Reconstruct Spine CT from Biplanar X-Rays via Diffusion Learning

Intraoperative CT imaging serves as a crucial resource for surgical guidance; however, it may not always be readily accessible or practical to implement. In scenarios where CT imaging is not an option, reconstructing CT scans from X-rays can offer a viable alternative. In this paper, we introduce an innovative method for 3D CT reconstruction utilizing biplanar X-rays. Distinct from previous research that relies on conventional image generation techniques, our approach leverages a conditional diffusion process to tackle the task of reconstruction. More precisely, we employ a diffusion-based probabilistic model trained to produce 3D CT images based on orthogonal biplanar X-rays. To improve the structural integrity of the reconstructed images, we incorporate a novel projection loss function. Experimental results validate that our proposed method surpasses existing state-of-the-art benchmarks in both visual image quality and multiple evaluative metrics. Specifically, our technique achieves a higher Structural Similarity Index (SSIM) of 0.83, a relative increase of 10\%, and a lower Fr\'echet Inception Distance (FID) of 83.43, which represents a relative decrease of 25\%.

DiffuX2CT: Diffusion Learning to Reconstruct CT Images from Biplanar X-Rays

Computed tomography (CT) is widely utilized in clinical settings because it delivers detailed 3D images of the human body. However, performing CT scans is not always feasible due to radiation exposure and limitations in certain surgical environments. As an alternative, reconstructing CT images from ultra-sparse X-rays offers a valuable solution and has gained significant interest in scientific research and medical applications. However, it presents great challenges as it is inherently an ill-posed problem, often compromised by artifacts resulting from overlapping structures in X-ray images. In this paper, we propose DiffuX2CT, which models CT reconstruction from orthogonal biplanar X-rays as a conditional diffusion process. DiffuX2CT is established with a 3D global coherence denoising model with a new, implicit conditioning mechanism. We realize the conditioning mechanism by a newly designed tri-plane decoupling generator and an implicit neural decoder. By doing so, DiffuX2CT achieves structure-controllable reconstruction, which enables 3D structural information to be recovered from 2D X-rays, therefore producing faithful textures in CT images. As an extra contribution, we collect a real-world lumbar CT dataset, called LumbarV, as a new benchmark to verify the clinical significance and performance of CT reconstruction from X-rays. Extensive experiments on this dataset and three more publicly available datasets demonstrate the effectiveness of our proposal.