Computed Tomography (CT) is a vital diagnostic tool in clinical practice, yet the health risks associated with ionizing radiation cannot be overlooked. Low-dose CT (LDCT) helps mitigate radiation exposure but simultaneously leads to reduced image quality. Consequently, researchers have sought to reconstruct clear images from LDCT scans using artificial intelligence-based image enhancement techniques. However, these studies typically rely on synthetic LDCT images for algorithm training, which introduces significant domain-shift issues and limits the practical effectiveness of these algorithms in real-world scenarios. To address this challenge, we constructed a real-world paired lung dataset, referred to as Patient-uLDCT (ultra-low-dose CT), by performing multiple scans on volunteers. The radiation dose for the low-dose images in this dataset is only 2% of the normal dose, substantially lower than the conventional 25% low-dose and 10% ultra-low-dose levels. Furthermore, to resolve the anatomical misalignment between normal-dose and uLDCT images caused by respiratory motion during acquisition, we propose a novel purification strategy to construct corresponding aligned image pairs. Finally, we introduce a Frequency-domain Flow Matching model (FFM) that achieves excellent image reconstruction performance. Code is available at https://github.com/MonkeyDadLufy/flow-matching.

Low-dose computed tomography (CT) images suffer from noise and artifacts due to photon starvation and electronic noise. Recently, some works have attempted to use diffusion models to address the over-smoothness and training instability encountered by previous deep-learning-based denoising models. However, diffusion models suffer from long inference times due to the large number of sampling steps involved. Very recently, cold diffusion model generalizes classical diffusion models and has greater flexibility. Inspired by the cold diffusion, this paper presents a novel COntextual eRror-modulated gEneralized Diffusion model for low-dose CT (LDCT) denoising, termed CoreDiff. First, CoreDiff utilizes LDCT images to displace the random Gaussian noise and employs a novel mean-preserving degradation operator to mimic the physical process of CT degradation, significantly reducing sampling steps thanks to the informative LDCT images as the starting point of the sampling process. Second, to alleviate the error accumulation problem caused by the imperfect restoration operator in the sampling process, we propose a novel ContextuaL Error-modulAted Restoration Network (CLEAR-Net), which can leverage contextual information to constrain the sampling process from structural distortion and modulate time step embedding features for better alignment with the input at the next time step. Third, to rapidly generalize to a new, unseen dose level with as few resources as possible, we devise a one-shot learning framework to make CoreDiff generalize faster and better using only a single LDCT image (un)paired with NDCT. Extensive experimental results on two datasets demonstrate that our CoreDiff outperforms competing methods in denoising and generalization performance, with a clinically acceptable inference time. Source code is made available at https://github.com/qgao21/CoreDiff.

In this work, we tackle the problem of robust computed tomography (CT) reconstruction issue under a cross-domain scenario, i.e., the training CT data as the source domain and the testing CT data as the target domain are collected from different anatomical regions. Due to the mismatches of the scan region and corresponding scan protocols, there is usually a difference of noise distributions between source and target domains (a.k.a. noise distribution shifts), resulting in a catastrophic deterioration of the reconstruction performance on target domain. To render a robust cross-domain CT reconstruction performance, instead of using deterministic models (e.g., convolutional neural network), a Bayesian-endowed probabilistic framework is introduced into robust cross-domain CT reconstruction task due to its impressive robustness. Under this probabilistic framework, we propose to alleviate the noise distribution shifts between source and target domains via implicit noise modeling schemes in the latent space and image space, respectively. Specifically, a novel Bayesian noise uncertainty alignment (BNUA) method is proposed to conduct implicit noise distribution modeling and alignment in the latent space. Moreover, an adversarial learning manner is imposed to reduce the discrepancy of noise distribution between two domains in the image space via a novel residual distribution alignment (RDA). Extensive experiments on the head and abdomen scans show that our proposed method can achieve a better performance of robust cross-domain CT reconstruction than existing approaches in terms of both quantitative and qualitative results.

Deep learning has been successfully applied to low-dose CT (LDCT) image denoising for reducing potential radiation risk. However, the widely reported supervised LDCT denoising networks require a training set of paired images, which is expensive to obtain and cannot be perfectly simulated. Unsupervised learning utilizes unpaired data and is highly desirable for LDCT denoising. As an example, an artifact disentanglement network (ADN) relies on unparied images and obviates the need for supervision but the results of artifact reduction are not as good as those through supervised learning.An important observation is that there is often hidden similarity among unpaired data that can be utilized. This paper introduces a new learning mode, called quasi-supervised learning, to empower the ADN for LDCT image denoising.For every LDCT image, the best matched image is first found from an unpaired normal-dose CT (NDCT) dataset. Then, the matched pairs and the corresponding matching degree as prior information are used to construct and train our ADN-type network for LDCT denoising.The proposed method is different from (but compatible with) supervised and semi-supervised learning modes and can be easily implemented by modifying existing networks. The experimental results show that the method is competitive with state-of-the-art methods in terms of noise suppression and contextual fidelity. The code and working dataset are publicly available at https://github.com/ruanyuhui/ADN-QSDL.git.

Deep learning has achieved notable performance in the denoising task of low-quality medical images and the detection task of lesions, respectively. However, existing low-quality medical image denoising approaches are disconnected from the detection task of lesions. Intuitively, the quality of denoised images will influence the lesion detection accuracy that in turn can be used to affect the denoising performance. To this end, we propose a play-and-plug medical image denoising framework, namely Lesion-Inspired Denoising Network (LIDnet), to collaboratively improve both denoising performance and detection accuracy of denoised medical images. Specifically, we propose to insert the feedback of downstream detection task into existing denoising framework by jointly learning a multi-loss objective. Instead of using perceptual loss calculated on the entire feature map, a novel region-of-interest (ROI) perceptual loss induced by the lesion detection task is proposed to further connect these two tasks. To achieve better optimization for overall framework, we propose a customized collaborative training strategy for LIDnet. On consideration of clinical usability and imaging characteristics, three low-dose CT images datasets are used to evaluate the effectiveness of the proposed LIDnet. Experiments show that, by equipping with LIDnet, both of the denoising and lesion detection performance of baseline methods can be significantly improved.

Computed tomography (CT) is a popular medical imaging modality in clinical applications. At the same time, the x-ray radiation dose associated with CT scans raises public concerns due to its potential risks to the patients. Over the past years, major efforts have been dedicated to the development of Low-Dose CT (LDCT) methods. However, the radiation dose reduction compromises the signal-to-noise ratio (SNR), leading to strong noise and artifacts that down-grade CT image quality. In this paper, we propose a novel 3D noise reduction method, called Structure-sensitive Multi-scale Generative Adversarial Net (SMGAN), to improve the LDCT image quality. Specifically, we incorporate three-dimensional (3D) volumetric information to improve the image quality. Also, different loss functions for training denoising models are investigated. Experiments show that the proposed method can effectively preserve structural and texture information from normal-dose CT (NDCT) images, and significantly suppress noise and artifacts. Qualitative visual assessments by three experienced radiologists demonstrate that the proposed method retrieves more detailed information, and outperforms competing methods.