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Sepideh Hatamikia

Publications and source records attributed to Sepideh Hatamikia.

At least 19 recordsLinked to original sources

From Density to Biopsy Decisions and Malignancy Prediction: A Benchmark Study of Multimodal Large Language Models Against Radiologists in Digital and Contrast-Enhanced Mammography

Purpose: To compare four multimodal large language models (MLLMs) with radiologists of varying expertise in breast density assessment, BI-RADS assessment, biopsy candidacy determination, and continuous malignancy probability estimation using digital mammography (DM) and contrast-enhanced mammography (CEM). Methods: This study included 179 women with paired DM/CEM examinations and reference standards. Four MLLMs (ChatGPT-5.2, Gemini-3.1 Pro, Sonnet-4.6, Muse Spark) interpreted images with and without masks; three radiologists interpreted non-masked images. Results: For binary density classification on DM, radiologist accuracies ranged from 55.81% to 78.60%, exceeding most MLLM values (62.33%-71.63%), while masks added limited benefit. Five-category BI-RADS accuracies were higher for radiologists on DM (56.74-67.44%) and CEM (62.33-82.79%) compared with MLLMs (DM 31.16-45.12%; CEM 40.00-55.81%). Binary biopsy-candidacy accuracies were likewise higher for radiologists (DM 85.12-89.77%; CEM 86.98-92.09%) than for MLLMs (DM 61.39-75.35%; CEM 69.30-82.79%), although CEM improved performance across all readers. Lesion masks substantially improved MLLM continuous malignancy-probability accuracies from 64.65%-71.63% to 72.56-78.60% on DM and from 67.91%-77.21% to 72.56%-81.86% on CEM, approaching radiologist ranges (DM 63.72-82.79%; CEM 81.86-88.84%). The corresponding AUCs for the top masked models overlapped those of the human readers. Overall, Muse Spark, followed by Sonnet-4.6, demonstrated the strongest performance among the MLLMs across domains. Conclusion: Radiologists generally outperformed MLLMs in categorical tasks, while selected masked models approached human performance for continuous malignancy probability estimation, suggesting a potential adjunctive role.

cs.CV

Less Contouring, More Accuracy: Lesion-Guided ROI Deep Learning for Ovarian Ultrasound Classification

Ovarian lesion classification using transvaginal ultrasound remains challenging due to overlapping imaging characteristics and the dependence on expert interpretation. This study investigates whether lesion-guided region-of-interest (ROI) deep learning can achieve competitive diagnostic performance while reducing the annotation burden associated with pixel-level lesion segmentation. Two publicly available ovarian ultrasound datasets were evaluated: the Multi-Modality Ovarian Tumor Ultrasound (MMOTU) dataset for eight-class classification and the Ovarian Ultrasound Dataset (OUD) for binary classification. Four strategies were compared under a unified framework: global image-based deep learning, lesion-guided ROI-based deep learning, lesion contour-based deep learning, and contour-based radiomics with machine learning classifiers. Four deep learning architectures, MaxViT-Tiny, Swin Transformer, EfficientNet-B7, and ResNet18, were evaluated. Radiomics models were developed using support vector machine, k-nearest neighbors, and artificial neural network classifiers, with ANOVA-based feature selection applied for the lower-sample OUD dataset. The lesion-guided ROI strategy achieved the strongest overall performance, with MaxViT-Tiny obtaining 93.10% accuracy and an AUC of 0.99 on MMOTU and 97.56% accuracy and an AUC of 0.99 on OUD. The contour-based approach achieved comparable accuracy but required substantially higher annotation effort. These findings demonstrate that lesion-guided ROI deep learning provides an effective balance between diagnostic performance and annotation efficiency, offering a practical approach for scalable AI-assisted ovarian ultrasound analysis

cs.CV

CBCT-IQ: A Publicly Available Annotated Cone-Beam CT Dataset for Image Quality Assessment and Benchmarking

Medical image quality plays a critical role in diagnostic accuracy, especially in X-ray-based imaging modalities such as cone-beam computed tomography (CBCT), where image quality must be balanced against radiation dose. While expert visual evaluation remains the clinical standard for image quality evaluation, it is time-consuming, subjective and affected by inter-observer variability, emphasizing the need for reliable quantitative image quality assessment (IQA) methods. However, the development and validation of such IQA methods have been limited by the lack of publicly available CBCT datasets with expert image quality annotations. In this study, we provide the first open-access CBCT IQA dataset containing 1,764 annotated image slices acquired using systematic variations in image acquisition and reconstruction parameters. Three clinical experts graded the overall image quality and a predefined regions of interest (ROI) using a four-level scoring scheme. In addition, we benchmark 26 full reference- and no reference-based IQA measures against expert annotations and introduce an exploratory IQA measure-based ranking capable of distinguishing subtle image quality differences. This dataset introduced a standardized benchmark for future CBCT IQA research and provides a valuable resource for the development and validation of new IQA methods, enabling reproducible research and advancing CBCT IQA.

physics.med-ph

A deep learning pipeline for PAM50 subtype classification using histopathology images and multi-objective patch selection

Breast cancer is a highly heterogeneous disease with diverse molecular profiles. The PAM50 gene signature is widely recognized as a standard for classifying breast cancer into intrinsic subtypes, enabling more personalized treatment strategies. In this study, we introduce a novel optimization-driven deep learning framework that aims to reduce reliance on costly molecular assays by directly predicting PAM50 subtypes from H&E-stained whole-slide images (WSIs). Our method jointly optimizes patch informativeness, spatial diversity, uncertainty, and patch count by combining the non-dominated sorting genetic algorithm II (NSGA-II) with Monte Carlo dropout-based uncertainty estimation. The proposed method can identify a small but highly informative patch subset for classification. We used a ResNet18 backbone for feature extraction and a custom CNN head for classification. For evaluation, we used the internal TCGA-BRCA dataset as the training cohort and the external CPTAC-BRCA dataset as the test cohort. On the internal dataset, an F1-score of 0.8812 and an AUC of 0.9841 using 627 WSIs from the TCGA-BRCA cohort were achieved. The performance of the proposed approach on the external validation dataset showed an F1-score of 0.7952 and an AUC of 0.9512. These findings indicate that the proposed optimization-guided, uncertainty-aware patch selection can achieve high performance and improve the computational efficiency of histopathology-based PAM50 classification compared to existing methods, suggesting a scalable imaging-based replacement that has the potential to support clinical decision-making.

cs.CV

Deep learning based Non-Rigid Volume-to-Surface Registration for Brain Shift compensation Using Point Cloud

Soft-tissue deformation remains a major limitation in image-guided neurosurgery, where intra-operative anatomy can deviate substantially from pre-operative imaging due to brain shift, compromising navigation accuracy and surgical safety. Existing compensation methods often rely on intra-operative MRI, CT, or ultrasound, which are disruptive and difficult to integrate repeatedly into the surgical workflow. In contrast, partial 3D cortical surfaces can be reconstructed as point clouds from stereoscopic microscopes or laser range scanners (LRS), capturing only a limited portion of the exposed cortex. This makes point cloud registration a practical alternative without interrupting surgery; however, such partial and noisy observations make deformation estimation highly challenging. In this study, we propose a deep learning-based framework for non-rigid volume-to-surface registration, enabling dense displacement field estimation from sparse intra-operative surface observations without explicit point correspondences or volumetric intra-operative imaging. The network leverages multi-scale point-based feature extraction and a hierarchical deformation decoder to capture both global and local deformations. The key contribution lies in integrating partial intra-operative surface information into the full pre-operative point cloud domain, enabling implicit correspondence learning and dense deformation recovery under limited visibility. Quantitative results demonstrate accurate recovery of fine-scale deformations, achieving an Endpoint Error (EPE) of 1.13 +/- 0.75 mm and RMSE of 1.33 +/- 0.81 mm under challenging partial-surface conditions. The proposed approach supports automatic, workflow-compatible brain-shift compensation from sparse surface observations.

cs.CV

Ultrasound-based detection and malignancy prediction of breast lesions eligible for biopsy: A multi-center clinical-scenario study using nomograms, large language models, and radiologist evaluation

To develop and externally validate integrated ultrasound nomograms combining BIRADS features and quantitative morphometric characteristics, and to compare their performance with expert radiologists and state of the art large language models in biopsy recommendation and malignancy prediction for breast lesions. In this retrospective multicenter, multinational study, 1747 women with pathologically confirmed breast lesions underwent ultrasound across three centers in Iran and Turkey. A total of 10 BIRADS and 26 morphological features were extracted from each lesion. A BIRADS, morphometric, and fused nomogram integrating both feature sets was constructed via logistic regression. Three radiologists (one senior, two general) and two ChatGPT variants independently interpreted deidentified breast lesion images. Diagnostic performance for biopsy recommendation (BIRADS 4,5) and malignancy prediction was assessed in internal and two external validation cohorts. In pooled analysis, the fused nomogram achieved the highest accuracy for biopsy recommendation (83.0%) and malignancy prediction (83.8%), outperforming the morphometric nomogram, three radiologists and both ChatGPT models. Its AUCs were 0.901 and 0.853 for the two tasks, respectively. In addition, the performance of the BIRADS nomogram was significantly higher than the morphometric nomogram, three radiologists and both ChatGPT models for biopsy recommendation and malignancy prediction. External validation confirmed the robust generalizability across different ultrasound platforms and populations. An integrated BIRADS morphometric nomogram consistently outperforms standalone models, LLMs, and radiologists in guiding biopsy decisions and predicting malignancy. These interpretable, externally validated tools have the potential to reduce unnecessary biopsies and enhance personalized decision making in breast imaging.

eess.IV

No-reference based automatic parameter optimization for iterative reconstruction using a novel search space aware crow search algorithm

Iterative reconstruction technique's ability to reduce radiation exposure by using fewer projections has attracted significant attention. However, these methods typically require a precise tuning of several hyperparameters, which can have a major impact on reconstruction quality. Manually setting these parameters is time-consuming and increases the workload for human operators. In this paper, we introduce a novel fully automatic parameter optimization framework that can be applied to a wide range of Cone-beam computed tomography (CBCT) iterative reconstruction algorithms to determine optimal parameters without requiring a reference reconstruction. The proposed method incorporates a modified crow search algorithm (CSA) featuring a superior set-dependent local search mechanism, a search-space-aware global search strategy, and an objective-driven balance between local and global search. Additionally, to ensure an effective initial population, we propose a chaotic diagonal linear uniform initialization scheme that accelerates algorithm convergence. The performance of the proposed framework was evaluated on three imaging machines and four real datasets, as well as three different iterative reconstruction methods with the highest number of tunable parameters, representing the most challenging senario. The results indicate that the proposed method could outperform manual settings and CSA, with an 4.19% improvement in average fitness and 4.89% and 3.82% improvements on CHILL@UK and RPI_AXIS, respectively, which are two benchmark no-reference learning-based quality metrics. In addition, the qualitative results clearly show the superiority of the proposed method by maintaining fine details sharply. The overall performance of the proposed framework across different comparison scenarios demonstrates its effectiveness and robustness across all cases.

cs.CV

Multimodal Connectome Fusion via Cross-Attention for Autism Spectrum Disorder Classification Using Graph Learning

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by atypical functional brain connectivity and subtle structural alterations. rs-fMRI has been widely used to identify disruptions in large-scale brain networks, while structural MRI provides complementary information about morphological organization. Despite their complementary nature, effectively integrating these heterogeneous imaging modalities within a unified framework remains challenging. This study proposes a multimodal graph learning framework that preserves the dominant role of functional connectivity while integrating structural imaging and phenotypic information for ASD classification. The proposed framework is evaluated on ABIDE-I dataset. Each subject is represented as a node within a population graph. Functional and structural features are extracted as modality-specific node attributes, while inter-subject relationships are modeled using a pairwise association encoder (PAE) based on phenotypic information. Two Edge Variational GCNs are trained to learn subject-level embeddings. To enable effective multimodal integration, we introduce a novel asymmetric transformer-based cross-attention mechanism that allows functional embeddings to selectively incorporate complementary structural information while preserving functional dominance. The fused embeddings are then passed to a MLP for ASD classification. Using stratified 10-fold cross-validation, the framework achieved an AUC of 87.3% and an accuracy of 84.4%. Under leave-one-site-out cross-validation (LOSO-CV), the model achieved an average cross-site accuracy of 82.0%, outperforming existing methods by approximately 3% under 10-fold cross-validation and 7% under LOSO-CV. The proposed framework effectively integrates heterogeneous multimodal data from the multi-site ABIDE-I dataset, improving automated ASD classification across imaging sites.

cs.CV

NucFuseRank: Dataset Fusion and Performance Ranking for Nuclei Instance Segmentation

Nuclei instance segmentation in hematoxylin and eosin (H&E)-stained images plays an important role in automated histological image analysis, with various applications in downstream tasks. While several machine learning and deep learning approaches have been proposed for nuclei instance segmentation, most research in this field focuses on developing new segmentation algorithms and benchmarking them on a limited number of arbitrarily selected public datasets. In this work, rather than focusing on model development, we focused on the datasets used for this task. Based on an extensive literature review, we identified manually annotated, publicly available datasets of H&E-stained images for nuclei instance segmentation and standardized them into a unified input and annotation format. Using two state-of-the-art segmentation models, one based on convolutional neural networks (CNNs) and one based on a hybrid CNN and vision transformer architecture, we systematically evaluated and ranked these datasets based on their nuclei instance segmentation performance. Furthermore, we proposed a unified test set (NucFuse-test) for fair cross-dataset evaluation and a unified training set (NucFuse-train) for improved segmentation performance by merging images from multiple datasets. By evaluating and ranking the datasets, performing comprehensive analyses, generating fused datasets, conducting external validation, and making our implementation publicly available, we provided a new benchmark for training, testing, and evaluating nuclei instance segmentation models on H&E-stained histological images.

cs.CV

Developing Predictive and Robust Radiomics Models for Chemotherapy Response in High-Grade Serous Ovarian Carcinoma

Objectives: High-grade serous ovarian carcinoma (HGSOC) is typically diagnosed at an advanced stage with extensive peritoneal metastases, making treatment challenging. Neoadjuvant chemotherapy (NACT) is often used to reduce tumor burden before surgery, but about 40% of patients show limited response. Radiomics, combined with machine learning (ML), offers a promising non-invasive method for predicting NACT response by analyzing computed tomography (CT) imaging data. This study aimed to improve response prediction in HGSOC patients undergoing NACT by integration different feature selection methods. Materials and methods: A framework for selecting robust radiomics features was introduced by employing an automated randomisation algorithm to mimic inter-observer variability, ensuring a balance between feature robustness and prediction accuracy. Four response metrics were used: chemotherapy response score (CRS), RECIST, volume reduction (VolR), and diameter reduction (DiaR). Lesions in different anatomical sites were studied. Pre- and post-NACT CT scans were used for feature extraction and model training on one cohort, and an independent cohort was used for external testing. Results: The best prediction performance was achieved using all lesions combined for VolR prediction, with an AUC of 0.83. Omental lesions provided the best results for CRS prediction (AUC 0.77), while pelvic lesions performed best for DiaR (AUC 0.76). Conclusion: The integration of robustness into the feature selection processes ensures the development of reliable models and thus facilitates the implementation of the radiomics models in clinical applications for HGSOC patients. Future work should explore further applications of radiomics in ovarian cancer, particularly in real-time clinical settings.

cs.CV

From ACR O-RADS 2022 to Explainable Deep Learning: Comparative Performance of Expert Radiologists, Convolutional Neural Networks, Vision Transformers, and Fusion Models in Ovarian Masses

Background: The 2022 update of the Ovarian-Adnexal Reporting and Data System (O-RADS) ultrasound classification refines risk stratification for adnexal lesions, yet human interpretation remains subject to variability and conservative thresholds. Concurrently, deep learning (DL) models have demonstrated promise in image-based ovarian lesion characterization. This study evaluates radiologist performance applying O-RADS v2022, compares it to leading convolutional neural network (CNN) and Vision Transformer (ViT) models, and investigates the diagnostic gains achieved by hybrid human-AI frameworks. Methods: In this single-center, retrospective cohort study, a total of 512 adnexal mass images from 227 patients (110 with at least one malignant cyst) were included. Sixteen DL models, including DenseNets, EfficientNets, ResNets, VGGs, Xception, and ViTs, were trained and validated. A hybrid model integrating radiologist O-RADS scores with DL-predicted probabilities was also built for each scheme. Results: Radiologist-only O-RADS assessment achieved an AUC of 0.683 and an overall accuracy of 68.0%. CNN models yielded AUCs of 0.620 to 0.908 and accuracies of 59.2% to 86.4%, while ViT16-384 reached the best performance, with an AUC of 0.941 and an accuracy of 87.4%. Hybrid human-AI frameworks further significantly enhanced the performance of CNN models; however, the improvement for ViT models was not statistically significant (P-value >0.05). Conclusions: DL models markedly outperform radiologist-only O-RADS v2022 assessment, and the integration of expert scores with AI yields the highest diagnostic accuracy and discrimination. Hybrid human-AI paradigms hold substantial potential to standardize pelvic ultrasound interpretation, reduce false positives, and improve detection of high-risk lesions.

cs.CV

Real-time CBCT reconstructions using Krylov solvers in repeated scanning procedures

This work introduces a new efficient iterative solver for the reconstruction of real-time cone-beam computed tomography (CBCT), which is based on the Prior Image Constrained Compressed Sensing (PICCS) regularization and leverages the efficiency of Krylov subspace methods. In particular, we focus on the setting where a sequence of under-sampled CT scans are taken on the same object with only local changes (e.g. changes in a tumour size or the introduction of a surgical tool). This is very common, for example, in image-guided surgery, where the amount of measurements is limited to ensure the safety of the patient. In this case, we can also typically assume that a (good) initial reconstruction for the solution exists, coming from a previously over-sampled scan, so we can use this information to aid the subsequent reconstructions. The effectiveness of this method is demonstrated in both a synthetic scan and using real CT data, where it can be observed that the PICCS framework is very effective for the reduction of artifacts, and that the new method is faster than other common alternatives used in the same setting.

math.NA

A Multi-Stage Auto-Context Deep Learning Framework for Tissue and Nuclei Segmentation and Classification in H&E-Stained Histological Images of Advanced Melanoma

Melanoma is the most lethal form of skin cancer, with an increasing incidence rate worldwide. Analyzing histological images of melanoma by localizing and classifying tissues and cell nuclei is considered the gold standard method for diagnosis and treatment options for patients. While many computerized approaches have been proposed for automatic analysis, most perform tissue-based analysis and nuclei (cell)-based analysis as separate tasks, which might be suboptimal. In this work, using the PUMA challenge dataset, we propose a novel multi-stage deep learning approach by combining tissue and nuclei information in a unified framework based on the auto-context concept to perform segmentation and classification in histological images of melanoma. Through pre-training and further post-processing, our approach achieved second and first place rankings in the PUMA challenge, with average micro Dice tissue score and summed nuclei F1-score of 73.40% for Track 1 and 63.48% for Track 2, respectively. Furthermore, through a comprehensive ablation study and additional evaluation on an external dataset, we demonstrated the effectiveness of the framework components as well as the generalization capabilities of the proposed approach. Our implementation for training and testing is available at: https://github.com/NimaTorbati/PumaSubmit

cs.CV

Evaluating Pre-trained Convolutional Neural Networks and Foundation Models as Feature Extractors for Content-based Medical Image Retrieval

Medical image retrieval refers to the task of finding similar images for given query images in a database, with applications such as diagnosis support. While traditional medical image retrieval relied on clinical metadata, content-based medical image retrieval (CBMIR) depends on image features, which can be extracted automatically or semi-automatically. Many approaches have been proposed for CBMIR, and among them, using pre-trained convolutional neural networks (CNNs) is a widely utilized approach. However, considering the recent advances in the development of foundation models for various computer vision tasks, their application for CBMIR can also be investigated. In this study, we used several pre-trained feature extractors from well-known pre-trained CNNs and pre-trained foundation models and investigated the CBMIR performance on eight types of two-dimensional (2D) and three-dimensional (3D) medical images. Furthermore, we investigated the effect of image size on the CBMIR performance. Our results show that, overall, for the 2D datasets, foundation models deliver superior performance by a large margin compared to CNNs, with the general-purpose self-supervised model for computational pathology (UNI) providing the best overall performance across all datasets and image sizes. For 3D datasets, CNNs and foundation models deliver more competitive performance, with contrastive learning from captions for histopathology model (CONCH) achieving the best overall performance. Moreover, our findings confirm that while using larger image sizes (especially for 2D datasets) yields slightly better performance, competitive CBMIR performance can still be achieved even with smaller image sizes. Our codes to reproduce the results are available at: https://github.com/masih4/MedImageRetrieval.

cs.CV

A study of why we need to reassess full reference image quality assessment with medical images

Image quality assessment (IQA) is indispensable in clinical practice to ensure high standards, as well as in the development stage of machine learning algorithms that operate on medical images. The popular full reference (FR) IQA measures PSNR and SSIM are known and tested for working successfully in many natural imaging tasks, but discrepancies in medical scenarios have been reported in the literature, highlighting the gap between development and actual clinical application. Such inconsistencies are not surprising, as medical images have very different properties than natural images, and PSNR and SSIM have neither been targeted nor properly tested for medical images. This may cause unforeseen problems in clinical applications due to wrong judgment of novel methods. This paper provides a structured and comprehensive overview of examples where PSNR and SSIM prove to be unsuitable for the assessment of novel algorithms using different kinds of medical images, including real-world MRI, CT, OCT, X-Ray, digital pathology and photoacoustic imaging data. Therefore, improvement is urgently needed in particular in this era of AI to increase reliability and explainability in machine learning for medical imaging and beyond. Lastly, we will provide ideas for future research as well as suggesting guidelines for the usage of FR-IQA measures applied to medical images.

eess.IV

A Review on the Integration of Artificial Intelligence and Medical Imaging in IVF Ovarian Stimulation

Artificial intelligence (AI) has emerged as a powerful tool to enhance decision-making and optimize treatment protocols in in vitro fertilization (IVF). In particular, AI shows significant promise in supporting decision-making during the ovarian stimulation phase of the IVF process. This review evaluates studies focused on the applications of AI combined with medical imaging in ovarian stimulation, examining methodologies, outcomes, and current limitations. Our analysis of 13 studies on this topic reveals that, reveal that while AI algorithms demonstrated notable potential in predicting optimal hormonal dosages, trigger timing, and oocyte retrieval outcomes, the medical imaging data utilized predominantly came from two-dimensional (2D) ultrasound which mainly involved basic quantifications, such as follicle size and number, with limited use of direct feature extraction or advanced image analysis techniques. This points to an underexplored opportunity where advanced image analysis approaches, such as deep learning, and more diverse imaging modalities, like three-dimensional (3D) ultrasound, could unlock deeper insights. Additionally, the lack of explainable AI (XAI) in most studies raises concerns about the transparency and traceability of AI-driven decisions - key factors for clinical adoption and trust. Furthermore, many studies relied on single-center designs and small datasets, which limit the generalizability of their findings. This review highlights the need for integrating advanced imaging analysis techniques with explainable AI methodologies, as well as the importance of leveraging multicenter collaborations and larger datasets. Addressing these gaps has the potential to enhance ovarian stimulation management, paving the way for efficient, personalized, and data-driven treatment pathways that improve IVF outcomes.

eess.IV

An Integrated Optimization and Deep Learning Pipeline for Predicting Live Birth Success in IVF Using Feature Optimization and Transformer-Based Models

In vitro fertilization (IVF) is a widely utilized assisted reproductive technology, yet predicting its success remains challenging due to the multifaceted interplay of clinical, demographic, and procedural factors. This study develops a robust artificial intelligence (AI) pipeline aimed at predicting live birth outcomes in IVF treatments. The pipeline uses anonymized data from 2010 to 2018, obtained from the Human Fertilization and Embryology Authority (HFEA). We evaluated the prediction performance of live birth success as a binary outcome (success/failure) by integrating different feature selection methods, such as principal component analysis (PCA) and particle swarm optimization (PSO), with different traditional machine learning-based classifiers including random forest (RF) and decision tree, as well as deep learning-based classifiers including custom transformer-based model and a tab transformer model with an attention mechanism. Our research demonstrated that the best performance was achieved by combining PSO for feature selection with the TabTransformer-based deep learning model, yielding an accuracy of 99.50% and an AUC of 99.96%, highlighting its significant performance to predict live births. This study establishes a highly accurate AI pipeline for predicting live birth outcomes in IVF, demonstrating its potential to enhance personalized fertility treatments.

cs.AI

TIGRE v3: Efficient and easy to use iterative computed tomographic reconstruction toolbox for real datasets

Computed Tomography (CT) has been widely adopted in medicine and it is increasingly being used in scientific and industrial applications. Parallelly, research in different mathematical areas concerning discrete inverse problems has led to the development of new sophisticated numerical solvers that can be applied in the context of CT. The Tomographic Iterative GPU-based Reconstruction (TIGRE) toolbox was born almost a decade ago precisely in the gap between mathematics and high performance computing for real CT data, providing user-friendly open-source software tools for image reconstruction. However, since its inception, the tools' features and codebase have had over a twenty-fold increase, and are now including greater geometric flexibility, a variety of modern algorithms for image reconstruction, high-performance computing features and support for other CT modalities, like proton CT. The purpose of this work is two-fold: first, it provides a structured overview of the current version of the TIGRE toolbox, providing appropriate descriptions and references, and serving as a comprehensive and peer-reviewed guide for the user; second, it is an opportunity to illustrate the performance of several of the available solvers showcasing real CT acquisitions, which are typically not be openly available to algorithm developers.

physics.med-ph