Conditional Diffusion Models for CT Image Synthesis from CBCT: A Systematic Review

Fuente: arXiv
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Autori principali: Altalib, Alzahra, Li, Chunhui, Perelli, Alessandro
Natura: Preprint
Pubblicazione: 2025
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author Altalib, Alzahra
Li, Chunhui
Perelli, Alessandro
author_facet Altalib, Alzahra
Li, Chunhui
Perelli, Alessandro
contents Objective: Cone-beam computed tomography (CBCT) provides a low-dose imaging alternative to conventional CT, but suffers from noise, scatter, and artifacts that degrade image quality. Synthetic CT (sCT) aims to translate CBCT to high-quality CT-like images for improved anatomical accuracy and dosimetric precision. Although deep learning approaches have shown promise, they often face limitations in generalizability and detail preservation. Conditional diffusion models (CDMs), with their iterative refinement process, offers a novel solution. This review systematically examines the use of CDMs for CBCT-to-sCT synthesis. Methods: A systematic search was conducted in Web of Science, Scopus, and Google Scholar for studies published between 2013 and 2024. Inclusion criteria targeted works employing conditional diffusion models specifically for sCT generation. Eleven relevant studies were identified and analyzed to address three questions: (1) What conditional diffusion methods are used? (2) How do they compare to conventional deep learning in accuracy? (3) What are their clinical implications? Results: CDMs incorporating anatomical priors and spatial-frequency features demonstrated improved structural preservation and noise robustness. Energy-guided and hybrid latent models enabled enhanced dosimetric accuracy and personalized image synthesis. Across studies, CDMs consistently outperformed traditional deep learning models in noise suppression and artefact reduction, especially in challenging cases like lung imaging and dual-energy CT. Conclusion: Conditional diffusion models show strong potential for generalized, accurate sCT generation from CBCT. However, clinical adoption remains limited. Future work should focus on scalability, real-time inference, and integration with multi-modal imaging to enhance clinical relevance.
format Preprint
id arxiv_https___arxiv_org_abs_2509_17790
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Conditional Diffusion Models for CT Image Synthesis from CBCT: A Systematic Review
Altalib, Alzahra
Li, Chunhui
Perelli, Alessandro
Medical Physics
Image and Video Processing
68T07
J.2
Objective: Cone-beam computed tomography (CBCT) provides a low-dose imaging alternative to conventional CT, but suffers from noise, scatter, and artifacts that degrade image quality. Synthetic CT (sCT) aims to translate CBCT to high-quality CT-like images for improved anatomical accuracy and dosimetric precision. Although deep learning approaches have shown promise, they often face limitations in generalizability and detail preservation. Conditional diffusion models (CDMs), with their iterative refinement process, offers a novel solution. This review systematically examines the use of CDMs for CBCT-to-sCT synthesis. Methods: A systematic search was conducted in Web of Science, Scopus, and Google Scholar for studies published between 2013 and 2024. Inclusion criteria targeted works employing conditional diffusion models specifically for sCT generation. Eleven relevant studies were identified and analyzed to address three questions: (1) What conditional diffusion methods are used? (2) How do they compare to conventional deep learning in accuracy? (3) What are their clinical implications? Results: CDMs incorporating anatomical priors and spatial-frequency features demonstrated improved structural preservation and noise robustness. Energy-guided and hybrid latent models enabled enhanced dosimetric accuracy and personalized image synthesis. Across studies, CDMs consistently outperformed traditional deep learning models in noise suppression and artefact reduction, especially in challenging cases like lung imaging and dual-energy CT. Conclusion: Conditional diffusion models show strong potential for generalized, accurate sCT generation from CBCT. However, clinical adoption remains limited. Future work should focus on scalability, real-time inference, and integration with multi-modal imaging to enhance clinical relevance.
title Conditional Diffusion Models for CT Image Synthesis from CBCT: A Systematic Review
topic Medical Physics
Image and Video Processing
68T07
J.2
url https://arxiv.org/abs/2509.17790