用真实X光片重建高精度3D CT,提升诊断可及性。
Conditional Diffusion for 3D CT Volume Reconstruction from 2D X-rays
- 分阶段扩散模型,先粗后细重建3D结构并增强细节
- 结合双平面X光,解决2D转3D的深度模糊问题
- 在多个数据集上显著优于现有方法,适合临床应用
计算机断层扫描(CT)提供丰富的3D解剖信息,但受限于高辐射剂量、高昂成本和有限可用性。标准胸部X光片成本低且普及率高,但仅提供二维投影,病理信息有限。从2D X光片重建3D CT体积可显著提升诊断可及性,但现有方法多依赖合成X光投影,限制了临床泛化能力。我们提出AXON,一种基于多阶段扩散的框架,直接从真实X光片重建3D CT体积,显著提升保真度。AXON采用粗到精范式:布朗桥扩散模型首先捕捉全局解剖结构,控制网引导的细化阶段再增强局部强度细节与解剖真实性。为缓解2D到3D重建固有的深度模糊,AXON引入双平面X光视角,实现更精准的空间推理与结构恢复。专用超分辨率模块进一步提升生成体积的空间分辨率。在公开和外部数据集上的实验表明,AXON持续超越当前最优方法,并在不同临床分布中具有良好泛化性。在最高分辨率双平面设置下,相比最强基线,PSNR提升11.9%,SSIM提升11.0%。在$128^3$单平面设置下,于LIDC-IDRI数据集上保持7.8%的PSNR优势,外部临床数据集上分别达8.0%的PSNR提升和16.9%的SSIM提升。代码已开源。
原文摘要 · Abstract (English)
Computed tomography (CT) provides rich 3D anatomical detail but is often constrained by high radiation exposure, substantial costs, and limited availability. Standard chest X-rays are cost-effective and widely accessible, but provide only 2D projections with limited pathological information. Reconstructing 3D CT volumes from 2D X-rays could markedly increase diagnostic accessibility, yet existing methods rely predominantly on synthetic X-ray projections, limiting clinical generalization. We propose AXON, a multi-stage diffusion-based framework that reconstructs 3D CT volumes directly from real X-rays with substantially improved fidelity over existing approaches. AXON follows a coarse-to-fine paradigm: a Brownian Bridge diffusion model first captures global anatomical structure, and a ControlNet-guided refinement stage then enhances local intensity detail and anatomical realism. To alleviate the depth ambiguity inherent in 2D-to-3D reconstruction, AXON incorporates bi-planar X-ray views, enabling more accurate spatial reasoning and structural recovery. A dedicated super-resolution module further increases the spatial resolution of the generated volumes. Experiments on public and external datasets show that AXON consistently surpasses state-of-the-art approaches while generalizing across diverse clinical distributions. At our highest-resolution bi-planar setting, AXON achieves an 11.9% improvement in PSNR and an 11.0% increase in SSIM over the strongest baseline evaluated at that resolution. In the $128^3$ single-planar setting, it maintains a lead of 7.8% in PSNR on LIDC-IDRI, with larger margins on the external clinical dataset of 8.0% in PSNR and 16.9% in SSIM. Our code is available at https://github.com/ai-med/AXON/.
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