GLFC: Unified Global-Local Feature and Contrast Learning with Mamba-Enhanced UNet for Synthetic CT Generation from CBCT

Generating synthetic Computed Tomography (CT) images from Cone Beam Computed Tomography (CBCT) is desirable for improving the image quality of CBCT. Existing synthetic CT (sCT) generation methods using Convolutional Neural Networks (CNN) and Transformers often face difficulties in effectively capturing both global and local features and contrasts for high-quality sCT generation. In this work, we propose a Global-Local Feature and Contrast learning (GLFC) framework for sCT generation. First, a Mamba-Enhanced UNet (MEUNet) is introduced by integrating Mamba blocks into the skip connections of a high-resolution UNet for effective global and local feature learning. Second, we propose a Multiple Contrast Loss (MCL) that calculates synthetic loss at different intensity windows to improve quality for both soft tissues and bone regions. Experiments on the SynthRAD2023 dataset demonstrate that GLFC improved the SSIM of sCT from 77.91% to 91.50% compared with the original CBCT, and significantly outperformed several existing methods for sCT generation. The code is available at https://github.com/intelland/GLFC

GaraMoSt: Parallel Multi-Granularity Motion and Structural Modeling for Efficient Multi-Frame Interpolation in DSA Images

The rapid and accurate direct multi-frame interpolation method for Digital Subtraction Angiography (DSA) images is crucial for reducing radiation and providing real-time assistance to physicians for precise diagnostics and treatment. DSA images contain complex vascular structures and various motions. Applying natural scene Video Frame Interpolation (VFI) methods results in motion artifacts, structural dissipation, and blurriness. Recently, MoSt-DSA has specifically addressed these issues for the first time and achieved SOTA results. However, MoSt-DSA's focus on real-time performance leads to insufficient suppression of high-frequency noise and incomplete filtering of low-frequency noise in the generated images. To address these issues within the same computational time scale, we propose GaraMoSt. Specifically, we optimize the network pipeline with a parallel design and propose a module named MG-MSFE. MG-MSFE extracts frame-relative motion and structural features at various granularities in a fully convolutional parallel manner and supports independent, flexible adjustment of context-aware granularity at different scales, thus enhancing computational efficiency and accuracy. Extensive experiments demonstrate that GaraMoSt achieves the SOTA performance in accuracy, robustness, visual effects, and noise suppression, comprehensively surpassing MoSt-DSA and other natural scene VFI methods. The code and models are available at https://github.com/ZyoungXu/GaraMoSt.

4DRGS: 4D Radiative Gaussian Splatting for Efficient 3D Vessel Reconstruction from Sparse-View Dynamic DSA Images

Reconstructing 3D vessel structures from sparse-view dynamic digital subtraction angiography (DSA) images enables accurate medical assessment while reducing radiation exposure. Existing methods often produce suboptimal results or require excessive computation time. In this work, we propose 4D radiative Gaussian splatting (4DRGS) to achieve high-quality reconstruction efficiently. In detail, we represent the vessels with 4D radiative Gaussian kernels. Each kernel has time-invariant geometry parameters, including position, rotation, and scale, to model static vessel structures. The time-dependent central attenuation of each kernel is predicted from a compact neural network to capture the temporal varying response of contrast agent flow. We splat these Gaussian kernels to synthesize DSA images via X-ray rasterization and optimize the model with real captured ones. The final 3D vessel volume is voxelized from the well-trained kernels. Moreover, we introduce accumulated attenuation pruning and bounded scaling activation to improve reconstruction quality. Extensive experiments on real-world patient data demonstrate that 4DRGS achieves impressive results in 5 minutes training, which is 32x faster than the state-of-the-art method. This underscores the potential of 4DRGS for real-world clinics.

MoSt-DSA: Modeling Motion and Structural Interactions for Direct Multi-Frame Interpolation in DSA Images

Artificial intelligence has become a crucial tool for medical image analysis. As an advanced cerebral angiography technique, Digital Subtraction Angiography (DSA) poses a challenge where the radiation dose to humans is proportional to the image count. By reducing images and using AI interpolation instead, the radiation can be cut significantly. However, DSA images present more complex motion and structural features than natural scenes, making interpolation more challenging. We propose MoSt-DSA, the first work that uses deep learning for DSA frame interpolation. Unlike natural scene Video Frame Interpolation (VFI) methods that extract unclear or coarse-grained features, we devise a general module that models motion and structural context interactions between frames in an efficient full convolution manner by adjusting optimal context range and transforming contexts into linear functions. Benefiting from this, MoSt-DSA is also the first method that directly achieves any number of interpolations at any time steps with just one forward pass during both training and testing. We conduct extensive comparisons with 7 representative VFI models for interpolating 1 to 3 frames, MoSt-DSA demonstrates robust results across 470 DSA image sequences (each typically 152 images), with average SSIM over 0.93, average PSNR over 38 (standard deviations of less than 0.030 and 3.6, respectively), comprehensively achieving state-of-the-art performance in accuracy, speed, visual effect, and memory usage. Our code is available at https://github.com/ZyoungXu/MoSt-DSA.

3D Vessel Reconstruction from Sparse-View Dynamic DSA Images via Vessel Probability Guided Attenuation Learning

Digital Subtraction Angiography (DSA) is one of the gold standards in vascular disease diagnosing. With the help of contrast agent, time-resolved 2D DSA images deliver comprehensive insights into blood flow information and can be utilized to reconstruct 3D vessel structures. Current commercial DSA systems typically demand hundreds of scanning views to perform reconstruction, resulting in substantial radiation exposure. However, sparse-view DSA reconstruction, aimed at reducing radiation dosage, is still underexplored in the research community. The dynamic blood flow and insufficient input of sparse-view DSA images present significant challenges to the 3D vessel reconstruction task. In this study, we propose to use a time-agnostic vessel probability field to solve this problem effectively. Our approach, termed as vessel probability guided attenuation learning, represents the DSA imaging as a complementary weighted combination of static and dynamic attenuation fields, with the weights derived from the vessel probability field. Functioning as a dynamic mask, vessel probability provides proper gradients for both static and dynamic fields adaptive to different scene types. This mechanism facilitates a self-supervised decomposition between static backgrounds and dynamic contrast agent flow, and significantly improves the reconstruction quality. Our model is trained by minimizing the disparity between synthesized projections and real captured DSA images. We further employ two training strategies to improve our reconstruction quality: (1) coarse-to-fine progressive training to achieve better geometry and (2) temporal perturbed rendering loss to enforce temporal consistency. Experimental results have demonstrated superior quality on both 3D vessel reconstruction and 2D view synthesis.

EVA-X: A Foundation Model for General Chest X-ray Analysis with Self-supervised Learning

The diagnosis and treatment of chest diseases play a crucial role in maintaining human health. X-ray examination has become the most common clinical examination means due to its efficiency and cost-effectiveness. Artificial intelligence analysis methods for chest X-ray images are limited by insufficient annotation data and varying levels of annotation, resulting in weak generalization ability and difficulty in clinical dissemination. Here we present EVA-X, an innovative foundational model based on X-ray images with broad applicability to various chest disease detection tasks. EVA-X is the first X-ray image based self-supervised learning method capable of capturing both semantic and geometric information from unlabeled images for universal X-ray image representation. Through extensive experimentation, EVA-X has demonstrated exceptional performance in chest disease analysis and localization, becoming the first model capable of spanning over 20 different chest diseases and achieving leading results in over 11 different detection tasks in the medical field. Additionally, EVA-X significantly reduces the burden of data annotation in the medical AI field, showcasing strong potential in the domain of few-shot learning. The emergence of EVA-X will greatly propel the development and application of foundational medical models, bringing about revolutionary changes in future medical research and clinical practice. Our codes and models are available at: https://github.com/hustvl/EVA-X.

TOGS: Gaussian Splatting with Temporal Opacity Offset for Real-Time 4D DSA Rendering

Four-dimensional Digital Subtraction Angiography (4D DSA) is a medical imaging technique that provides a series of 2D images captured at different stages and angles during the process of contrast agent filling blood vessels. It plays a significant role in the diagnosis of cerebrovascular diseases. Improving the rendering quality and speed under sparse sampling is important for observing the status and location of lesions. The current methods exhibit inadequate rendering quality in sparse views and suffer from slow rendering speed. To overcome these limitations, we propose TOGS, a Gaussian splatting method with opacity offset over time, which can effectively improve the rendering quality and speed of 4D DSA. We introduce an opacity offset table for each Gaussian to model the temporal variations in the radiance of the contrast agent. By interpolating the opacity offset table, the opacity variation of the Gaussian at different time points can be determined. This enables us to render the 2D DSA image at that specific moment. Additionally, we introduced a Smooth loss term in the loss function to mitigate overfitting issues that may arise in the model when dealing with sparse view scenarios. During the training phase, we randomly prune Gaussians, thereby reducing the storage overhead of the model. The experimental results demonstrate that compared to previous methods, this model achieves state-of-the-art reconstruction quality under the same number of training views. Additionally, it enables real-time rendering while maintaining low storage overhead. The code will be publicly available.

TiAVox: Time-aware Attenuation Voxels for Sparse-view 4D DSA Reconstruction

Four-dimensional Digital Subtraction Angiography (4D DSA) plays a critical role in the diagnosis of many medical diseases, such as Arteriovenous Malformations (AVM) and Arteriovenous Fistulas (AVF). Despite its significant application value, the reconstruction of 4D DSA demands numerous views to effectively model the intricate vessels and radiocontrast flow, thereby implying a significant radiation dose. To address this high radiation issue, we propose a Time-aware Attenuation Voxel (TiAVox) approach for sparse-view 4D DSA reconstruction, which paves the way for high-quality 4D imaging. Additionally, 2D and 3D DSA imaging results can be generated from the reconstructed 4D DSA images. TiAVox introduces 4D attenuation voxel grids, which reflect attenuation properties from both spatial and temporal dimensions. It is optimized by minimizing discrepancies between the rendered images and sparse 2D DSA images. Without any neural network involved, TiAVox enjoys specific physical interpretability. The parameters of each learnable voxel represent the attenuation coefficients. We validated the TiAVox approach on both clinical and simulated datasets, achieving a 31.23 Peak Signal-to-Noise Ratio (PSNR) for novel view synthesis using only 30 views on the clinically sourced dataset, whereas traditional Feldkamp-Davis-Kress methods required 133 views. Similarly, with merely 10 views from the synthetic dataset, TiAVox yielded a PSNR of 34.32 for novel view synthesis and 41.40 for 3D reconstruction. We also executed ablation studies to corroborate the essential components of TiAVox. The code will be publically available.