arXiv subjects

Alessandro Perelli

Publications and source records attributed to Alessandro Perelli.

At least 19 recordsLinked to original sources

arXiv2026

Toward CT-Equivalent Image Quality in Low-Dose Radiotherapy Planning: Conditional Diffusion-Based CBCT-to-CT Synthesis and the Impact of CBCT Input Representation

During standard radiotherapy planning, repeated CT acquisitions are often required for patient registration, verification, and adaptive planning, resulting in increased cumulative X-ray dose. To mitigate this, low-dose cone-beam CT (CBCT) is routinely acquired during treatment delivery. However, CBCT image quality remains insufficient for accurate dose calculation and adaptive radiotherapy planning due to increased scatter, noise, beam hardening, and reconstruction related artifacts. This study develops a supervised deep learning based CBCT to CT synthesis framework using a conditional denoising diffusion probabilistic model (DDPM), where the generation of a CT-based planning for accurate positioning and dose calculation is obtained using generative models with low dose CBCT imaging. Beyond demonstrating CBCT to CT synthesis, the primary objective is to investigate how the representation of CBCT input data, either standard clinical DICOM CBCT images or filtered back-projection (FDK) reconstructions from raw projection data, affects the performance of diffusion based CT synthesis. The overarching aim is to assess whether physics aware CBCT representations better support CT-equivalent image quality while maintaining reduced imaging dose in radiotherapy workflows.

physics.med-ph↗

arXiv2026

Dual-Domain Equivariant Generative Adversarial Network for Multimodal CT-PET Synthesis

We present a Dual-Domain Equivariant Generative Adversarial Network (DDE-GAN) for multimodal CT-PET image synthesis. Traditional GAN-based approaches often operate solely in the spatial domain and ignore geometric consistency, resulting in limited structural fidelity. DDE-GAN addresses these challenges by jointly learning from both spatial and frequency (Fourier) domains, capturing complementary anatomical and spectral information. Furthermore, rotational equivariance embedded in the physics of the CT and PET measurements are integrated into the loss of both the generator and discriminator to ensure consistent responses under rotations, improving anatomical accuracy. A hierarchical dual-domain training strategy enforces intra- and inter-domain consistency through multi-stage loss functions. Evaluated on the HECKTOR 2022 CT-PET dataset, DDE-GAN achieves superior synthesis quality over baseline models for CT-PET image synthesis. The results demonstrate that combining dual-domain learning with geometric equivariance substantially enhances multimodal image synthesis accuracy and robustness, enabling practical applications in PET completion and data augmentation.

cs.CV↗

arXiv2026

EPC-3D-Diff: Equivariant Physics Consistent Conditional 3D Latent Diffusion for CBCT to CT Synthesis

Cone-beam CT (CBCT) is routinely acquired during radiotherapy for patient setup, but its quantitative reliability is degraded by scatter, noise, and reconstruction artifacts, limiting Hounsfield Unit (HU) accuracy. We propose EPC-3D-Diff, a novel conditional 3D latent diffusion framework for volumetric CBCT to CT synthesis that introduces a projection domain equivariance loss derived from acquisition physics. Unlike common image domain equivariance, we exploit the fact that an in plane rotation of the volume corresponds to an angular shift in its projections. During training, we enforce this relationship by forward projecting rotated synthesized CT volumes and matching them to appropriately angle shifted projections of the paired target CT, yielding a physics consistent equivariance constraint integrated into the diffusion objective. To capture full 3D context efficiently, conditional diffusion is performed in a compact latent space learnt by a lightweight 3D autoencoder, preserving axial depth while downsampling in plane resolution for stable training. We validate on a paired head CBCT/CT phantom dataset, including repeat scans, and paired clinical data using patient wise splits, and perform single and mixed domain training, ablations, and comparisons with diffusion and CycleGAN. EPC-3D-Diff generalizes well and achieved substantial improvements, +7.4 dB (phantom) and +1.8 dB (clinical data) in PSNR compared to state of the art methods, alongside improved SSIM and HU accuracy, within tissue boundaries. Overall, EPC-3D-Diff improves robustness and physics consistency, supporting HU aware synthesis for downstream radiotherapy workflows. The open source code for EPC-3D-Diff is available at https://github.com/ALZAHRAALTALIB/EPC-3D-Diff.

cs.CV↗

arXiv2025

FOD-Diff: 3D Multi-Channel Patch Diffusion Model for Fiber Orientation Distribution

Diffusion MRI (dMRI) is a critical non-invasive technique to estimate fiber orientation distribution (FOD) for characterizing white matter integrity. Estimating FOD from single-shell low angular resolution dMRI (LAR-FOD) is limited by accuracy, whereas estimating FOD from multi-shell high angular resolution dMRI (HAR-FOD) requires a long scanning time, which limits its applicability. Diffusion models have shown promise in estimating HAR-FOD based on LAR-FOD. However, using diffusion models to efficiently generate HAR-FOD is challenging due to the large number of spherical harmonic (SH) coefficients in FOD. Here, we propose a 3D multi-channel patch diffusion model to predict HAR-FOD from LAR-FOD. We design the FOD-patch adapter by introducing the prior brain anatomy for more efficient patch-based learning. Furthermore, we introduce a voxel-level conditional coordinating module to enhance the global understanding of the model. We design the SH attention module to effectively learn the complex correlations of the SH coefficients. Our experimental results show that our method achieves the best performance in HAR-FOD prediction and outperforms other state-of-the-art methods.

cs.CV↗

arXiv2025

Equivariant Conditional Diffusion Model for Head and Neck CT Image Synthesis from CBCT

Background: Cone-beam computed tomography CBCT is a commonly used modality for image guided radiotherapy. It offers real time anatomical visualization with low acquisition cost and dose. Nevertheless, photon scattering and beam hindrance lead CBCT images to suffer from several artifacts. These involve inaccurate Hounsfield Unit HU values, which render a lower reliability towards the dose calculations and adaptive planning. Purpose: Computed tomography CT, on the contrary, offers better image quality and accurate HU calibration, yet is typically acquired using offline mode and fails to capture the intra-treatment anatomical changes. This renders a need for developing an accurate CBCT to CT synthesis to mitigate the gap in imaging quality in the adaptive radiotherapy workflow. Methods: We propose a novel diffusion based conditional generative model, coined EqDiff-CT, to synthesize high quality CT images from CBCT. EqDiff-CT employs a denoising diffusion probabilistic model DDPM to iteratively inject noise and learn latent representations that enable reconstruction of anatomically consistent CT images. A group equivariant conditional U-Net backbone, implemented with e2cnn steerable layers, enforces rotational equivariance cyclic C4 symmetry, helping preserve fine structural details while minimizing noise and artifacts. Results: The system was trained and validated on the SynthRAD2025 dataset, comprising CBCT-CT scans across multiple head and neck anatomical sites, and we compared it with advanced methods such as CycleGAN and DDPM. EqDiff-CT provided substantial gains in structural fidelity, HU accuracy and quantitative metrics. Visual findings confirm the improved recovery, sharper soft tissue boundaries, and realistic bone reconstructions. Conclusions: The findings suggest that the diffusion model has offered a robust and generalizable framework for CBCT improvements.

physics.med-ph↗

arXiv2025

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

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.

physics.med-ph↗

arXiv2025

Direct Dual-Energy CT Material Decomposition using Model-based Denoising Diffusion Model

Dual-energy X-ray Computed Tomography (DECT) constitutes an advanced technology which enables automatic decomposition of materials in clinical images without manual segmentation using the dependency of the X-ray linear attenuation with energy. However, most methods perform material decomposition in the image domain as a post-processing step after reconstruction but this procedure does not account for the beam-hardening effect and it results in sub-optimal results. In this work, we propose a deep learning procedure called Dual-Energy Decomposition Model-based Diffusion (DEcomp-MoD) for quantitative material decomposition which directly converts the DECT projection data into material images. The algorithm is based on incorporating the knowledge of the spectral DECT model into the deep learning training loss and combining a score-based denoising diffusion learned prior in the material image domain. Importantly the inference optimization loss takes as inputs directly the sinogram and converts to material images through a model-based conditional diffusion model which guarantees consistency of the results. We evaluate the performance with both quantitative and qualitative estimation of the proposed DEcomp-MoD method on synthetic DECT sinograms from the low-dose AAPM dataset. Finally, we show that DEcomp-MoD outperform state-of-the-art unsupervised score-based model and supervised deep learning networks, with the potential to be deployed for clinical diagnosis.

eess.IV↗

arXiv2025

Material Decomposition in Photon-Counting Computed Tomography with Diffusion Models: Comparative Study and Hybridization with Variational Regularizers

Photon-counting computed tomography (PCCT) has emerged as a promising imaging technique, enabling spectral imaging and material decomposition (MD). However, images typically suffer from a low signal-to-noise ratio (SNR) due to constraints such as low photon counts and sparse-view settings which provoke artifacts. To prevent this, variational methods minimize a data-fit function coupled with handcrafted regularizers that mimic a prior by enforcing image properties such as gradient sparsity. In the last few years, diffusion models (DMs) have become predominant in the field of generative models and have been used as a learned prior for image reconstruction. This work investigates the use of DMs as regularizers for MD tasks in PCCT, specifically using diffusion posterior sampling (DPS) guidance. Three DPS-based approaches -- image-domain two-step DPS (im-TDPS), projection-domain two-step DPS (proj-TDPS), and one-step DPS (ODPS) -- are evaluated. The first two methods achieve MD in two steps by performing reconstruction and MD separately. The last method, ODPS, samples the material images directly from the measurement data. The results indicate that ODPS achieves superior performance compared to im-TDPS and proj-TDPS, providing sharper, noise-free and crosstalk-free images. Furthermore, we introduce a novel hybrid method for scenarios involving materials absent from the training dataset which combines DM priors with standard variational handcrafted regularizers for the materials unknown to the DM. This hybrid method demonstrates improved MD quality compared to a standard variational method and does not require additional training of the DM neural network (NN).

physics.med-ph↗

arXiv2025

Synthetic CT image generation from CBCT: A Systematic Review

The generation of synthetic CT (sCT) images from cone-beam CT (CBCT) data using deep learning methodologies represents a significant advancement in radiation oncology. This systematic review, following PRISMA guidelines and using the PICO model, comprehensively evaluates the literature from 2014 to 2024 on the generation of sCT images for radiation therapy planning in oncology. A total of 35 relevant studies were identified and analyzed, revealing the prevalence of deep learning approaches in the generation of sCT. This review comprehensively covers synthetic CT generation based on CBCT and proton-based studies. Some of the commonly employed architectures explored are convolutional neural networks (CNNs), generative adversarial networks (GANs), transformers, and diffusion models. Evaluation metrics including mean absolute error (MAE), root mean square error (RMSE), peak signal-to-noise ratio (PSNR) and structural similarity index (SSIM) consistently demonstrate the comparability of sCT images with gold-standard planning CTs (pCT), indicating their potential to improve treatment precision and patient outcomes. Challenges such as field-of-view (FOV) disparities and integration into clinical workflows are discussed, along with recommendations for future research and standardization efforts. In general, the findings underscore the promising role of sCT-based approaches in personalized treatment planning and adaptive radiation therapy, with potential implications for improved oncology treatment delivery and patient care.

eess.IV↗

arXiv2024

Stochastic Multiresolution Image Sketching for Inverse Imaging Problems

A challenge in high-dimensional inverse problems is developing iterative solvers to find the accurate solution of regularized optimization problems with low computational cost. An important example is computed tomography (CT) where both image and data sizes are large and therefore the forward model is costly to evaluate. Since several years algorithms from stochastic optimization are used for tomographic image reconstruction with great success by subsampling the data. Here we propose a novel way how stochastic optimization can be used to speed up image reconstruction by means of image domain sketching such that at each iteration an image of different resolution is being used. Hence, we coin this algorithm ImaSk. By considering an associated saddle-point problem, we can formulate ImaSk as a gradient-based algorithm where the gradient is approximated in the same spirit as the stochastic average gradient am\'elior\'e (SAGA) and uses at each iteration one of these multiresolution operators at random. We prove that ImaSk is linearly converging for linear forward models with strongly convex regularization functions. Numerical simulations on CT show that ImaSk is effective and increasing the number of multiresolution operators reduces the computational time to reach the modeled solution.

math.NA↗

arXiv2024

Multimodal 3D Brain Tumor Segmentation with Adversarial Training and Conditional Random Field

Accurate brain tumor segmentation remains a challenging task due to structural complexity and great individual differences of gliomas. Leveraging the pre-eminent detail resilience of CRF and spatial feature extraction capacity of V-net, we propose a multimodal 3D Volume Generative Adversarial Network (3D-vGAN) for precise segmentation. The model utilizes Pseudo-3D for V-net improvement, adds conditional random field after generator and use original image as supplemental guidance. Results, using the BraTS-2018 dataset, show that 3D-vGAN outperforms classical segmentation models, including U-net, Gan, FCN and 3D V-net, reaching specificity over 99.8%.

eess.IV↗

arXiv2024

Phy-Diff: Physics-guided Hourglass Diffusion Model for Diffusion MRI Synthesis

Diffusion MRI (dMRI) is an important neuroimaging technique with high acquisition costs. Deep learning approaches have been used to enhance dMRI and predict diffusion biomarkers through undersampled dMRI. To generate more comprehensive raw dMRI, generative adversarial network based methods are proposed to include b-values and b-vectors as conditions, but they are limited by unstable training and less desirable diversity. The emerging diffusion model (DM) promises to improve generative performance. However, it remains challenging to include essential information in conditioning DM for more relevant generation, i.e., the physical principles of dMRI and white matter tract structures. In this study, we propose a physics-guided diffusion model to generate high-quality dMRI. Our model introduces the physical principles of dMRI in the noise evolution in the diffusion process and introduce a query-based conditional mapping within the difussion model. In addition, to enhance the anatomical fine detials of the generation, we introduce the XTRACT atlas as prior of white matter tracts by adopting an adapter technique. Our experiment results show that our method outperforms other state-of-the-art methods and has the potential to advance dMRI enhancement.

eess.IV↗

arXiv2024

End-to-End Model-based Deep Learning for Dual-Energy Computed Tomography Material Decomposition

Dual energy X-ray Computed Tomography (DECT) enables to automatically decompose materials in clinical images without the manual segmentation using the dependency of the X-ray linear attenuation with energy. In this work we propose a deep learning procedure called End-to-End Material Decomposition (E2E-DEcomp) for quantitative material decomposition which directly convert the CT projection data into material images. The algorithm is based on incorporating the knowledge of the spectral model DECT system into the deep learning training loss and combining a data-learned prior in the material image domain. Furthermore, the training does not require any energy-based images in the dataset but rather only sinogram and material images. We show the effectiveness of the proposed direct E2E-DEcomp method on the AAPM spectral CT dataset (Sidky and Pan, 2023) compared with state of the art supervised deep learning networks.

eess.IV↗

arXiv2023

Rotational Augmented Noise2Inverse for Low-dose Computed Tomography Reconstruction

In this work, we present a novel self-supervised method for Low Dose Computed Tomography (LDCT) reconstruction. Reducing the radiation dose to patients during a CT scan is a crucial challenge since the quality of the reconstruction highly degrades because of low photons or limited measurements. Supervised deep learning methods have shown the ability to remove noise in images but require accurate ground truth which can be obtained only by performing additional high-radiation CT scans. Therefore, we propose a novel self-supervised framework for LDCT, in which ground truth is not required for training the convolutional neural network (CNN). Based on the Noise2Inverse (N2I) method, we enforce in the training loss the equivariant property of rotation transformation, which is induced by the CT imaging system, to improve the quality of the CT image in a lower dose. Numerical and experimental results show that the reconstruction accuracy of N2I with sparse views is degrading while the proposed rotational augmented Noise2Inverse (RAN2I) method keeps better image quality over a different range of sampling angles. Finally, the quantitative results demonstrate that RAN2I achieves higher image quality compared to N2I, and experimental results of RAN2I on real projection data show comparable performance to supervised learning.

eess.IV↗

arXiv2023

Uconnect: Synergistic Spectral CT Reconstruction with U-Nets Connecting the Energy bins

Spectral computed tomography (CT) offers the possibility to reconstruct attenuation images at different energy levels, which can be then used for material decomposition. However, traditional methods reconstruct each energy bin individually and are vulnerable to noise. In this paper, we propose a novel synergistic method for spectral CT reconstruction, namely Uconnect. It utilizes trained convolutional neural networks (CNNs) to connect the energy bins to a latent image so that the full binned data is used synergistically. We experiment on two types of low-dose data: simulated and real patient data. Qualitative and quantitative analysis show that our proposed Uconnect outperforms state-of-art model-based iterative reconstruction (MBIR) techniques as well as CNN-based denoising.

physics.med-ph↗

arXiv2023

Systematic Review on Learning-based Spectral CT

Spectral computed tomography (CT) has recently emerged as an advanced version of medical CT and significantly improves conventional (single-energy) CT. Spectral CT has two main forms: dual-energy computed tomography (DECT) and photon-counting computed tomography (PCCT), which offer image improvement, material decomposition, and feature quantification relative to conventional CT. However, the inherent challenges of spectral CT, evidenced by data and image artifacts, remain a bottleneck for clinical applications. To address these problems, machine learning techniques have been widely applied to spectral CT. In this review, we present the state-of-the-art data-driven techniques for spectral CT.

physics.med-ph↗

arXiv2022

Multi-Channel Convolutional Analysis Operator Learning for Dual-Energy CT Reconstruction

Objective. Dual-energy computed tomography (DECT) has the potential to improve contrast, reduce artifacts and the ability to perform material decomposition in advanced imaging applications. The increased number or measurements results with a higher radiation dose and it is therefore essential to reduce either number of projections per energy or the source X-ray intensity, but this makes tomographic reconstruction more ill-posed. Approach. We developed the multi-channel convolutional analysis operator learning (MCAOL) method to exploit common spatial features within attenuation images at different energies and we propose an optimization method which jointly reconstructs the attenuation images at low and high energies with a mixed norm regularization on the sparse features obtained by pre-trained convolutional filters through the convolutional analysis operator learning (CAOL) algorithm. Main results. Extensive experiments with simulated and real computed tomography (CT) data were performed to validate the effectiveness of the proposed methods and we reported increased reconstruction accuracy compared to CAOL and iterative methods with single and joint total-variation (TV) regularization. Significance. Qualitative and quantitative results on sparse-views and low-dose DECT demonstrate that the proposed MCAOL method outperforms both CAOL applied on each energy independently and several existing state-of-the-art model-based iterative reconstruction (MBIR) techniques, thus paving the way for dose reduction.

eess.IV↗

arXiv2021

Regularization by Denoising Sub-sampled Newton Method for Spectral CT Multi-Material Decomposition

Spectral Computed Tomography (CT) is an emerging technology that enables to estimate the concentration of basis materials within a scanned object by exploiting different photon energy spectra. In this work, we aim at efficiently solving a model-based maximum-a-posterior problem to reconstruct multi-materials images with application to spectral CT. In particular, we propose to solve a regularized optimization problem based on a plug-in image-denoising function using a randomized second order method. By approximating the Newton step using a sketching of the Hessian of the likelihood function, it is possible to reduce the complexity while retaining the complex prior structure given by the data-driven regularizer. We exploit a non-uniform block sub-sampling of the Hessian with inexact but efficient Conjugate gradient updates that require only Jacobian-vector products for denoising term. Finally, we show numerical and experimental results for spectral CT materials decomposition.

math.OC↗