X-Recon: Learning-based Patient-specific High-Resolution CT Reconstruction from Orthogonal X-Ray Images

Rapid and accurate diagnosis of pneumothorax, utilizing chest X-ray and computed tomography (CT), is crucial for assisted diagnosis. Chest X-ray is commonly used for initial localization of pneumothorax, while CT ensures accurate quantification. However, CT scans involve high radiation doses and can be costly. To achieve precise quantitative diagnosis while minimizing radiation exposure, we proposed X-Recon, a CT ultra-sparse reconstruction network based on ortho-lateral chest X-ray images. X-Recon integrates generative adversarial networks (GANs), including a generator with a multi-scale fusion rendering module and a discriminator enhanced by 3D coordinate convolutional layers, designed to facilitate CT reconstruction. To improve precision, a projective spatial transformer is utilized to incorporate multi-angle projection loss. Additionally, we proposed PTX-Seg, a zero-shot pneumothorax segmentation algorithm, combining image processing techniques with deep-learning models for the segmentation of air-accumulated regions and lung structures. Experiments on a large-scale dataset demonstrate its superiority over existing approaches. X-Recon achieved a significantly higher reconstruction resolution with a higher average spatial resolution and a lower average slice thickness. The reconstruction metrics achieved state-of-the-art performance in terms of several metrics including peak signal-to-noise ratio. The zero-shot segmentation algorithm, PTX-Seg, also demonstrated high segmentation precision for the air-accumulated region, the left lung, and the right lung. Moreover, the consistency analysis for the pneumothorax chest occupancy ratio between reconstructed CT and original CT obtained a high correlation coefficient. Code will be available at: https://github.com/wangyunpengbio/X-Recon