Computed Tomography

Also known as CT

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18 papers in the last four weeks, up 80% on the four weeks before. 0.2% of all new papers.

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Latest papers 186

May 29, 2026cs.CV

LegSegNet: A Public Deep Learning System for Lower Extremity CT Tissue Segmentation and Quantification

Lower extremity computed tomography (CT) contains clinically relevant information for body composition analysis, sarcopenia assessment, and musculoskeletal disease monitoring, but extracting these measurements at scale requires accurate tissue segmentation and an automated quantification workflow. Existing public segmentation tools are not designed for comprehensive lower extremity CT analysis, particularly for clinically important inter/intramuscular adipose tissue, and most public methods only provide mask prediction rather than an end-to-end quantification system. To address this problem, we present LegSegNet, a deep learning system for lower extremity CT tissue segmentation and body composition quantification. Given an input CT scan, LegSegNet segments bone, skeletal muscle, subcutaneous adipose tissue, and inter/intramuscular adipose tissue. It then computes quantitative tissue measurements for downstream analysis. We developed the segmentation model using 1,302 manually annotated CT slices and evaluated it on 900 held-out test slices, with all annotations reviewed by radiologists. We benchmark LegSegNet against a broad set of 2D segmentation methods, including CNN-based models, transformer-based models, and finetuned foundation models, and further evaluate its generalization on an external public CT dataset. LegSegNet achieves the best overall segmentation performance, with an average Dice score of 89.31 on the held-out test set. To our knowledge, LegSegNet is the first publicly available end-to-end system for lower extremity CT tissue segmentation and quantification, providing a practical evaluation tool for future computer vision research in medical image analysis. The code and model weights are available at: https://github.com/mazurowski-lab/LegSegNet

Yuwen Chen, Yaqian Chen, Roy Colglazier +4

Department of Electrical and Computer Engineering, Duke University, Durham, NC 27708 · Department of Radiology, Duke University, Durham, NC 27708 · Department of Biostatistics & Bioinformatics, Duke University, Durham, NC 27708 +2

Medical Image Analysis Medical Image Segmentation Computed Tomography

May 28, 2026eess.IV

A unified deeplearning framework for contrast-phase-specific virtual monochromatic imaging

Dual-energy CT (DECT) enables virtual monochromatic imaging (VMI) and improved contrast resolution, but its clinical adoption is limited by hardware complexity and cost. In this work, we propose a unified deep learning framework that synthesizes contrast-phase-specific virtual monochromatic 50 keV images from single-energy CT (SECT) data by leveraging contrast phase information as a prior. The model is trained using DECT-derived 70 keV and 50 keV image pairs across four contrast phases -- Angio, Arterial, Portal, and Delayed -- using a novel prior conditioning architecture that integrates contrast phase priors into the energy transformation process. We demonstrate that the proposed unified model achieves contrast enhancement and generalizes well across contrast phases. Additionally, we show that the model can generate 50 keV-like images from SECT inputs, preserving contrast phase-specific dynamics.

Antony Jerald, Hemant K Aggarwal, Brian Nett +4

Science and Technology Organization, GE HealthCare, Bangalore, INDIA · CT Engineering, GE HealthCare, Waukesha, USA · Science and Technology Organization, GE HealthCare, San Ramon, USA +1

Conditional Image Generation Image Reconstruction Medical Image Synthesis Computed Tomography

May 26, 2026cs.RO

Towards Drone-based Mapping of Volcanic Gases using Gas Tomography

Volcanoes emit large amounts of CO2, directly influencing human lives. Mapping volcanic gas emissions helps to forecast eruptions and understand the impact of volcanoes on climate and the environment. Drone-based gas sensing significantly reduces risks in volcanic monitoring but faces technical limitations when measuring gas, as rotor downwash disperses the gas plume before detection. Gas Tomography using remote gas sensing addresses this challenge. At the Salinelle dei Cappuccini mud volcanoes, we demonstrate that while drone-mounted in-situ sensors failed to detect CO2 emissions due to aerodynamic disturbance, open-path sensing successfully enabled remote gas distribution mapping. We present a novel model-based gas tomographic reconstruction approach that incorporates a Lagrangian model to compensate for wind-induced advection. The resulting gas distribution maps align with manually collected in-situ measurements, confirming that model-based gas tomography effectively overcomes downwash limitations and enables accurate mapping of volcanic emissions.

Marius Schaab, Niklas Karbach, Antonia Rabe +5

School of Computation, Information and Technology, Technical University of Munich (TUM), Germany · Department of Chemistry, Johannes Gutenberg-University (JGU), Germany · Institute of Communications and Navigation, German Aerospace Center (DLR), Germany

Computed Tomography UAV Remote Sensing

May 26, 2026eess.IV

Unsupervised Deep Image Prior for Sparse-View and Limited-Angle Electron Tomography

Electron tomography (ET) plays an important role in the three-dimensional (3D) characterization of nanomaterials. However, under limited-angle and sparse-view conditions, conventional algorithms produce degraded reconstructions, which compromise the quality and interpretability of resulting 3D data. In this paper, we present deep image prior (DIP), an unsupervised deep learning (DL) approach, for highly degraded tomography acquisitions and demonstrate, using simulated data, that its performance is comparable to that of supervised approaches requiring training datasets, even for tilt ranges as limited as 60° and tilt increments of 10°. We then apply it to experimental data and show that it enables reliable 3D quantification under both sparse-view and limited-angle conditions, highlighting its potential for a wide range of materials and acquisition modalities.

Serge Brosset, Daniel del Pozo Bueno, Thomas David +3

a Univ. Grenoble Alpes, CEA, Leti, F-38000 Grenoble, France. · b Univ. Grenoble Alpes, CEA, Liten, F-38000 Grenoble, France. · c CEA, Joliot, NeuroSpin, Gif-sur-Yvette Cedex 91191, France. +1

Sparse-View CT Reconstruction Computed Tomography Image Inverse Problems

May 25, 2026eess.IV

NL-MambaXCT: Self-Supervised Nested-Learning Mamba for Nomex Honeycomb X-ray CT Defect Classification

X-ray computed tomography (XCT) is widely used for non-destructive testing of Nomex honeycomb structures in aerospace manufacturing, but industrial inspection still relies heavily on manual interpretation and supervised models trained on limited labeled data. This work introduces NL-MambaXCT, a Mamba-based framework that combines self-supervised masked image modelling with a Nested Learning (NL) formulation for automated, label-efficient defect classification from production XCT slices. The backbone is a four-stage 2D encoder with RegNet convolutional blocks in the early stages and Mamba-based sequence mixing with attention in the deeper stages. It is pretrained by masked image modelling on 19,961 unlabeled industrial XCT slices and fine-tuned on 2,000 relabeled Nomex XCT slices split by production order. NL is instantiated through two-timescale parameter dynamics: selected projections maintain slow exponential-moving-average traces alongside fast weights, while a deep-momentum optimizer introduces an additional slow parameter-update trajectory. On the held-out test set, the MIM-pretrained NL-MambaXCT model achieves 96.91% accuracy and 96.8% macro F1, outperforming CNN, attention, and single-timescale Mamba baselines by 3.11--10.31 percentage points in accuracy. The results suggest that combining masked self-supervision with NL-style fast/ slow learning dynamics is a promising strategy for robust defect classification in Nomex honeycomb XCT inspection.

Ghaleb Aldoboni, Lobna Nassar, Fakhri Karray +1

Department of Computer Science and Engineering, American University of Ras Al Khaimah (AURAK), Ras Al Khaimah, United Arab Emirates · Department of Machine Learning, Mohamed bin Zayed University of Artificial Intelligence (MBZUAI), Abu Dhabi, United Arab Emirates · Centre for Pattern Analysis and Machine Intelligence, Department of Electrical and Computer Engineering, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada +1

Computed Tomography

May 25, 2026eess.IV

Parameter-Efficient CT Reconstruction via Deep Graph Laplacian Regularization

Low-dose computed tomography (LDCT) reconstruction faces a critical tradeoff between reconstruction quality and resource requirements. While recent deep learning methods achieve state-of-the-art performance, they typically rely on over 500,000 parameters trained on large-scale datasets exceeding 35,000 scans. This work investigates whether graph-based regularization can provide meaningful noise reduction under strict resource constraints. We propose Deep Graph Laplacian Regularization (Deep GLR), integrating quadratic graph regularization into a Proximal Forward-Backward Splitting optimization framework with three lightweight CNN modules. Evaluated on the LoDoPaB-CT benchmark, Deep GLR achieves 30.70 dB PSNR, representing a 6.33 dB improvement over filtered backprojection, while using only 91,848 parameters trained on 1000 samples (2.8% of standard training set). Compared to benchmark methods, this represents 5.8 times better parameter efficiency and 30 times better data efficiency per dB improvement. The learned graph bandwidth parameter (

ε

=1.25) converges to interpretable values, suggesting the method captures meaningful image priors rather than overfitting. While a 13 dB gap remains versus state-of-the-art methods, results demonstrate that graph-based regularization provides a favorable efficiency-quality tradeoff for resource-constrained medical imaging scenarios.

Veera Varuni Radhakrishnan, Chinthaka Dinesh, Qurat-ul-Ain Azim

Mechanical and Industrial Engineering Department Northeastern University Vancouver, Canada

Computed Tomography

May 23, 2026cs.CV

SliceWorld: A Predictive and Controllable World-State Model for CT Report Generation

CT report generation (CTRG) requires models to summarize three-dimensional anatomical context and pathological findings from hundreds of axial slices. Existing methods typically learn a direct image-to-text mapping, providing limited mechanisms for modeling how CT evidence evolves across slices or how reports respond to controlled changes in latent lesion-related factors. We propose SliceWorld, a CT-specific world-state framework that treats an axial CT scan as an ordered sequence along the z-axis. SliceWorld encodes prefix CT evidence into factor-aware latent states containing anatomy, lesion, and uncertainty components, and projects these states into world tokens used for multi-step future-slice feature prediction, lesion-factor intervention, and LLM-based report generation. The model is first pretrained on CT slice sequences with predictive, factor-aware, and counterfactual objectives, and is then fine-tuned on paired CT-report data. Experiments on M3D-Cap and CT-RATE show that SliceWorld improves natural language generation metrics and clinically oriented automatic evaluation. Further analyses demonstrate multi-horizon future-slice prediction, measurable factor alignment, reduced-slice robustness, and selective lesion-sensitive report modulation.

Yuanhe Tian, Yan Song

Zhongguancun Academy · University of Science and Technology of China

Radiology Report Generation World Model Learning Medical VLMs Latent World Models Computed Tomography

May 21, 2026cs.CV

GLeVE: Graph-Guided Lesion Grounding with Proposal Verification in 3D CT

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.

Shuo Jiang, Yuhao Hong, Chunbo Jiang +9

Zhejiang Key Laboratory of Space Information Sensing and Transmission, Hangzhou Dianzi University, Hangzhou, China · Zhejiang University, Hangzhou, China · Tsinghua University, Beijing, China +1

3D Medical Image Segmentation Medical Image Grounding Computed Tomography Medical Image Localization

May 21, 2026cs.CV

VEELA: A Clinically-Constrained Benchmark for Liver Vessel Segmentation in Computed Tomography Angiography

Accurate segmentation of hepatic and portal vessels in contrast-enhanced computed tomography angiography (CTA) remains challenging due to complex vascular topology, peripheral visibility limitations, and acquisition-induced ambiguities. While existing public datasets offer valuable benchmarks, few include clinically realistic annotation constraints. We introduce VEELA (Vessel Extraction and Extrication for Liver Analysis), a rigorously curated liver vessel dataset derived from 40 CTA scans inherited from the CHAOS grand-challenge cohort. All vessels were manually delineated slice-by-slice under multi-expert consensus, using a strict visibility-driven annotation policy and avoiding anatomically inferred interpolation. This design explicitly captures anatomical variability and imaging-related uncertainty. As a continuation of the CHAOS challenge, VEELA enables reproducible cross-benchmark evaluation while extending the scope to fine-grained hepatic and portal vessel segmentation. We further establish a standardized benchmarking framework and analyze complementary evaluation metrics, including topology-aware (clDice), overlap-based (IoU), boundary-sensitive (NSD), and geometry-aware (area, length) measures. Our results demonstrate that different metrics capture distinct aspects of vascular integrity, underscoring the necessity of multi-perspective evaluation for clinically meaningful vessel segmentation. VEELA is publicly released to facilitate reproducible research and support the development of robust vascular segmentation methods. Researchers can access the evaluation metrics, dataset, and submission platform at https://www.synapse.org/Synapse:syn65471967.

Ziya Ata Yazıcı, N. Sinem Gezer, İlkay Öksüz +19

Huawei Türkiye R&D Center, Istanbul, 34768, Türkiye · Department of Radiology, Dokuz Eylul University, Izmir, 35100, Türkiye · Department of Computer Engineering, Istanbul Technical University, Istanbul, 34469, Türkiye +8

Medical Image Segmentation Computed Tomography Medical Image Benchmarks

May 21, 2026cs.CV

Universal CT Representations from Anatomy to Disease Phenotype through Agglomerative Pretraining

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.

Yuheng Li, Yuan Gao, Haoyu Dong +5

Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA · Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA · Department of Electrical and Computer Engineering, Duke University, Durham, NC 27705, USA +2

Medical Imaging Foundation Models Medical VLMs Continued Pretraining Medical Image Representation Learning Computed Tomography

May 20, 2026cs.LG

Machine learning prediction of obstructive coronary artery disease using opportunistic coronary calcium and epicardial fat assessments from CT calcium scoring scans

Non-contrast computed tomography calcium scoring (CTCS) is a cost-effective imaging modality widely used to detect coronary artery calcifications. This study aimed to develop an advanced machine learning framework that utilizes quantitative analyses of coronary calcium and epicardial fat from CTCS images to predict obstructive coronary artery disease (CAD). The study population consisted of 1,324 patients from the SCOT-HEART clinical trial who underwent both CTCS and coronary CT angiography. We extracted and analyzed a broad range of features, including 24 clinical variables, 189 calcium-omics, and 211 epicardial fat-omics features from the CTCS images. Feature selection was conducted using the CatBoost algorithm combined with SHapley Additive exPlanation (SHAP) values. Predictive modeling utilized the CatBoost gradient boosting method, focusing on the most informative features. From an initial set of 424 candidate features, 14 were identified as most predictive through the CatBoost-SHAP method. The top two predictive features originated from fat-omics, with the remaining 12 features derived from calcium-omics. The optimized model achieved robust predictive capabilities, demonstrating a sensitivity of 83.1+/-4.6%, specificity of 93.8+/-1.7%, accuracy of 85.3+/-2.0%, and an F1 score of 73.9+/-3.3%. Inclusion of calcium-omics and fat-omics data significantly improved predictive performance. Notably, the model also showed reliable predictive accuracy in patients with diverse coronary calcium scores, including cases with obstructive CAD despite a zero-calcium score. This innovative approach holds promise for improving clinical decision-making and potentially reducing dependence on contrast-enhanced or invasive diagnostic procedures, particularly within low-to intermediate-risk patient groups.

Juhwan Lee, Ammar Hoori, Tao Hu +7

Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, 23284, USA · Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA · Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA +2

Radiomics Computed Tomography Clinical Risk Prediction

May 20, 2026cs.LG

Quantitative coronary calcification analysis for prediction of myocardial ischemia using non-contrast CT calcium scoring

Non-contrast computed tomography calcium scoring (CTCS) is widely recognized as an effective tool for cardiovascular risk stratification. This study aimed to develop a novel machine learning framework for predicting myocardial ischemia from routine non-contrast CTCS scans using quantitative coronary calcium assessment. This study analyzed 1,375 patients who underwent both non-contrast CTCS and regadenoson stress cardiac positron emission tomography myocardial perfusion imaging within one year at University Hospitals Cleveland Medical Center. A total of 74 variables, including clinical variables, Agatston score, and calcium-omics features, were evaluated. Relevant features were identified using XGBoost with Shapley Additive exPlanations (SHAP). Predictive models were trained and evaluated using 5-fold cross-validation. Among 987 patients, 89 (9%) were positive for myocardial ischemia. The final model incorporated the Agatston score, eight calcium-omics features, and age. The proposed model achieved a precision of 98.9+/-3.0%, sensitivity of 79.2+/-8.4, and F1 score of 87.7+/-5.3%. The addition of calcium-omics features significantly improved predictive performance compared with models using clinical variables alone or clinical variables with the Agatston score (p<0.05). Interestingly, the number of calcified arteries, despite being the lowest-ranked feature based on SHAP analysis, showed the strongest association with myocardial ischemia in logistic regression analysis (odds ratio: 3.63, 95% confidence interval: 2.80-4.77, p<0.00001). We developed a machine learning approach for predicting myocardial ischemia using routinely acquired non-contrast CTCS scans. Calcium-omics features provided incremental predictive value beyond conventional risk factors and Agatston scoring and may support more accessible cardiovascular risk stratification.

Juhwan Lee, Sadeer Al-Kindi, Ammar Hoori +6

Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, 23284, USA · Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA · DeBakey Heart and Vascular Institute, Houston Methodist Hospital, Houston, TX, 77030 +2

Clinical Outcome Prediction Radiomics Computed Tomography Clinical Risk Prediction

May 20, 2026cs.CV

SpineContextResUNet: A Computationally Efficient Residual UNet for Spine CT Segmentation

Automated segmentation of the vertebral column in Computed Tomography (CT) scans is a prerequisite for pathological assessment and surgical planning. However, state-of-the-art methods, particularly those based on Transformers or large-scale ensembles, demand substantial GPU resources, creating a barrier for clinical adoption in resource-constrained environments or on edge devices. To address this, we introduce SpineContextResUNet, a computationally efficient 3D Residual U-Net designed for rapid spinal localization. Our architecture integrates a lightweight Context Block that employs parallel multi-dilated convolutions to capture long-range anatomical dependencies without the high latency of Recurrent Neural Networks (RNNs) or the memory overhead of Self-Attention mechanisms. Extensive validation on two public benchmarks, VerSe2020 and CTSpine1K, demonstrates that our model achieves a Dice score of 88.17% and 88.13% respectively. To evaluate performance under strict hardware constraints, we compared our model against a bottlenecked SwinUNETR scaled to match our ~1.7M hardware footprint. While the constrained Transformer suffers severe performance degradation due to a lack of spatial inductive biases in a limited-data regime, our CNN-based approach successfully maintains high accuracy. Crucially, heavy baselines like TotalSegmentator fail due to memory exhaustion on commodity hardware (Intel Core i5, 8GB RAM), our model performs robust inference, making it a viable solution for point-of-care diagnostics and deployment on edge platforms like the Nvidia Jetson Orin Nano.

K S Nithurshen, Saurabh J. Shigwan

Shiv Nadar University, Delhi NCR, India

Efficient Neural Network Inference U-Net Medical Image Segmentation 3D Medical Image Segmentation Computed Tomography

May 19, 2026cs.CV

Regulating Anatomy-Aware Rewards via Trajectory-Integral Feedback for Volumetric Computed Tomography Analysis

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 GitHub.

Tianwei Lin, Zhongwei Qiu, Jie Cao +7

Zhejiang University · DAMO Academy, Alibaba Group · Hupan Lab +1

Radiology Report Generation Radiology VLMs Medical Image Anomaly Detection Computed Tomography Medical Image Benchmarks RL for VLMs

May 17, 2026cs.CV

GraphMAR: Geometry-Aware Graph Learning Framework for Spatially Adaptive CT Metal Artifact Reduction

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.

Zilong Li, Chenglong Ma, Yiming Lei +7

Shanghai Key Lab of Intelligent Information Processing, College of Computer Science and Artificial Intelligence, Fudan University, Shanghai 200433, China · Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai 200433, China · College of Computer Science and Technology, Qingdao University, Qingdao 266071, China +2

Graph Neural Networks Image Restoration Computed Tomography

May 15, 2026cs.CV

TriALS: Triphasic-Aided Liver Lesion Segmentation Benchmark in Non-Contrast CT

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.

Marawan Elbatel, Mohamed Ghonim, Jiaji Mao +62

Image Segmentation Medical Image Segmentation Computed Tomography Medical Image Benchmarks

May 15, 2026cs.CV

Segmentation, Detection and Explanation: A Unified Framework for CT Appearance Reasoning

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.

Yuyuan Liu, Can Peng, Yingyu Yang +3

Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford

Image Segmentation Medical VLMs Medical Image Segmentation Computed Tomography Medical Image Localization

May 15, 2026cs.CV

Conservative AI for Safety-Sensitive Medical Image Restoration: Residual-Bounded CT-CTA Enhancement for Intracranial Aneurysm-Relevant Signal Recovery

Image restoration models are increasingly applied to degraded medical scans, but in safety-sensitive settings they must improve image quality without uncontrolled modification of clinically important regions. This is especially relevant for intracranial CT and CT angiography (CTA), where small vessels and aneurysm-relevant cues lie near high-contrast anatomical boundaries. We frame medical image restoration as a conservative AI problem and present a residual-bounded 2.5D restoration framework trained on synthetically degraded CT/CTA inputs. The model adds a learned residual to the original center slice through an edit-control map that limits the magnitude and spatial extent of modification. We evaluate the framework using an aneurysm-relevant image-recovery matrix, paired comparison against a Gaussian baseline, Monte Carlo stability testing, anatomical localization of meaningful edits, and external evaluation on low-dose CT. On 50 out-of-distribution CT-CTA cases, the bounded model achieved a mean target gain of 0.0635, a mean PSNR of 37.51 dB, and an iatrogenic-edit rate of 4.0%. Across 1,000 Monte Carlo runs, it remained net positive in 85.4% of runs with no stably negative cases. On external low-dose CT, the model was directionally beneficial and produced a substantially smaller modification footprint than the baseline. Meaningful edits concentrated in brain and skull regions while unrelated anatomy showed negligible change. These findings provide preliminary computational evidence that residual-bounded restoration is feasible in boundary-sensitive vascular imaging, but they do not establish clinical diagnostic performance and require expert review and prospective validation before clinical use.

Weijun Ma

King George, Vancouver School Board Vancouver, BC, Canada

Coronary Angiography Image Restoration Computed Tomography

May 14, 2026cs.CV

CT-DegradBench: A Physics-Informed Benchmark for CT Degradation Detection and Severity Estimation

Computed tomography (CT) images are frequently degraded by acquisition artifacts, including noise, blur, streaking, aliasing, and metal artifacts. Yet CT enhancement is still largely evaluated using image quality metrics with limited perceptual and clinical validity, while existing datasets remain focused on isolated restoration tasks, hindering unified benchmarking across diverse degradation types. We present CT-DegradBench, a dataset and benchmark for CT degradation detection and severity estimation under controlled single- and mixed-artifact settings. CT-DegradBench enables systematic evaluation across multiple degradation families and severity levels within a common experimental framework. We further propose SeSpeCT (Semantic-Spectral CT degradation estimation), a framework that combines semantic priors from medical vision-language models with complementary frequency-domain cues for artifact analysis. SeSpeCT constructs a training-free semantic quality axis in the multimodal embedding space using radiology-informed text prompts, without task-specific fine-tuning, and combines it with spectral features that capture degradation-specific frequency patterns. The resulting representation enables joint prediction of artifact type and severity. Experimental results show that SeSpeCT consistently outperforms the evaluated baselines under both single- and mixed-degradation settings. The framework is available at https://github.com/yousranb/CT-DEGRADBENCH.

Yousra Nabila Taifour, Marouane Tliba, Zuheng Ming +9

1Université Sorbonne Paris Nord · University of Dubai · 3Northwestern University +3

Image Quality Assessment Computed Tomography Medical Image Benchmarks

May 14, 2026cs.CV

CoralLite: μCT Reconstruction of Coral Colonies from Individual Corallites

The life history of an individual coral is archived within the accreting skeleton of the colony. While reef-forming coral colonies (e.g. massive

\textit{Porites}

sp.) may live for hundreds of years and deposit calcareous structures many metres in height and width, their living tissue is a thin outer surface layer comprised of asexually-dividing polyps that only survive a few years. To understand the rate and timing of polyp division and the consequences for colony skeletal growth, scientists need to track the skeletal corallite deposited around each polyp. Here we propose CoralLite, an annotated

μ

CT scan dataset of entire calcareous skeletons and an associated, first corallite deep learning reconstruction baseline. CoralLite combines fully quantified volumetric segmentations with cross-slice linking for visualisations of 3D models for each corallite up to colony scale. For segmentation, we propose and evaluate in detail a hybrid V-Trans-UNet architecture applicable to segmenting tiled

μ

CT virtual slabs of

\textit{Porites}

sp. colonies. The model is pre-trained on weakly annotated data and topology-aware fine-tuned using fully annotated slice sections with 8k+ manual corallite region annotations. On unseen slices of the same colony, the resulting model reaches 0.94 topological accuracy at mean Dice scores of 0.77 on the same colony and projection axis, and 0.63 mean Dice scores on a different, biologically unrelated specimen. Whilst our experiments are limited in scale and context, our results show for the first time that visual machine learning can effectively support full 3D individual corallite modelling from

μ

CT scans of coral skeletons alone. For reproducibility and as a baseline for future research we publish our full dataset of 697

μ

CT slices, 37 partial or full slice annotations, and all network weights and source code with this paper.

Jess Jones, Leonardo Bertini, Kenneth Johnson +2

University of Bristol · University of Liverpool · Natural History Museum

3D Reconstruction Computed Tomography Semantic Segmentation 3D Instance Segmentation

May 14, 2026cs.AI

How Sensitive Are Radiomic AI Models to Acquisition Parameters?

A main barrier for the deployment of AI radiomic systems in clinical routine is their drop in performance under heterogeneous multicentre acquisition protocols. This work presents a performance-oriented framework for quantifying scan parameter sensitivity of radiomic AI models, while identifying clinically significant parameter regions associated with improved cross-dataset robustness. We formulate a mixed-effects framework for quantifying the influence that clinically relevant acquisition parameters have on models performance, while accounting for subject-level random effects. We have applied our framework to lung cancer diagnosis in CT scans using two independent multicentre datasets (a public database and own-collected data) and several SoA architectures. To evaluate across-database reproducibility, CT parameters have been adjusted using the data collected and tested on the public set. The optimal configuration selected is the current of the X-ray tube >= 200 mA, spiral pitch <= 1.5, slice thickness <= 1.25 mm, which balances diagnostic quality with low radiation dose. These configuration push metrics from 0.79+-0.04 sensitivity, 0.47+-0.10 specificity in low quality scans to 0.90+-0.10 sensitivity, 0.79 +- 0.13 specificity in high quality ones.

D. Gil, I. Sanchez, C. Sanchez

Universitat Autònoma de Barcelona and Computer Vision Center, Edifici O, Campus UAB, Bellaterra (Cerdanyola), 08193, Barcleona, Spain

Medical Imaging Medical Diagnosis Radiomics Computed Tomography Mixed-Effects Models Cross-Dataset Generalization

May 13, 2026cs.CV

JANUS: Anatomy-Conditioned Gating for Robust CT Triage Under Distribution Shift

Automated CT triage requires models that are simultaneously accurate across diverse pathologies and reliable under institutional shift. While Vision Transformers provide strong visual representations, many clinically significant findings are defined by quantitative imaging biomarkers rather than appearance alone. We introduce JANUS, a physiology-guided dual-stream architecture that conditions visual embeddings on macro-radiomic priors via Anatomically Guided Gating. On the MERLIN test set (N=5082), JANUS attains macro-AUROC 0.88 and AUPRC 0.74, outperforming all reproduced baselines. It generalizes to an external dataset N=2000; AUROC 0.87), with the largest gains on findings defined by size and attenuation as well as improved calibration on both datasets. We further quantify prediction suppression using the Physiological Veto Rate (PVR), showing that under domain shift JANUS reduces high-confidence false positives substantially more often than true positives. Together, these results are consistent with physically grounded conditioning that improves both discrimination and reliability in CT triage. Code is made publicly available at github repository https://github.com/lavsendahal/janus and model weights are at https://huggingface.co/lavsendahal/janus.

Lavsen Dahal, Yubraj Bhandari, Geoffrey Rubin +1

Center for Virtual Imaging Trials, RAI Labs, Department of Radiology, Duke University, Durham NC 27708, USA · Electrical and Computer Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA · Department of Mathematics, Trinity College of Arts & Sciences, Duke University,2026 Durham, NC 27708, USA +1

Distribution Shift Robustness Healthcare Clinical Triage Medical Image Classification Radiomics Computed Tomography

May 12, 2026cs.CV

H3D-MarNet: Wavelet-Guided Dual-Path Learning for Metal Artifact Suppression and CT Modality Transformation for Radiotherapy Workflows

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.

Mubashara Rehman, Niki Martinel, Michele Avanzo +2

Machine Learning and Perception Lab, Università degli Studi di Udine, 33100 Udine, Italy · Centro di Riferimento Oncologico di Aviano IRCCS, 33081 Aviano, Italy

Image Enhancement Image-to-Image Translation Medical Image Synthesis Computed Tomography

May 12, 2026eess.IV

Uncovering Latent Pathological Signatures in Pulmonary CT via Cross-Window Knowledge Distillation

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.

Bo Peng, Wujian Xu, Kun Wang +8

*These authors contributed equally to this work.

Medical Image Classification Computed Tomography Knowledge Distillation

May 11, 2026cs.CV

FrequencyCT: Frequency Domain Self-supervised Low-dose CT Denoising

Despite extensive research on computed tomography (CT) denoising, few studies exploit projection-domain data characteristics to mitigate noise correlation. To bridge this gap, this work proposes FrequencyCT, the first zero-shot self-supervised method for pseudo-sample generation in the frequency domain for low-dose CT denoising. Specifically, by exploiting the distinct frequency-domain distributions of noise and true signal, a regional low-frequency anchoring technique is proposed. Applying phase-preserving noise and mask perturbations to the high-frequency region generates pseudo-samples for self-supervision. Driven by the exponential correlation between noise variance of noisy projections and the underlying true signal, consistent data truncation is applied to the generated samples to stabilize optimization gradients. Evaluation results on multiple public and real datasets confirm the clinical application potential of this research, which provides an innovative perspective for the field of denoising. The code is available at: https://github.com/yqx7150/FrequencyCT.

Guoquan Wei, Liu Shi, Chong Chen +1

School of Information Engineering, Nanchang University, Nanchang 330031, China · SKLMS, ICMSEC, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China

Self-Supervised Image Denoising Self-Supervised Learning Frequency-Domain Image Processing Computed Tomography LDCT Denoising Image Denoising

May 9, 2026cs.CV

The Direct Integration Theorem: A Rigorous Framework for Consistent Discrete Solutions of the Inverse Radon Problem

This paper presents a novel Direct Integration Theorem (DIT), derived as a non-trivial corollary of the classical Central Slice Theorem (CST). The DIT provides a mathematically consistent transition from the continuous to the discrete domain - a fundamental challenge in computed tomography - thereby eliminating the need for frequency-domain interpolation without resorting to conventional ramp-filtering. The proposed approach circumvents two principal limitations inherent in traditional methods: (i) the zero-frequency singularity and spectral distortions introduced by the mandatory ramp-filtering step, and (ii) discretization inaccuracies associated with frequency-domain interpolation. Based on the DIT, we develop a rigorous framework for consistent discrete solutions of the inverse Radon problem. Mathematical modeling demonstrates that this approach achieves quasi-exact reconstruction, with errors constrained solely by sampling parameters and grid geometry. Furthermore, while Filtered Back Projection (FBP) inherently distorts the variance of the reconstructed image, the DIT-based algorithm preserves it. Comparative simulations confirm that the proposed method eliminates common artifacts, such as intensity cupping, and consistently outperforms FBP in terms of PSNR, SSIM, and reprojection fidelity, faithfully restoring the original image's statistical characteristics.

Mikhail G. Mozerov

Institute for Information Transmission Problems, Russian Academy of Sciences, Moscow, 127051 Russia

Image Reconstruction Computed Tomography Inverse Problems

May 9, 2026cs.CV

CT-IDP: Segmentation-Derived Quantitative Phenotypes for Interpretable Abdominal CT Disease Classification

In this retrospective multi-institutional study, a quantitative phenotyping framework, CT-IDP (CT Image-Derived Phenotypes) was developed on the MERLIN abdominal CT benchmark (training, validation, and test sets- 15,175, 5,018, and 5,082 studies, respectively) and externally evaluated on two independent dataset: Duke-Abdomen (2,000) and AMOS (1,107). Multi-organ segmentations were generated with TotalSegmentator and used to derive over 900 organ and compartment-level descriptors spanning morphometry, attenuation, and contextual/burden findings. Sparse disease-specific logistic regression with elastic-net regularization was trained on MERLIN and externally validated under a frozen specification. Performance was compared against a DINOv3-based vision-transformer baseline using AUC and average precision (AP), supported by phenotype-stratified audits and coefficient-level inspection. Macro-AUC for CT-IDP versus the baseline was 0.897 versus 0.880 on MERLIN, 0.877 versus 0.857 on the Duke-Abdomen dataset, and 0.780 versus 0.756 on AMOS.

Lavsen Dahal, Joseph Y. Lo

1. Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Laboratories · 3. Electrical and Computer Engineering, Pratt School of Engineering, Duke University · 4. Medical Physics Graduate Program, Duke University +1

Medical Image Classification Explainable Medical Image Analysis Radiomics Computed Tomography

May 9, 2026cs.CV

Lost in Volume: The CT-SpatialVQA Benchmark for Evaluating Semantic-Spatial Understanding of 3D Medical Vision-Language Models

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.

Mashrafi Monon, Umaima Rahman, Asif Hanif +2

Mohamed Bin Zayed University of Artificial Intelligence, Abu Dhabi, UAE · New York University Abu Dhabi, Abu Dhabi, UAE

VLM Evaluation 3D Spatial Reasoning Medical VQA Computed Tomography Medical Image Benchmarks

May 7, 2026cs.CV

Whole-body CT attenuation and volume charts from routine clinical scans via evidence-grounded LLM report filtering

Interpreting quantitative CT biomarkers, such as organ volume and tissue attenuation, requires large-scale healthy reference distributions. However, creating these is challenging because clinical datasets are often heavily enriched with pathology. Here, we develop an evidence-grounded, cross-verified large language model (LLM) ensemble to filter pathological findings from radiology reports, enabling the construction of pathology-reduced cohorts from over 350,000 CT examinations. Five LLMs, first, flag structure-level abnormality candidates grounded in verbatim report evidence and, second, resolve disagreements via cross-verification. Using distribution-aware generalized additive models for location, scale, and shape, we establish comprehensive whole-body reference charts for 106 anatomical structures (volumes and attenuation) across adulthood, accounting for age, sex, contrast enhancement, and acquisition parameters. Longitudinal analyses reveal structure- and contrast-dependent changes distinct from cross-sectional trends. These resources facilitate covariate-adjusted centile scoring from routine CT, supporting standardized quantitative phenotyping, multi-site imaging studies, and scalable opportunistic screening research.

Christian Wachinger, Bernhard Renger, Christopher Späth +2

Institute of Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany · Munich Data Science Institute (MDSI), Technical University of Munich, Munich, Germany · Munich Center for Machine Learning (MCML), Munich, Germany +1

Medical Imaging Healthcare Computed Tomography

May 5, 2026cs.CV

GeoTopoDiff: Learning Geometry--Topology Graph Priors through Boundary-Constrained Mixed Diffusion for Sparse-Slice 3D Porous Reconstruction

Diffusion-based voxel prior modelling is challenging for the reconstruction of large-scale 3D porous microstructures. Due to the demanding requirements for simultaneously modelling both the continuous pore morphology and the discrete pore-throat topology, the diffusion models require fully observed CT scans to provide topology-faithful priors, which results in an inherent trade-off among throughput, topological fidelity, and field of view in practical industrial applications. We propose GeoTopoDiff, a graph diffusion-based framework for reconstructing 3D porous microstructures from sparse CT slices. GeoTopoDiff transfers the learning of diffusion priors from a voxel-based space to a mixed graph state space, which simultaneously encompasses continuous pore geometry and discrete pore-throat topology. A topology-aware partial graph prior from sparsely observed CT slices is introduced to constrain the reverse denoising process. Experiments on anisotropic PTFE and Fontainebleau sandstone show that GeoTopoDiff reduces morphology-related errors by 19.8% and topology-sensitive transport errors by 36.5% on average. Our findings suggest that the mixed graph state space promotes the diffusion denoising process to reduce posterior uncertainty under a sparse observations. All models and code have been made publicly available to facilitate the exploration of diffusion models in the field of 3D porous microstructures simulation.

Yue Shi, Peng Wang, Mingzhe Yu +5

Manchester Metropolitan University, Manchester M1 5GD, U.K. · University of Surrey, Surrey, GU2 7XH, U.K. · Johnson Matthey Billingham, TS23 1LB, U.K. +1

3D Reconstruction Sparse-View CT Reconstruction Computed Tomography Graph Diffusion