Zhan Wu

Yuxin Liu, Yiqing Dong, Wenxue Yu et al.

Medical image denoising (MID) lacks absolutely clean images for supervision, leading to a noisy reference problem that fundamentally limits denoising performance. Existing simulated-supervised discriminative learning (SimSDL) and simulated-supervised generative learning (SimSGL) treat noisy references as clean targets, causing suboptimal convergence or reference-biased learning, while self-supervised learning (SSL) imposes restrictive noise assumptions that are seldom satisfied in realistic MID scenarios. We propose \textbf{RelativeFlow}, a flow matching framework that learns from heterogeneous noisy references and drives inputs from arbitrary quality levels toward a unified high-quality target. RelativeFlow reformulates flow matching by decomposing the absolute noise-to-clean mapping into relative noisier-to-noisy mappings, and realizes this formulation through two key components: 1) consistent transport (CoT), a displacement map that constrains relative flows to be components of and progressively compose a unified absolute flow, and 2) simulation-based velocity field (SVF), which constructs a learnable velocity field using modality-specific degradation operators to support different medical imaging modalities. Extensive experiments on Computed Tomography (CT) and Magnetic Resonance (MR) denoising demonstrate that RelativeFlow significantly outperforms existing methods, taming MID with noisy references.

Rongjun Ge, Yuxin Liu, Zhan Wu et al.

Non-ideal measurement computed tomography (NICT) employs suboptimal imaging protocols to expand CT applications. However, the resulting trade-offs degrade image quality, limiting clinical acceptability. Although deep learning methods have been used to enhance NICT images, their reliance on large training datasets and limited generalizability across diverse settings hinder practical use. We propose the multi-scale integrated Transformer AMPlifier (TAMP), the first imaging foundation model for universal NICT enhancement. Pre-trained on 10.8 million physics-driven simulated NICT images, TAMP generalizes effectively across various NICT settings, defect degrees, and body regions. Moreover, a parameter-efficient fine-tuning strategy enables TAMP to adapt to specific clinical scenarios using only few slices. Extensive experiments, including radiologists and real-world validations, demonstrate that TAMP consistently improves image quality and clinical acceptability, underscoring its significant potential to advance CT imaging and broaden NICT applications in clinical practice.

Dayang Wang, Yongshun Xu, Shuo Han et al.

Low-dose computed tomography (LDCT) offers reduced X-ray radiation exposure but at the cost of compromised image quality, characterized by increased noise and artifacts. Recently, transformer models emerged as a promising avenue to enhance LDCT image quality. However, the success of such models relies on a large amount of paired noisy and clean images, which are often scarce in clinical settings. In the fields of computer vision and natural language processing, masked autoencoders (MAE) have been recognized as an effective label-free self-pretraining method for transformers, due to their exceptional feature representation ability. However, the original pretraining and fine-tuning design fails to work in low-level vision tasks like denoising. In response to this challenge, we redesign the classical encoder-decoder learning model and facilitate a simple yet effective low-level vision MAE, referred to as LoMAE, tailored to address the LDCT denoising problem. Moreover, we introduce an MAE-GradCAM method to shed light on the latent learning mechanisms of the MAE/LoMAE. Additionally, we explore the LoMAE's robustness and generability across a variety of noise levels. Experiments results show that the proposed LoMAE can enhance the transformer's denoising performance and greatly relieve the dependence on the ground truth clean data. It also demonstrates remarkable robustness and generalizability over a spectrum of noise levels.

Hao Tang, Rongxi Yi, Lei Li et al.

Conventional computed tomography (CT) lacks the ability to capture dynamic, weight-bearing joint motion. Functional evaluation, particularly after surgical intervention, requires four-dimensional (4D) imaging, but current methods are limited by excessive radiation exposure or incomplete spatial information from 2D techniques. We propose an integrated 4D joint analysis platform that combines: (1) a dual robotic arm cone-beam CT (CBCT) system with a programmable, gantry-free trajectory optimized for upright scanning; (2) a hybrid imaging pipeline that fuses static 3D CBCT with dynamic 2D X-rays using deep learning-based preprocessing, 3D-2D projection, and iterative optimization; and (3) a clinically validated framework for quantitative kinematic assessment. In simulation studies, the method achieved sub-voxel accuracy (0.235 mm) with a 99.18 percent success rate, outperforming conventional and state-of-the-art registration approaches. Clinical evaluation further demonstrated accurate quantification of tibial plateau motion and medial-lateral variance in post-total knee arthroplasty (TKA) patients. This 4D CBCT platform enables fast, accurate, and low-dose dynamic joint imaging, offering new opportunities for biomechanical research, precision diagnostics, and personalized orthopedic care.

Dayang Wang, Fenglei Fan, Zhan Wu et al.

Low-dose computed tomography (LDCT) denoising is an important problem in CT research. Compared to the normal dose CT (NDCT), LDCT images are subjected to severe noise and artifacts. Recently in many studies, vision transformers have shown superior feature representation ability over convolutional neural networks (CNNs). However, unlike CNNs, the potential of vision transformers in LDCT denoising was little explored so far. To fill this gap, we propose a Convolution-free Token2Token Dilated Vision Transformer for low-dose CT denoising. The CTformer uses a more powerful token rearrangement to encompass local contextual information and thus avoids convolution. It also dilates and shifts feature maps to capture longer-range interaction. We interpret the CTformer by statically inspecting patterns of its internal attention maps and dynamically tracing the hierarchical attention flow with an explanatory graph. Furthermore, an overlapped inference mechanism is introduced to effectively eliminate the boundary artifacts that are common for encoder-decoder-based denoising models. Experimental results on Mayo LDCT dataset suggest that the CTformer outperforms the state-of-the-art denoising methods with a low computation overhead.

Dayang Wang, Zhan Wu, Hengyong Yu

Low dose computed tomography is a mainstream for clinical applications. How-ever, compared to normal dose CT, in the low dose CT (LDCT) images, there are stronger noise and more artifacts which are obstacles for practical applications. In the last few years, convolution-based end-to-end deep learning methods have been widely used for LDCT image denoising. Recently, transformer has shown superior performance over convolution with more feature interactions. Yet its ap-plications in LDCT denoising have not been fully cultivated. Here, we propose a convolution-free T2T vision transformer-based Encoder-decoder Dilation net-work (TED-net) to enrich the family of LDCT denoising algorithms. The model is free of convolution blocks and consists of a symmetric encoder-decoder block with sole transformer. Our model is evaluated on the AAPM-Mayo clinic LDCT Grand Challenge dataset, and results show outperformance over the state-of-the-art denoising methods.