Deep Slice Interpolation for Reducing Through-Plane Anisotropy and Noise in Head CT

Head computed tomography (CT) typically uses sub-millimeter in-plane resolution but 2-5 mm through-plane spacing, creating substantial anisotropy that degrades multiplanar reconstructions, volumetric measurements such as hematoma volume estimation, and downstream algorithms that assume near-isotropic voxels. We present a deep learning system that synthesizes intermediate CT slices from pairs of neighboring axial slices, halving the effective through-plane spacing. The system improves three-dimensional visualization while simultaneously producing inherently denoised outputs, yielding two complementary benefits from a single inference pass. To build a reliable system, we systematically evaluate pixel-wise losses, namely mean squared error (MSE) and mean absolute error (L1); structural-similarity losses, namely the structural similarity index (SSIM) and its multi-scale variant (MS-SSIM); and hybrid combinations. On a held-out test set, all converged models outperform classical interpolation baselines and pretrained video frame interpolation methods (RIFE, FILM) on all structural measures, with MS-SSIM+L1 offering the strongest balanced profile. We also document training instability in SSIM-family losses and identify partial remedies: the standard numerical fixes eliminate the dominant failure mode but leave residual divergence at smaller batch sizes. All results are reported with patient-level bootstrap confidence intervals and paired statistical tests. As an illustration, we apply the system to an out-of-distribution head CT series from Hospital Universitario Virgen del Rocío: the model synthesizes intermediate slices and exhibits on the real slices the implicit-denoising signature predicted by our theoretical analysis, supporting in a single external case that interpolation quality and implicit denoising are not confined to the training distribution.