized contrastive learning strategies to learn continuous representations that quantify ordinal dose variations and identify salient anatomical regions. Second, we design a dose- and anatomy-aware diffusion model (DA-Diff) to perform adaptive and generalizable denoising by synergistically integrating the learned dose and anatomy embeddings from DA-CLIP into diffusion process via a novel dose and anatomy conditional block (DACB) based on Mamba. Extensive experiments on a large simulated multi-dose CT dataset spanning three anatomical regions, together with cross-dataset evaluations on Mayo-2016, CQ500, and piglet datasets, demonstrate superior denoising performance and strong generalization to unseen dose levels and anatomical regions. The codes and models are available at https: //github.com/hao1635/FoundDiff.

Current CT report generation frameworks predominantly rely on global feature representations, often failing to capture region-specific details and potentially missing certain abnormalities. To overcome this limitation, we propose MedRegion-CT, a region-focused multimodal large language model framework featuring three key innovations. First, we revisit the SlowFast strategy to jointly model global and fine-grained information and adapt it to the medical domain via a Region-based SlowFast Tokenizer that extracts tokens guided by clinically meaningful regions. Second, generated pseudo-masks guide the model to attend to diagnostically important anatomical regions, facilitating a systematic understanding of the overall scan context. Third, quantitative lesion information, including size, diameter, and spatial location, is encoded as structured textual prompts, enabling context-aware and clinically informed report generation. To enable rigorous evaluation, we validate our framework on multi-institutional structured report generation benchmarks. Experimental results demonstrate that MedRegion-CT achieves state-of-the-art performance, outperforming existing approaches in both linguistic quality and clinical accuracy. All code is publicly available at: https://github.com/babbu3682/MedRegion-CT.

Photorealistic volumetric rendering of CT scans greatly benefits clinical workflows, yet neural approaches such as Neural Radiance Fields (NeRF) and 3D Gaussian Splatting (3DGS) require prohibitive per-scan optimization (hours for NeRF, about 30 minutes for 3DGS), making them impractical in clinical settings. We propose Render-FM, a feedforward model that eliminates this bottleneck by directly regressing 6D Gaussian Splatting (6DGS) parameters from a CT volume in a single 2.8-second forward pass, a 500x speedup over per-scan optimization. To bridge the domain gap between natural scene reconstruction and medical volumetric rendering, we introduce Anatomy-Guided Priming (AGP), which incorporates segmentation masks and transfer functions as structural and appearance priors, information that existing Gaussian splatting methods overlook. Built on an nnU-Net-inspired 3D U-Net trained on diverse CT scans, Render-FM predicts per-voxel 6DGS parameters and supports immediate real-time rendering. Unlike per-scan methods, it generalizes to unseen anatomies, novel transfer functions, and enables compositional organ visualization with zero additional preparation time. Optional 89-second fine-tuning further improves quality, surpassing per-scan optimized baselines. Project page: https://gaozhongpai.github.io/renderfm/.

The higher-order autocorrelations of integer-valued or rational-valued functions on finite Abelian groups appear naturally in X-ray crystallography, and have applications in computer vision systems, correlation tomography, correlation spectroscopy, and pattern recognition. In this paper, we consider the problem of reconstructing a rational-valued function on finite Abelian groups from its higher-order autocorrelations. We describe an explicit reconstruction algorithm, and prove that the autocorrelations up to order $3r+3$ are always sufficient to determine the data up to translation, where $r$ is the rank of the group. We also provide examples of rational-valued functions on finite Abelian group which are not determined by their autocorrelations up to order $3r+2$. In particular, we provide a sharp upper bound on the separating degree of the regular representation of a finite Abelian group in terms of its rank.

Automatic cardiac image segmentation is pivotal for diagnosing and treating cardiac diseases. In this work, we introduce MCSeg, a volumetric transformer-based network tailored for multi-modal cardiac segmentation. To overcome the architectural mismatch inherent in existing hybrid networks, we propose a novel Scaling Feature Pyramid (SFP). Unlike conventional skip connections, the SFP effectively bridges the single-scale 3D Vision Transformer (ViT) encoder and the multi-scale CNN decoder by transforming the ViT's output into a hierarchical feature pyramid, ensuring that global contextual information is effectively leveraged. For the training paradigm, the ViT encoder first undergoes self-supervised pre-training via masked image modeling. Subsequently, the network is fine-tuned on downstream tasks, during which a regional mutual information (RMI) loss is integrated to improve boundary segmentation accuracy. In experiments, MCSeg consistently outperforms eleven SOTA methods on CT dataset ImageCHD, multi-modal dataset MM-WHS, MRI dataset HVSMR-2.0 and MSD Heart, highlighting the effectiveness of our MCSeg for multi-modal cardiac segmentation tasks. Furthermore, MCSeg's superior performance in few-shot experiment showcases its significant potential in adapting to limited data scenarios. Codes and pre-trained ViT-B weights are open-sourced at https://openi.pcl.ac.cn/OpenMedIA/MCSeg

Subcortical segmentation in neuroimages plays an important role in understanding brain anatomy and facilitating computer-aided diagnosis of traumatic brain injuries and neurodegenerative disorders. However, training accurate automatic models requires large amounts of labelled data. Despite the availability of publicly available subcortical segmentation datasets for Magnetic Resonance Imaging (MRI), a significant gap exists for Computed Tomography (CT). This paper proposes an automatic ensemble framework to generate high-quality subcortical segmentation labels for CT scans by leveraging existing MRI-based models. We introduce a robust ensembling pipeline to integrate them and apply it to unannotated paired MRI-CT data, resulting in a comprehensive CT subcortical segmentation dataset. Extensive experiments on multiple public datasets demonstrate the superior performance of our proposed framework. Furthermore, using our generated CT dataset, we train segmentation models that achieve improved performance on related segmentation tasks. To facilitate future research, we make our source code, generated dataset, and trained models publicly available at https://github.com/alxw0671/CT_Subcortical_Segmentation, marking the first open-source release for CT subcortical segmentation to the best of our knowledge.

This paper proposes a fully differentiable jitter correction method for X-ray phase-contrast micro computed tomography using a deep learning-based image quality metric that estimates and compensates per-projection rigid jitter directly from the acquired projection data, without a pre-scan motion-free reference. The approach builds on a gradient-based auto-focus strategy adapted to parallel-beam geometry. A set of candidate objective functions is benchmarked in a controlled study, and the sensitivity of the visual information fidelity (VIF) metric to the jitter artifact is verified with the target phase-contrast data. To operate without a clean reference, a compact 3D convolutional neural network is trained to predict the VIF score from a single corrupted volume. A spatially selective total variation penalty applied exclusively to the image background is introduced to penalize spurious high-frequency structures that otherwise emerge during optimization. Experiments on biological specimens acquired at different synchrotron beamlines are conducted. Evaluation uses jitter motion applied to simulated and experimentally acquired projection data. The result confirms that the integrated pipeline reliably recovers fine structural detail lost due to jitter, with generalization demonstrated across morphologically distinct samples.

Computed Tomography (CT) is essential for diagnosing pediatric craniofacial abnormalities, yet poses radiation risks to developing anatomies. Reconstructing 3D CT from sparse bi-planar X-rays offers a low-dose alternative but is severely ill-posed. Existing methods employ geometry-agnostic feature lifting, naively projecting 2D features into 3D without explicit spatial modeling, causing depth ambiguity and degraded osseous boundaries. We present PSCT-Net, a geometry-aware framework with differentiable back-projection. Differentiable back-projection establishes a spatially faithful volumetric prior, alleviating depth ambiguity. An Attention-Guided Projection (AGP-3D) module then learns non-linear voxel-wise correspondences between 2D regions and 3D locations. A Bidirectional Mamba (BiM-3D) module captures long-range volumetric dependencies with linear complexity. We further curate a private institutional pediatric skull CT cohort, PedSkull-CT, comprising normal and pathological cases for internal evaluation, addressing the gap in adult-centric, trunk-focused datasets. Project page and code are available at https://dydevelop.github.io/PSCT-Net/.