Flow Matching for Conditional MRI-CT and CBCT-CT Image Synthesis

Generating synthetic CT (sCT) from MRI or CBCT plays a crucial role in enabling MRI-only and CBCT-based adaptive radiotherapy, improving treatment precision while reducing patient radiation exposure. To address this task, we adopt a fully 3D Flow Matching (FM) framework, motivated by recent work demonstrating FM's efficiency in producing high-quality images. In our approach, a Gaussian noise volume is transformed into an sCT image by integrating a learned FM velocity field, conditioned on features extracted from the input MRI or CBCT using a lightweight 3D encoder. We evaluated the method on the SynthRAD2025 Challenge benchmark, training separate models for MRI $\rightarrow$ sCT and CBCT $\rightarrow$ sCT across three anatomical regions: abdomen, head and neck, and thorax. Validation and testing were performed through the challenge submission system. The results indicate that the method accurately reconstructs global anatomical structures; however, preservation of fine details was limited, primarily due to the relatively low training resolution imposed by memory and runtime constraints. Future work will explore patch-based training and latent-space flow models to improve resolution and local structural fidelity.

Synthetic Augmentation for Anatomical Landmark Localization using DDPMs

Deep learning techniques for anatomical landmark localization (ALL) have shown great success, but their reliance on large annotated datasets remains a problem due to the tedious and costly nature of medical data acquisition and annotation. While traditional data augmentation, variational autoencoders (VAEs), and generative adversarial networks (GANs) have already been used to synthetically expand medical datasets, diffusion-based generative models have recently started to gain attention for their ability to generate high-quality synthetic images. In this study, we explore the use of denoising diffusion probabilistic models (DDPMs) for generating medical images and their corresponding heatmaps of landmarks to enhance the training of a supervised deep learning model for ALL. Our novel approach involves a DDPM with a 2-channel input, incorporating both the original medical image and its heatmap of annotated landmarks. We also propose a novel way to assess the quality of the generated images using a Markov Random Field (MRF) model for landmark matching and a Statistical Shape Model (SSM) to check landmark plausibility, before we evaluate the DDPM-augmented dataset in the context of an ALL task involving hand X-Rays.

Teeth Localization and Lesion Segmentation in CBCT Images using SpatialConfiguration-Net and U-Net

The localization of teeth and segmentation of periapical lesions in cone-beam computed tomography (CBCT) images are crucial tasks for clinical diagnosis and treatment planning, which are often time-consuming and require a high level of expertise. However, automating these tasks is challenging due to variations in shape, size, and orientation of lesions, as well as similar topologies among teeth. Moreover, the small volumes occupied by lesions in CBCT images pose a class imbalance problem that needs to be addressed. In this study, we propose a deep learning-based method utilizing two convolutional neural networks: the SpatialConfiguration-Net (SCN) and a modified version of the U-Net. The SCN accurately predicts the coordinates of all teeth present in an image, enabling precise cropping of teeth volumes that are then fed into the U-Net which detects lesions via segmentation. To address class imbalance, we compare the performance of three reweighting loss functions. After evaluation on 144 CBCT images, our method achieves a 97.3% accuracy for teeth localization, along with a promising sensitivity and specificity of 0.97 and 0.88, respectively, for subsequent lesion detection.