Igor Peterlik

Daniel Barco, Marc Stadelmann, Martin Oswald et al.

We present MInDI-3D (Medical Inversion by Direct Iteration in 3D), the first 3D conditional diffusion-based model for real-world sparse-view Cone Beam Computed Tomography (CBCT) artefact removal, aiming to reduce imaging radiation exposure. A key contribution is extending the "InDI" concept from 2D to a full 3D volumetric approach for medical images, implementing an iterative denoising process that refines the CBCT volume directly from sparse-view input. A further contribution is the generation of a large pseudo-CBCT dataset (16,182) from chest CT volumes of the CT-RATE public dataset to robustly train MInDI-3D. We performed a comprehensive evaluation, including quantitative metrics, scalability analysis, generalisation tests, and a clinical assessment by 11 clinicians. Our results show MInDI-3D's effectiveness, achieving a 12.96 (6.10) dB PSNR gain over uncorrected scans with only 50 projections on the CT-RATE pseudo-CBCT (independent real-world) test set and enabling an 8x reduction in imaging radiation exposure. We demonstrate its scalability by showing that performance improves with more training data. Importantly, MInDI-3D matches the performance of a 3D U-Net on real-world scans from 16 cancer patients across distortion and task-based metrics. It also generalises to new CBCT scanner geometries. Clinicians rated our model as sufficient for patient positioning across all anatomical sites and found it preserved lung tumour boundaries well.

Jaime Garcia Guevara, Igor Peterlik, Marie-Odile Berger et al.

An automatic elastic registration method suited for vascularized organs is proposed. The vasculature in both the preoperative and intra-operative images is represented as a graph. A typical application of this method is the fusion of pre-operative information onto the organ during surgery, to compensate for the limited details provided by the intra-operative imaging modality (e.g. CBCT) and to cope with changes in the shape of the organ. Due to image modalities differences and organ deformation, each graph has a different topology and shape. The Adaptive Compliance Graph Matching (ACGM) method presented does not require any manual initialization, handles intra-operative nonrigid deformations of up to 65 mm and computes a complete displacement field over the organ from only the matched vasculature. ACGM is better than the previous Biomechanical Graph Matching method 3 (BGM) because it uses an efficient biomechanical vascularized liver model to compute the organ's transformation and the vessels bifurcations compliance. This allows to efficiently find the best graph matches with a novel compliance-based adaptive search. These contributions are evaluated on ten realistic synthetic and two real porcine automatically segmented datasets. ACGM obtains better target registration error (TRE) than BGM, with an average TRE in the real datasets of 4.2 mm compared to 6.5 mm, respectively. It also is up to one order of magnitude faster, less dependent on the parameters used and more robust to noise.