arXiv subjects

Shaoyan Pan

Publications and source records attributed to Shaoyan Pan.

18 recordsLinked to original sources

arXiv2026

One-for-All Adaptive Radiotherapy Planning Agent: A Foundation Framework for Daily CBCT-guided Radiotherapy

In this work, we introduce the One-for-All Adaptive Radiotherapy Planning Agent, a unified foundation-model-based system that performs complete, treatment-specific online adaptive planning directly from daily cone-beam CT in under two minutes. The agent first autonomously predicts all essential planning components, including synthetic CT generation, multimodal alignment, and tumor/organ segmentation. It then intelligently leverages these outputs to execute the final clinical plan design, providing a comprehensive, automated solution for daily treatment. We also demonstrate that the agent enables clinicians to define planning with intent and intervene at critical decision points, ensuring a "human-in-the-loop" framework that generates acceptable plans before final approval. Evaluated on multiple datasets spanning head-and-neck, lung, abdominal, and prostate cancers with both photon and proton therapy, the proposed framework achieves clinically acceptable accuracy and plan quality comparable to clinically generated treatment plans, with target dose errors (D98) generally within 2.0 Gy of the reference plan. The strong performance of the One-for-All agent highlights the promise of a unified foundation-model approach and opens opportunities for fast, scalable, and fully automated online adaptive radiotherapy across diverse clinical scenarios.

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arXiv2025

Limited-Angle CBCT Reconstruction via Geometry-Integrated Cycle-domain Denoising Diffusion Probabilistic Models

Cone-beam CT (CBCT) is widely used in clinical radiotherapy for image-guided treatment, improving setup accuracy, adaptive planning, and motion management. However, slow gantry rotation limits performance by introducing motion artifacts, blurring, and increased dose. This work aims to develop a clinically feasible method for reconstructing high-quality CBCT volumes from consecutive limited-angle acquisitions, addressing imaging challenges in time- or dose-constrained settings. We propose a limited-angle (LA) geometry-integrated cycle-domain (LA-GICD) framework for CBCT reconstruction, comprising two denoising diffusion probabilistic models (DDPMs) connected via analytic cone-beam forward and back projectors. A Projection-DDPM completes missing projections, followed by back-projection, and an Image-DDPM refines the volume. This dual-domain design leverages complementary priors from projection and image spaces to achieve high-quality reconstructions from limited-angle (<= 90 degrees) scans. Performance was evaluated against full-angle reconstruction. Four board-certified medical physicists conducted assessments. A total of 78 planning CTs in common CBCT geometries were used for training and evaluation. The method achieved a mean absolute error of 35.5 HU, SSIM of 0.84, and PSNR of 29.8 dB, with visibly reduced artifacts and improved soft-tissue clarity. LA-GICD's geometry-aware dual-domain learning, embedded in analytic forward/backward operators, enabled artifact-free, high-contrast reconstructions from a single 90-degree scan, reducing acquisition time and dose four-fold. LA-GICD improves limited-angle CBCT reconstruction with strong data fidelity and anatomical realism. It offers a practical solution for short-arc acquisitions, enhancing CBCT use in radiotherapy by providing clinically applicable images with reduced scan time and dose for more accurate, personalized treatments.

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arXiv2025

Dual-Energy Cone-Beam CT Using Two Orthogonal Projection Views: A Phantom Study

This study proposes a novel imaging and reconstruction framework for dual-energy cone-beam CT (DECBCT) using only two orthogonal X-ray projections at different energy levels (2V-DECBCT). The goal is to enable fast and low-dose DE volumetric imaging with high spectral fidelity and structural accuracy, suitable for DECBCT-guided radiation therapy. We introduce a framework for 2V-DECBCT based on physics-informed dual-domain diffusion models. A cycle-domain training strategy is employed to enforce consistency between projection and volume reconstructions through a differentiable physics-informed module. Furthermore, a spectral-consistency loss is introduced to preserve inter-energy contrast during the generative process. The model is trained and evaluated using 4D XCAT phantom data under realistic anatomical motion. The method produces high-fidelity DECBCT volumes from only two views, accurately preserving anatomical boundaries and suppressing artifacts. Subtraction maps computed from the reconstructed energy volumes show strong visual and numerical agreement with ground truth. This work presents the first diffusion model-based framework for 2V-DECBCT reconstruction, demonstrating accurate structural and spectral recovery from extremely sparse inputs.

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arXiv2024

Label-Efficient Data Augmentation with Video Diffusion Models for Guidewire Segmentation in Cardiac Fluoroscopy

The accurate segmentation of guidewires in interventional cardiac fluoroscopy videos is crucial for computer-aided navigation tasks. Although deep learning methods have demonstrated high accuracy and robustness in wire segmentation, they require substantial annotated datasets for generalizability, underscoring the need for extensive labeled data to enhance model performance. To address this challenge, we propose the Segmentation-guided Frame-consistency Video Diffusion Model (SF-VD) to generate large collections of labeled fluoroscopy videos, augmenting the training data for wire segmentation networks. SF-VD leverages videos with limited annotations by independently modeling scene distribution and motion distribution. It first samples the scene distribution by generating 2D fluoroscopy images with wires positioned according to a specified input mask, and then samples the motion distribution by progressively generating subsequent frames, ensuring frame-to-frame coherence through a frame-consistency strategy. A segmentation-guided mechanism further refines the process by adjusting wire contrast, ensuring a diverse range of visibility in the synthesized image. Evaluation on a fluoroscopy dataset confirms the superior quality of the generated videos and shows significant improvements in guidewire segmentation.

cs.CV↗

arXiv2024

Patient-Specific CBCT Synthesis for Real-time Tumor Tracking in Surface-guided Radiotherapy

We present a new imaging system to support real-time tumor tracking for surface-guided radiotherapy (SGRT). SGRT uses optical surface imaging (OSI) to acquire real-time surface topography images of the patient on the treatment couch. However, OSI cannot visualize internal anatomy. This study proposes an Advanced Surface Imaging (A-SI) framework to address this issue. In the proposed A-SI framework, a high-speed surface imaging camera consistently captures surface images during radiation delivery, and a CBCT imager captures single-angle X-ray projections at low frequency. The A-SI then utilizes a generative model to generate real-time volumetric images with full anatomy, referred to as Optical Surface-Derived cone beam computed tomography (OSD-CBCT), based on the real-time high-frequent surface images and the low-frequency collected single-angle X-ray projections. The generated OSD-CBCT can provide accurate tumor motion for precise radiation delivery. The A-SI framework uses a patient-specific generative model: physics-integrated consistency-refinement denoising diffusion probabilistic model (PC-DDPM). This model leverages patient-specific anatomical structures and respiratory motion patterns derived from four-dimensional CT (4DCT) during treatment planning. It then employs a geometric transformation module (GTM) to extract volumetric anatomy information from the single-angle X-ray projection. A simulation study with 22 lung cancer patients evaluated the A-SI framework supported by PC-DDPM. The results showed that the framework produced real-time OSD-CBCT with high reconstruction fidelity and precise tumor localization. This study demonstrates the potential of A-SI to enable real-time tumor tracking with minimal imaging dose, advancing SGRT for motion-associated cancers and interventional procedures.

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arXiv2024

AnatoMask: Enhancing Medical Image Segmentation with Reconstruction-guided Self-masking

Due to the scarcity of labeled data, self-supervised learning (SSL) has gained much attention in 3D medical image segmentation, by extracting semantic representations from unlabeled data. Among SSL strategies, Masked image modeling (MIM) has shown effectiveness by reconstructing randomly masked images to learn detailed representations. However, conventional MIM methods require extensive training data to achieve good performance, which still poses a challenge for medical imaging. Since random masking uniformly samples all regions within medical images, it may overlook crucial anatomical regions and thus degrade the pretraining efficiency. We propose AnatoMask, a novel MIM method that leverages reconstruction loss to dynamically identify and mask out anatomically significant regions to improve pretraining efficacy. AnatoMask takes a self-distillation approach, where the model learns both how to find more significant regions to mask and how to reconstruct these masked regions. To avoid suboptimal learning, Anatomask adjusts the pretraining difficulty progressively using a masking dynamics function. We have evaluated our method on 4 public datasets with multiple imaging modalities (CT, MRI, and PET). AnatoMask demonstrates superior performance and scalability compared to existing SSL methods. The code is available at https://github.com/ricklisz/AnatoMask.

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arXiv2024

Self-Supervised Adversarial Diffusion Models for Fast MRI Reconstruction

Purpose: To propose a self-supervised deep learning-based compressed sensing MRI (DL-based CS-MRI) method named "Adaptive Self-Supervised Consistency Guided Diffusion Model (ASSCGD)" to accelerate data acquisition without requiring fully sampled datasets. Materials and Methods: We used the fastMRI multi-coil brain axial T2-weighted (T2-w) dataset from 1,376 cases and single-coil brain quantitative magnetization prepared 2 rapid acquisition gradient echoes (MP2RAGE) T1 maps from 318 cases to train and test our model. Robustness against domain shift was evaluated using two out-of-distribution (OOD) datasets: multi-coil brain axial postcontrast T1 -weighted (T1c) dataset from 50 cases and axial T1-weighted (T1-w) dataset from 50 patients. Data were retrospectively subsampled at acceleration rates R in {2x, 4x, 8x}. ASSCGD partitions a random sampling pattern into two disjoint sets, ensuring data consistency during training. We compared our method with ReconFormer Transformer and SS-MRI, assessing performance using normalized mean squared error (NMSE), peak signal-to-noise ratio (PSNR), and structural similarity index (SSIM). Statistical tests included one-way analysis of variance (ANOVA) and multi-comparison Tukey's Honesty Significant Difference (HSD) tests. Results: ASSCGD preserved fine structures and brain abnormalities visually better than comparative methods at R = 8x for both multi-coil and single-coil datasets. It achieved the lowest NMSE at R in {4x, 8x}, and the highest PSNR and SSIM values at all acceleration rates for the multi-coil dataset. Similar trends were observed for the single-coil dataset, though SSIM values were comparable to ReconFormer at R in {2x, 8x}. These results were further confirmed by the voxel-wise correlation scatter plots. OOD results showed significant (p << 10^-5 ) improvements in undersampled image quality after reconstruction.

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arXiv2024

Clinically Feasible Diffusion Reconstruction for Highly-Accelerated Cardiac Cine MRI

The currently limited quality of accelerated cardiac cine reconstruction may potentially be improved by the emerging diffusion models, but the clinically unacceptable long processing time poses a challenge. We aim to develop a clinically feasible diffusion-model-based reconstruction pipeline to improve the image quality of cine MRI. A multi-in multi-out diffusion enhancement model together with fast inference strategies were developed to be used in conjunction with a reconstruction model. The diffusion reconstruction reduced spatial and temporal blurring in prospectively undersampled clinical data, as validated by experts inspection. The 1.5s per video processing time enabled the approach to be applied in clinical scenarios.

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arXiv2024

Spatiotemporal Diffusion Model with Paired Sampling for Accelerated Cardiac Cine MRI

Current deep learning reconstruction for accelerated cardiac cine MRI suffers from spatial and temporal blurring. We aim to improve image sharpness and motion delineation for cine MRI under high undersampling rates. A spatiotemporal diffusion enhancement model conditional on an existing deep learning reconstruction along with a novel paired sampling strategy was developed. The diffusion model provided sharper tissue boundaries and clearer motion than the original reconstruction in experts evaluation on clinical data. The innovative paired sampling strategy substantially reduced artificial noises in the generative results.

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arXiv2023

Multi-dimension unified Swin Transformer for 3D Lesion Segmentation in Multiple Anatomical Locations

In oncology research, accurate 3D segmentation of lesions from CT scans is essential for the modeling of lesion growth kinetics. However, following the RECIST criteria, radiologists routinely only delineate each lesion on the axial slice showing the largest transverse area, and delineate a small number of lesions in 3D for research purposes. As a result, we have plenty of unlabeled 3D volumes and labeled 2D images, and scarce labeled 3D volumes, which makes training a deep-learning 3D segmentation model a challenging task. In this work, we propose a novel model, denoted a multi-dimension unified Swin transformer (MDU-ST), for 3D lesion segmentation. The MDU-ST consists of a Shifted-window transformer (Swin-transformer) encoder and a convolutional neural network (CNN) decoder, allowing it to adapt to 2D and 3D inputs and learn the corresponding semantic information in the same encoder. Based on this model, we introduce a three-stage framework: 1) leveraging large amount of unlabeled 3D lesion volumes through self-supervised pretext tasks to learn the underlying pattern of lesion anatomy in the Swin-transformer encoder; 2) fine-tune the Swin-transformer encoder to perform 2D lesion segmentation with 2D RECIST slices to learn slice-level segmentation information; 3) further fine-tune the Swin-transformer encoder to perform 3D lesion segmentation with labeled 3D volumes. The network's performance is evaluated by the Dice similarity coefficient (DSC) and Hausdorff distance (HD) using an internal 3D lesion dataset with 593 lesions extracted from multiple anatomical locations. The proposed MDU-ST demonstrates significant improvement over the competing models. The proposed method can be used to conduct automated 3D lesion segmentation to assist radiomics and tumor growth modeling studies. This paper has been accepted by the IEEE International Symposium on Biomedical Imaging (ISBI) 2023.

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arXiv2023

Full-dose Whole-body PET Synthesis from Low-dose PET Using High-efficiency Denoising Diffusion Probabilistic Model: PET Consistency Model

Objective: Positron Emission Tomography (PET) has been a commonly used imaging modality in broad clinical applications. One of the most important tradeoffs in PET imaging is between image quality and radiation dose: high image quality comes with high radiation exposure. Improving image quality is desirable for all clinical applications while minimizing radiation exposure is needed to reduce risk to patients. Approach: We introduce PET Consistency Model (PET-CM), an efficient diffusion-based method for generating high-quality full-dose PET images from low-dose PET images. It employs a two-step process, adding Gaussian noise to full-dose PET images in the forward diffusion, and then denoising them using a PET Shifted-window Vision Transformer (PET-VIT) network in the reverse diffusion. The PET-VIT network learns a consistency function that enables direct denoising of Gaussian noise into clean full-dose PET images. PET-CM achieves state-of-the-art image quality while requiring significantly less computation time than other methods. Results: In experiments comparing eighth-dose to full-dose images, PET-CM demonstrated impressive performance with NMAE of 1.278+/-0.122%, PSNR of 33.783+/-0.824dB, SSIM of 0.964+/-0.009, NCC of 0.968+/-0.011, HRS of 4.543, and SUV Error of 0.255+/-0.318%, with an average generation time of 62 seconds per patient. This is a significant improvement compared to the state-of-the-art diffusion-based model with PET-CM reaching this result 12x faster. Similarly, in the quarter-dose to full-dose image experiments, PET-CM delivered competitive outcomes, achieving an NMAE of 0.973+/-0.066%, PSNR of 36.172+/-0.801dB, SSIM of 0.984+/-0.004, NCC of 0.990+/-0.005, HRS of 4.428, and SUV Error of 0.151+/-0.192% using the same generation process, which underlining its high quantitative and clinical precision in both denoising scenario.

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arXiv2023

Synthetic CT Generation from MRI using 3D Transformer-based Denoising Diffusion Model

Magnetic resonance imaging (MRI)-based synthetic computed tomography (sCT) simplifies radiation therapy treatment planning by eliminating the need for CT simulation and error-prone image registration, ultimately reducing patient radiation dose and setup uncertainty. We propose an MRI-to-CT transformer-based denoising diffusion probabilistic model (MC-DDPM) to transform MRI into high-quality sCT to facilitate radiation treatment planning. MC-DDPM implements diffusion processes with a shifted-window transformer network to generate sCT from MRI. The proposed model consists of two processes: a forward process which adds Gaussian noise to real CT scans, and a reverse process in which a shifted-window transformer V-net (Swin-Vnet) denoises the noisy CT scans conditioned on the MRI from the same patient to produce noise-free CT scans. With an optimally trained Swin-Vnet, the reverse diffusion process was used to generate sCT scans matching MRI anatomy. We evaluated the proposed method by generating sCT from MRI on a brain dataset and a prostate dataset. Qualitative evaluation was performed using the mean absolute error (MAE) of Hounsfield unit (HU), peak signal to noise ratio (PSNR), multi-scale Structure Similarity index (MS-SSIM) and normalized cross correlation (NCC) indexes between ground truth CTs and sCTs. MC-DDPM generated brain sCTs with state-of-the-art quantitative results with MAE 43.317 HU, PSNR 27.046 dB, SSIM 0.965, and NCC 0.983. For the prostate dataset, MC-DDPM achieved MAE 59.953 HU, PSNR 26.920 dB, SSIM 0.849, and NCC 0.948. In conclusion, we have developed and validated a novel approach for generating CT images from routine MRIs using a transformer-based DDPM. This model effectively captures the complex relationship between CT and MRI images, allowing for robust and high-quality synthetic CT (sCT) images to be generated in minutes.

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arXiv2023

Data-Driven Volumetric Image Generation from Surface Structures using a Patient-Specific Deep Leaning Model

The advent of computed tomography significantly improves patient health regarding diagnosis, prognosis, and treatment planning and verification. However, tomographic imaging escalates concomitant radiation doses to patients, inducing potential secondary cancer. We demonstrate the feasibility of a data-driven approach to synthesize volumetric images using patient surface images, which can be obtained from a zero-dose surface imaging system. This study includes 500 computed tomography (CT) image sets from 50 patients. Compared to the ground truth CT, the synthetic images result in the evaluation metric values of 26.9 Hounsfield units, 39.1dB, and 0.965 regarding the mean absolute error, peak signal-to-noise ratio, and structural similarity index measure. This approach provides a data integration solution that can potentially enable real-time imaging, which is free of radiation-induced risk and could be applied to image-guided medical procedures.

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arXiv2023

Cross-Shaped Windows Transformer with Self-supervised Pretraining for Clinically Significant Prostate Cancer Detection in Bi-parametric MRI

Biparametric magnetic resonance imaging (bpMRI) has demonstrated promising results in prostate cancer (PCa) detection using convolutional neural networks (CNNs). Recently, transformers have achieved competitive performance compared to CNNs in computer vision. Large scale transformers need abundant annotated data for training, which are difficult to obtain in medical imaging. Self-supervised learning (SSL) utilizes unlabeled data to generate meaningful semantic representations without the need for costly annotations, enhancing model performance on tasks with limited labeled data. We introduce a novel end-to-end Cross-Shaped windows (CSwin) transformer UNet model, CSwin UNet, to detect clinically significant prostate cancer (csPCa) in prostate bi-parametric MR imaging (bpMRI) and demonstrate the effectiveness of our proposed self-supervised pre-training framework. Using a large prostate bpMRI dataset with 1500 patients, we first pretrain CSwin transformer using multi-task self-supervised learning to improve data-efficiency and network generalizability. We then finetune using lesion annotations to perform csPCa detection. Five-fold cross validation shows that self-supervised CSwin UNet achieves 0.888 AUC and 0.545 Average Precision (AP), significantly outperforming four comparable models (Swin UNETR, DynUNet, Attention UNet, UNet). Using a separate bpMRI dataset with 158 patients, we evaluate our method robustness to external hold-out data. Self-supervised CSwin UNet achieves 0.79 AUC and 0.45 AP, still outperforming all other comparable methods and demonstrating good generalization to external data.

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arXiv2023

Cycle-guided Denoising Diffusion Probability Model for 3D Cross-modality MRI Synthesis

This study aims to develop a novel Cycle-guided Denoising Diffusion Probability Model (CG-DDPM) for cross-modality MRI synthesis. The CG-DDPM deploys two DDPMs that condition each other to generate synthetic images from two different MRI pulse sequences. The two DDPMs exchange random latent noise in the reverse processes, which helps to regularize both DDPMs and generate matching images in two modalities. This improves image-to-image translation ac-curacy. We evaluated the CG-DDPM quantitatively using mean absolute error (MAE), multi-scale structural similarity index measure (MSSIM), and peak sig-nal-to-noise ratio (PSNR), as well as the network synthesis consistency, on the BraTS2020 dataset. Our proposed method showed high accuracy and reliable consistency for MRI synthesis. In addition, we compared the CG-DDPM with several other state-of-the-art networks and demonstrated statistically significant improvements in the image quality of synthetic MRIs. The proposed method enhances the capability of current multimodal MRI synthesis approaches, which could contribute to more accurate diagnosis and better treatment planning for patients by synthesizing additional MRI modalities.

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arXiv2023

Advancing Medical Imaging with Language Models: A Journey from N-grams to ChatGPT

In this paper, we aimed to provide a review and tutorial for researchers in the field of medical imaging using language models to improve their tasks at hand. We began by providing an overview of the history and concepts of language models, with a special focus on large language models. We then reviewed the current literature on how language models are being used to improve medical imaging, emphasizing different applications such as image captioning, report generation, report classification, finding extraction, visual question answering, interpretable diagnosis, and more for various modalities and organs. The ChatGPT was specially highlighted for researchers to explore more potential applications. We covered the potential benefits of accurate and efficient language models for medical imaging analysis, including improving clinical workflow efficiency, reducing diagnostic errors, and assisting healthcare professionals in providing timely and accurate diagnoses. Overall, our goal was to bridge the gap between language models and medical imaging and inspire new ideas and innovations in this exciting area of research. We hope that this review paper will serve as a useful resource for researchers in this field and encourage further exploration of the possibilities of language models in medical imaging.

cs.CV↗

arXiv2023

CBCT-Based Synthetic CT Image Generation Using Conditional Denoising Diffusion Probabilistic Model

Background: Daily or weekly cone-beam computed tomography (CBCT) scans are commonly used for accurate patient positioning during the image-guided radiotherapy (IGRT) process, making it an ideal option for adaptive radiotherapy (ART) replanning. However, the presence of severe artifacts and inaccurate Hounsfield unit (HU) values prevent its use for quantitative applications such as organ segmentation and dose calculation. To enable the clinical practice of online ART, it is crucial to obtain CBCT scans with a quality comparable to that of a CT scan. Purpose: This work aims to develop a conditional diffusion model to perform image translation from the CBCT to the CT domain for the image quality improvement of CBCT. Methods: The proposed method is a conditional denoising diffusion probabilistic model (DDPM) that utilizes a time-embedded U-net architecture with residual and attention blocks to gradually transform standard Gaussian noise to the target CT distribution conditioned on the CBCT. The model was trained on deformed planning CT (dpCT) and CBCT image pairs, and its feasibility was verified in brain patient study and head-and-neck (H&N) patient study. The performance of the proposed algorithm was evaluated using mean absolute error (MAE), peak signal-to-noise ratio (PSNR) and normalized cross-correlation (NCC) metrics on generated synthetic CT (sCT) samples. The proposed method was also compared to four other diffusion model-based sCT generation methods. Conclusions: The proposed conditional DDPM method can generate sCT from CBCT with accurate HU numbers and reduced artifacts, enabling accurate CBCT-based organ segmentation and dose calculation for online ART.

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arXiv2023

Deep Learning-based Multi-Organ CT Segmentation with Adversarial Data Augmentation

In this work, we propose an adversarial attack-based data augmentation method to improve the deep-learning-based segmentation algorithm for the delineation of Organs-At-Risk (OAR) in abdominal Computed Tomography (CT) to facilitate radiation therapy. We introduce Adversarial Feature Attack for Medical Image (AFA-MI) augmentation, which forces the segmentation network to learn out-of-distribution statistics and improve generalization and robustness to noises. AFA-MI augmentation consists of three steps: 1) generate adversarial noises by Fast Gradient Sign Method (FGSM) on the intermediate features of the segmentation network's encoder; 2) inject the generated adversarial noises into the network, intentionally compromising performance; 3) optimize the network with both clean and adversarial features. Experiments are conducted segmenting the heart, left and right kidney, liver, left and right lung, spinal cord, and stomach. We first evaluate the AFA-MI augmentation using nnUnet and TT-Vnet on the test data from a public abdominal dataset and an institutional dataset. In addition, we validate how AFA-MI affects the networks' robustness to the noisy data by evaluating the networks with added Gaussian noises of varying magnitudes to the institutional dataset. Network performance is quantitatively evaluated using Dice Similarity Coefficient (DSC) for volume-based accuracy. Also, Hausdorff Distance (HD) is applied for surface-based accuracy. On the public dataset, nnUnet with AFA-MI achieves DSC = 0.85 and HD = 6.16 millimeters (mm); and TT-Vnet achieves DSC = 0.86 and HD = 5.62 mm. AFA-MI augmentation further improves all contour accuracies up to 0.217 DSC score when tested on images with Gaussian noises. AFA-MI augmentation is therefore demonstrated to improve segmentation performance and robustness in CT multi-organ segmentation.

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