Slice-Consistent 3D Volumetric Brain CT-to-MRI Translation with 2D Brownian Bridge Diffusion Model

In neuroimaging, generally, brain CT is more cost-effective and accessible imaging option compared to MRI. Nevertheless, CT exhibits inferior soft-tissue contrast and higher noise levels, yielding less precise structural clarity. In response, leveraging more readily available CT to construct its counterpart MRI, namely, medical image-to-image translation (I2I), serves as a promising solution. Particularly, while diffusion models (DMs) have recently risen as a powerhouse, they also come with a few practical caveats for medical I2I. First, DMs' inherent stochasticity from random noise sampling cannot guarantee consistent MRI generation that faithfully reflects its CT. Second, for 3D volumetric images which are prevalent in medical imaging, naively using 2D DMs leads to slice inconsistency, e.g., abnormal structural and brightness changes. While 3D DMs do exist, significant training costs and data dependency bring hesitation. As a solution, we propose novel style key conditioning (SKC) and inter-slice trajectory alignment (ISTA) sampling for the 2D Brownian bridge diffusion model. Specifically, SKC ensures a consistent imaging style (e.g., contrast) across slices, and ISTA interconnects the independent sampling of each slice, deterministically achieving style and shape consistent 3D CT-to-MRI translation. To the best of our knowledge, this study is the first to achieve high-quality 3D medical I2I based only on a 2D DM with no extra architectural models. Our experimental results show superior 3D medical I2I than existing 2D and 3D baselines, using in-house CT-MRI dataset and BraTS2023 FLAIR-T1 MRI dataset.