Cone-Beam CT

Trajectory optimisation for cone-beam computed tomography (CT) determines which information sparse-view scans acquire. Fixed candidate pools prevent off-grid refinement and require new object-specific precomputation for each acquisition manifold. We make every source pose an individual continuous variable and move all poses jointly by gradient ascent on the scanner's kinematic manifold. The objective combines soft-Tuy plane coverage, continuous View Covariance Loss, and an analytic attenuation-aware ray-bundle penalty. The same optimiser handles circular, limited C-arm, two-axis, and freesphere parametrisations. On a Defrise flange, continuous selection recovers laminar defects invisible to a circular orbit, matches discrete swap search on the free sphere at the sparser budget, and leads at the denser one, with the same objective evaluated in every arm. A moderate elevation band already recovers most of the free-sphere gain at the defects, so the same optimiser transfers to bounded scanner envelopes. Photon noise preserves the ordering on the flange and compresses it on a dense fuel nozzle. Sparseprescan planning benefits from matching prescan and planned acquisition manifolds. Selection takes seconds rather than minutes without an object-specific reconstruction basis. Prescan-planned poses were executed on a robot CT bench and reconstructed in a common frame, demonstrating feasibility but no consistent metric gain over uniform band sampling. Continuous pose optimisation incorporates attenuation and scanner constraints directly into sparse-view acquisition design.

Cone-beam computed tomography (CBCT) is widely used in image-guided radiotherapy, but scatter, beam hardening, noise, truncation, and other artifacts limit image quality and CT number accuracy. Paired CBCT and CT data are difficult to obtain clinically because of motion, anatomical changes, and acquisition mismatch. We present RefineCBCT, an unpaired CBCT refinement framework that uses pseudo-label guidance and short-step diffusion to reduce artifacts while preserving patient-specific anatomy. RefineCBCT was trained and evaluated on unpaired CBCT and planning CT data from public LUNG TCIA and PELVIC TCIA datasets and compared with representative GAN and diffusion based methods. On LUNG TCIA, it achieved the best results across all metrics, with MAE 19.411, RMSE 62.758, PSNR 30.845 dB, and SSIM 0.931. On PELVIC TCIA, it achieved the best MAE, PSNR, and SSIM, with values of 14.905, 36.671 dB, and 0.876. The refined images showed fewer streaking and shading artifacts, clearer anatomical boundaries, and improved soft tissue uniformity, with line profile and ROI analyses showing closer agreement with planning CT. These results suggest that RefineCBCT provides efficient and effective CBCT refinement under clinically realistic unpaired training conditions and may support more reliable CBCT use in image-guided radiotherapy workflows. Code is publicly available on GitHub, and the evaluated datasets are available from The Cancer Imaging Archive.

Dental cone-beam computed tomography (CBCT) systems often employ detector configurations that provide a truncated field of view (FOV) that only captures a small part of the patient's anatomy. In this work, we aim to reconstruct an extended FOV using projections of truncated FOV scans. To this end, we propose a three-stage framework that consists of (1) an implicit neural representation (INR) for estimating missing parts of the truncated projection data, (2) an iterative reconstruction for generating a secondary volumetric image with improved anatomical consistency and (3) a fast diffusion model for image enhancement. The proposed approach combines the strengths of continuous representations, physics-based reconstruction and generative refinement within a unified pipeline for truncated CBCT imaging. Experimental results demonstrate that the method effectively reduces truncation artifacts, improves the reconstruction of structures extending beyond the original FOV and produces images with enhanced quality. Our code is publicly available at https://github.com/SusanneSchaub/CBCT-FOV-Extension.

Cone-beam computed tomography (CBCT) enables volumetric reconstruction from X-ray projections, but suffers from severe artifacts--especially beam hardening--when imaging materials with high attenuation such as metals. These artifacts arise from the polychromatic nature of X-rays and are not properly addressed by conventional monochromatic reconstruction algorithms. While recent neural representation-based methods offer improved reconstruction quality, they are computationally expensive and often impractical for deployment. We propose a novel physics-inspired, self-calibrating metal artifact reduction method that efficiently reconstructs 3D CBCT volumes while correcting beam hardening artifacts. Our method integrates a polychromatic X-ray projection model, material-dependent attenuation profiles, and system response modeling into a Gaussian Splatting framework. Unlike prior work, we eliminate the need for manual metal masks or strong prior assumptions, and we optimize both reconstruction parameters and X-ray spectral characteristics jointly during training. We further introduce a high-fidelity synthetic CBCT dataset generation pipeline validated on Monte-Carlo x-ray simulation toolbox and release new datasets with severe metal-induced artifacts to support the community. This is the first splat-based method for reducing beam hardening in CBCT. Extensive experiments on both synthetic and real-world datasets demonstrate that our method outperforms state-of-the-art approaches in artifact suppression and reconstruction accuracy.

During standard radiotherapy planning, repeated CT acquisitions are often required for patient registration, verification, and adaptive planning, resulting in increased cumulative X-ray dose. To mitigate this, low-dose cone-beam CT (CBCT) is routinely acquired during treatment delivery. However, CBCT image quality remains insufficient for accurate dose calculation and adaptive radiotherapy planning due to increased scatter, noise, beam hardening, and reconstruction related artifacts. This study develops a supervised deep learning based CBCT to CT synthesis framework using a conditional denoising diffusion probabilistic model (DDPM), where the generation of a CT-based planning for accurate positioning and dose calculation is obtained using generative models with low dose CBCT imaging. Beyond demonstrating CBCT to CT synthesis, the primary objective is to investigate how the representation of CBCT input data, either standard clinical DICOM CBCT images or filtered back-projection (FDK) reconstructions from raw projection data, affects the performance of diffusion based CT synthesis. The overarching aim is to assess whether physics aware CBCT representations better support CT-equivalent image quality while maintaining reduced imaging dose in radiotherapy workflows.

Registration between cone-beam computed tomography (CBCT) and intraoral scans (IOS) is essential for patient-specific surgical planning. However, disparate imaging modalities, limited overlap, and large pose offsets make automated registration unreliable. Consequently, clinical registration remains dependent on conventional geometry pipelines and manual clinician adjustment. To address these challenges, we propose APCReg, an anatomical-prior-guided coarse-to-fine framework for global registration and reliability-controlled residual correction. Specifically, multi-view anatomical coarse registration (MACR) performs ordered orthogonal projection alignment (buccal, proximal, and occlusal) to decompose the six-degree-of-freedom search before three-dimensional refinement. Overlap-aware residual registration (OARR) combines shared KPConv features, a folded arch-length cue, overlap-gated cross-attention, and Sinkhorn matching. Finally, dental-arch-structured hypothesis selection evaluates diverse poses on held-out reliable correspondences, while a ground-truth-free coarse-retention guard conditionally retains a geometrically reliable coarse pose. On 60 held-out jaw pairs, APCReg achieves a submillimeter mean Chamfer distance of 0.87 mm and a Hausdorff distance of 2.92 mm under this evaluation protocol, and ranks first across the six reported metrics among the evaluated open-source baselines.

X-ray computed tomography (CT) suffers from severe metal artifacts when high-attenuation objects such as dental fillings or orthopedic implants are present. These artifacts originate from the polychromatic nature of X-rays, where attenuation varies strongly with photon energy and material composition, breaking the monochromatic assumption used by conventional reconstruction algorithms. Recent neural rendering approaches attempt to address this mismatch through differentiable polychromatic projection models, but they still struggle with smoothness bias, loss of fine structures, and prohibitive computation when extended to large-scale cone-beam CT. We introduce a splat-based metal artifact reduction framework that incorporates a physically grounded polychromatic forward model into a continuous Gaussian representation for cone-beam CT. Each Gaussian encodes the energy-dependent attenuation of the underlying material using a compact material parameterization, which enables efficient joint optimization of geometric and material properties without relying on a metal mask. This compact attenuation formulation captures the essential variation across biological tissues and metallic implants, allowing our model to explain metal-induced nonlinearity while preserving high-frequency structure. Experiments on simulated and real cone-beam CT scans show that our method converges significantly faster and suppresses metal artifacts more effectively than existing reconstruction and neural field-based approaches.

X-ray computed tomography (CT) reconstructs volumetric representations of objects from projection images obtained by transmitting X-rays through a target. Recent splat-based tomography, which represents a volume as a continuous distribution of 3D Gaussians, has demonstrated both high reconstruction quality and fast convergence in cone-beam sparse-view CT. However, when deployed in real CT systems with limited and non-uniform view distributions, we observe distinctive streak and strip artifacts that are far more pronounced than in conventional reconstruction methods. Through detailed analysis, we show that these artifacts primarily originate from pose inaccuracies in the acquisition geometry rather than from view sparsity itself. We revisit pose sensitivity in the splatting formulation and derive a stable gradient-based framework that jointly refines geometric parameters during reconstruction. Our study not only identifies how pose perturbations propagate through the differentiable projection operator but also reveals why splat-based CT is particularly vulnerable to geometric misalignment. The resulting formulation remains lightweight and easily integrable into existing pipelines while substantially improving reconstruction fidelity under real-world sparse-view conditions.

Four-dimensional cone beam CT (4D CBCT) is important for image-guided radiation therapy of thoracic cancers, but its use is limited by long scan times, causing high patient dose and motion/sparse-sampling artifacts. We propose a deep learning method for motion-resolved 4D CBCT reconstruction from conventional free-breathing scans, without a respiratory signal or explicit projection binning. Our CNN takes free-breathing 3D CBCT projections as input and predicts a static volume at maximum inhalation plus ten displacement vector fields (DVFs) spanning a breathing cycle. The network extends U-Net: the encoder acts on filtered projection stacks, the decoder acts in the volume domain, and skip connections are replaced with non-trainable back-projection functions at multiple resolutions to transfer features between domains. The model is trained on simulated CBCT scans and evaluated on 11 unseen simulated patients and 13 clinical free-breathing scans. Two additional models (60 s and 6 s scans) were evaluated by clinical experts on three and two scans, comparing single phases of our 4D reconstruction to reference 3D SART-TV images for tumor and esophagus visibility. Experts preferred our method for tumor visibility (59% vs. 36% no preference, 5% reference) and esophagus visibility (47% vs. 42%, 11%). On simulated data, image quality matched SART-TV (mean RMSE: -1.19 HU, PSNR: +0.09 dB, SSIM: -0.009) while enabling 4D reconstruction. On clinical scans, our method showed sharper dynamic structures (e.g., diaphragm) and fewer motion streak artifacts than traditional reconstruction. This non-patient-specific CNN predicts static volumes and full 4D respiratory motion models from a single free-breathing scan, without a respiratory surrogate or projection binning, reducing motion artifacts while adding motion-modeling capability.

Medical image quality plays a critical role in diagnostic accuracy, especially in X-ray-based imaging modalities such as cone-beam computed tomography (CBCT), where image quality must be balanced against radiation dose. While expert visual evaluation remains the clinical standard for image quality evaluation, it is time-consuming, subjective and affected by inter-observer variability, emphasizing the need for reliable quantitative image quality assessment (IQA) methods. However, the development and validation of such IQA methods have been limited by the lack of publicly available CBCT datasets with expert image quality annotations. In this study, we provide the first open-access CBCT IQA dataset containing 1,764 annotated image slices acquired using systematic variations in image acquisition and reconstruction parameters. Three clinical experts graded the overall image quality and a predefined regions of interest (ROI) using a four-level scoring scheme. In addition, we benchmark 26 full reference- and no reference-based IQA measures against expert annotations and introduce an exploratory IQA measure-based ranking capable of distinguishing subtle image quality differences. This dataset introduced a standardized benchmark for future CBCT IQA research and provides a valuable resource for the development and validation of new IQA methods, enabling reproducible research and advancing CBCT IQA.

Metal artifacts generated by dental implants significantly degrade cone-beam computed tomography (CBCT) volumes, obscuring critical anatomical structures and compromising diagnostic precision. To address this, an unsupervised deep learning framework has been proposed for Metal Artifact Reduction (MAR) utilizing a Cycle-Consistent Adversarial Network (CycleGAN) optimized for high-fidelity restoration. Unlike supervised methods that rely on unattainable voxel-aligned paired datasets, the proposed approach leverages an unpaired dataset of approximately 4,000 images, curated from the public ToothFairy dataset. The architecture integrates U-Net-based generators and PatchGAN discriminators, specifically tuned to mitigate generative hallucinations and preserve morphological integrity. Quantitative benchmarking on a held-out test set demonstrates a 34.6% improvement in the Blind/Referenceless Image Spatial Quality Evaluator (BRISQUE) score, a substantial reduction in Fréchet Inception Distance (FID) from 207.03 to 157.04, and a superior Structural Similarity Index Measure (SSIM) of 0.9105. The framework achieves real-time efficiency with a 3.03 ms inference time per slice, effectively suppressing artifacts while preserving anatomical detail. Expert validation confirms high fidelity; however, to ensure reliability in extreme cases, the architecture is recommended as a clinical decision-support tool under human-in-the-loop oversight. By enhancing diagnostic clarity via a scalable software pipeline, this study provides a robust solution for high-fidelity dental implant imaging.

Computed Tomography (CT) carries significant ionizing radiation risks, driving the need for sparse-view reconstruction. Implicit scene representations (ISRs) address this by recovering continuous volumetric attenuation fields directly from sparse projections, and recent geometry-aware extensions jointly model surface geometry alongside attenuation to improve fidelity and enable clean tissue segmentation without manual thresholding. However, these methods remain limited by manually tuned attenuation bounds and rigid two-material constraints. This paper proposes $K$-NeAS, a unified and scalable architecture for automated, multi-material surface reconstruction. We replace independent material networks with a shared latent backbone and introduce a fully differentiable $K$-material sequential soft selector to model an arbitrary number of overlapping tissues. To eliminate manual tuning, we automate attenuation bounding using a Gaussian Mixture Model (GMM) and implement a scheduled auxiliary floater loss to mitigate geometric hallucinations common under extreme sparsity. Evaluated across four clinical Cone-Beam CT (CBCT) datasets, $K$-NeAS successfully scales to arbitrary material counts, achieving superior 3D volumetric fidelity at $K=3$ materials on complex multi-tissue regions such as the Abdomen ($33.28\text{ dB}$ 3D PSNR vs. $31.40\text{ dB}$ single-material NeAS baseline, a $+1.88\text{ dB}$ improvement). Furthermore, our model exhibits enhanced robustness under sparse-sampling conditions, outperforming baseline 3D PSNR by up to $1.17\text{ dB}$ under 5- and 10-view constraints.

This paper proposes a Gaussian-Based Shift-Variant filtered backprojection (FBP) neural network, which is designed for the efficient reconstruction of non-circular trajectory cone beam computed tomography. The traditional differentiable shift-variant FBP model consists of a filtering component and a backprojection process. The filtering component includes operations such as weightings, differentiations, a 2D Radon transform, and a 2D backprojection. The proposed methods build on this framework by introducing a trainable 2D Gaussian model to represent the trajectory-related part in the filtering process, achieving a substantial reduction in the number of trainable parameters. Experimental results demonstrate that the proposed model reduces the parameter count by 99%, while only sacrificing a slight amount of reconstruction quality. Furthermore, the training time for each trajectory is reduced to one-fourth of the original, significantly accelerating convergence. These enhancements demonstrate a considerable augmentation in the model's practicality and effectiveness, making it a valuable asset for real-world applications.

The differentiable shift-variant filtered backprojection (SV-FBP) framework enables data-driven estimation of redundancy weights for cone-beam CT reconstruction under general source trajectories, removing the need for analytically derived weighting schemes. In this work, we present a systematic study of the robustness and adaptability of differentiable SV-FBP under challenging acquisition settings. We show that the framework remains stable across highly irregular and discontinuous trajectories, indicating that reconstruction performance is largely insensitive to trajectory ordering or continuity. Instead, the spatial distribution of sampling points plays a more dominant role. Under sparse-view conditions, differentiable SV-FBP achieves competitive reconstruction quality while providing an order-of-magnitude reduction in computation time compared to iterative reconstruction methods at moderate sampling densities. However, we identify a clear transition regime under severe undersampling, where the absence of iterative data consistency leads to performance degradation. Furthermore, we demonstrate that the framework remains applicable to non-planar multi-isocenter geometries, such as Lissajous-saddle trajectories, without requiring architectural modifications. These findings provide new insights into the behavior and limitations of the differentiable SV-FBP model and highlight it as a flexible and efficient solution for non-standard and robotic CBCT acquisition scenarios.

Mobile C-arm cone-beam computed tomography (CBCT) has been widely used for real-time intraoperative 3D imaging. However, current practice often mechanically applies the fan-beam CT criterion of "180° plus fan angle" in pursuit of "data completeness" in reconstruction. This review argues that, under the single circular trajectory of three-dimensional cone-beam geometry, complete data are mathematically unattainable; moreover, blindly increasing sampling may exacerbate the trade-off among intraoperative image quality (Q), imaging time (T), and radiation dose (D). Against this background, this review reframes the evaluation of intraoperative CBCT around "data sufficiency" rather than "data completeness." This perspective moves beyond the excessive pursuit of absolute mathematical and analytic accuracy, and instead emphasizes task-specific minimum image-quality thresholds required for clinical decision-making. By synthesizing evidence from multiple clinical scenarios, this review suggests that approximation errors can be acceptable when clinical decision-making requirements are satisfied, thereby achieving a Q-T-D balance.

Generating a 3D dental volume from a single panoramic radiograph (PXR) could provide a low-radiation alternative to Cone-Beam Computed Tomography (CBCT), but the problem is highly underdetermined: panoramic acquisition integrates 3D attenuation along curved X-ray paths into a 2D image, leaving depth-resolved anatomy unobserved. Existing implicit and generative approaches often produce oversmoothed geometry or anatomically inconsistent hallucinations, lacking geometry-driven supervision and relying on smooth representations unable to precisely localize sharp anatomical boundaries. We propose X-Splat, the first Gaussian Splatting framework for generating CBCT-like 3D dental volumes from a single PXR. X-Splat uses the known panoramic acquisition geometry as a generation scaffold: learnable anisotropic Gaussian primitives are initialized along the X-ray paths that formed the input image and adjusted in a single feed-forward pass, constrained by Beer-Lambert reprojection and multi-view radiographic training supervision. A lightweight residual refiner adds dataset-level anatomical priors without overriding the geometry already resolved by the Gaussians. We train on synthetic PXR-CBCT pairs, enabling direct volumetric supervision without paired real scans. We further introduce segmentation-based geometry-aware metrics, providing the first evaluation of PXR-based generation over maxillofacial anatomy. X-Splat outperforms NeRF- and GAN-based baselines, recovering individual teeth, cortical boundaries, and alveolar structure, including the mandibular canal which prior methods fail to reconstruct. Code will be available at https://github.com/tomek1911/X-Splat

Temporomandibular joint osteoarthritis (TMJ OA) is a prevalent degenerative condition whose osseous changes are often subtle on cone-beam CT (CBCT), making automated detection challenging. We study how well the DINO family of self-supervised vision transformers -- DINOv1, DINOv2, DINOv2+reg, and RAD-DINO (a radiology-pretrained variant) -- transfers to CBCT, asking how much backbone adaptation is needed and of what kind. We propose a simple slice-based pipeline using Vision Transformer (ViT) backbones: axial CBCT slices are encoded per-slice by a frozen or partially adapted ViT and aggregated via attention-based multiple instance learning (MIL) for patient-level binary OA/Normal classification. Through systematic ablation across unfreezing strategies and aggregation designs on a multi-source CBCT dataset, we find that partial unfreezing of the final two transformer blocks is the decisive factor, improving AUC from 0.671 (fully frozen DINOv2) to 0.902. This outperforms DINOv1 (0.867), DINOv2+reg (0.774), and a supervised ImageNet ViT-B/16 baseline (0.843). Our results provide practical guidance for adapting DINO-family foundation models in low-data medical imaging settings, showing that adaptation strategy is a stronger driver of performance than backbone choice alone.

Cone-beam computed tomography (CBCT) frequently suffers from data truncation, which introduces severe artifacts and limits the effective field of view (FOV). Existing deep learning methods for truncated cone-beam computed tomography (CBCT) reconstruction suffer from serious limitations, including a strict reliance on supervised ground truth and a failure to account for continuous 3D spatial truncation variations. To address these challenges, we introduce a self-supervised 3D reconstruction framework based on neural scene representations. By directly mapping spatial coordinates to radiodensity under projection supervision, our approach inherently bypasses traditional filtering and backprojection operations, thereby fundamentally eliminating truncation-induced ring artifacts while enabling robust continuous 3D data extrapolation. However, coordinate networks are susceptible to an inherent spectral bias, which leads to a severe loss of clinically vital high-frequency textures. To resolve this bottleneck, we further incorporate a physics-based iterative refinement module into the neural scene representation architecture. Leveraging the artifact-free, extrapolated volume from the coordinate network as an optimal initialization, this module progressively re-extracts and injects high-frequency structural information from the original projections back into the volume. Extensive experiments on both simulated and real-world datasets demonstrate that our method successfully unifies the exceptional artifact suppression and extrapolation capabilities of neural networks with the high-fidelity detail preservation of iterative algorithms.

The goal of this work is to reduce the effect of photon noise in dental cone-beam CT reconstruction. We consider an inverse problem formulation and develop a databased prior. To this end, we simulate fan-beam acquisitions and add photon noise to the projection data. The prior is obtained by training a gradient-step denoiser using reconstructed simulated acquisitions. The trained model is integrated into a plug-and-play gradient-step algorithm to reconstruct images from simulated projections. Experiments on synthetic data demonstrate the denoising capabilities of the trained model, while qualitative evaluations on real images showcase the algorithm's performance and generalization ability.

A panoramic X-ray compresses a 3D jaw into a 2D strip; we aim to recover the missing depth cleanly and fast. Existing implicit neural representations render realistic volumes but are slow to train, sensitive to sampling and positional encodings, and costly in practice. Pure CNN baselines are efficient yet struggle with the dental arch's long-range geometry, blur fine enamel-dentin boundaries, and offer little interpretability. We present K-U-KAN, a three-stage pipeline that (i) lifts 2D features into depth-aware observables with Kolmogorov-Arnold Networks, (ii) advances these observables by a stable, phase-aware linear evolution via a Koopman token block, and (iii) places the predicted depth bins onto focal-trough rays before a lightweight 3D attention U-KAN refines the volume. This marriage of physics (Beer-Lambert image formation), geometry (horseshoe focal trough), and learned linear dynamics yields sharp anatomy, fewer artifacts, and robust behavior on native radiographic intensities with batch size one. On held-out data, K-U-KAN matches transformer/implicit baselines on signal and structure metrics, clearly improves perceptual quality, and trains in roughly half the time-making single-view PX $\to$ CBCT reconstruction more practical for clinical pipelines.

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.

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.

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.

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.

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.

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/.

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/.