BS-LDM: Effective Bone Suppression in High-Resolution Chest X-Ray Images with Conditional Latent Diffusion Models
Hangzhou Dianzi University（杭州电子科技大学）；National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital&Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College（中国医学科学院国家癌症中心/国家临床医学研究中心/癌症医院及深圳医院）；Central South University（中南大学）；Yunnan University（云南大学）；School of Biomedical Engineering, Shenzhen University（深圳大学生物医学工程学院）；Shenzhen Research Institute of Big Data（深圳大数据研究院）
Yifei Sun, Zhanghao Chen, Hao Zheng, Wenming Deng, Jin Liu, Wenwen Min, Ahmed Elazab, Xiang Wan, Changmiao Wang, Ruiquan Ge
备注：
12 pages, 8 figures, accepted by IEEE Journal of Biomedical and Health Informatics (JBHI) on July 4, 2025
Lung diseases represent a significant global health challenge, with Chest X-Ray (CXR) being a key diagnostic tool due to its accessibility and affordability. Nonetheless, the detection of pulmonary lesions is often hindered by overlapping bone structures in CXR images, leading to potential misdiagnoses. To address this issue, we develop an end-to-end framework called BS-LDM, designed to effectively suppress bone in high-resolution CXR images. This framework is based on conditional latent diffusion models and incorporates a multi-level hybrid loss-constrained vector-quantized generative adversarial network which is crafted for perceptual compression, ensuring the preservation of details. To further enhance the framework's performance, we utilize offset noise in the forward process, and a temporal adaptive thresholding strategy in the reverse process. These additions help minimize discrepancies in generating low-frequency information of soft tissue images. Additionally, we have compiled a high-quality bone suppression dataset named SZCH-X-Rays. This dataset includes 818 pairs of high-resolution CXR and soft tissue images collected from our partner hospital. Moreover, we processed 241 data pairs from the JSRT dataset into negative images, which are more commonly used in clinical practice. Our comprehensive experiments and downstream evaluations reveal that BS-LDM excels in bone suppression, underscoring its clinical value. Our code is available at https://github.com/diaoquesang/BS-LDM.
Imaging Biomarkers and Computer-aided Diagnosis Laboratory, Radiology and Imaging Sciences, National Institutes of Health Clinical Center（美国国立卫生研究院临床中心放射学与成像科学部成像生物标志物和计算机辅助诊断实验室）；Ping An Technology Co., Ltd.（平安科技有限公司）
Dual-energy (DE) chest radiography provides the capability of selectively imaging two clinically relevant materials, namely soft tissues, and osseous structures, to better characterize a wide variety of thoracic pathology and potentially improve diagnosis in posteroanterior (PA) chest radiographs. However, DE imaging requires specialized hardware and a higher radiation dose than conventional radiography, and motion artifacts sometimes happen due to involuntary patient motion. In this work, we learn the mapping between conventional radiographs and bone suppressed radiographs. Specifically, we p…
BS-Diff: Effective Bone Suppression Using Conditional Diffusion Models from Chest X-Ray Images
Hangzhou Dianzi University（杭州电子科技大学）；Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences（中国科学院深圳先进技术研究院）；Sanda University（上海杉达学院）；National Cancer Center, Chinese Academy of Medical Sciences（中国医学科学院国家癌症中心）；Peking Union Medical College（北京协和医学院）；Yunnan University（云南大学）；Shenzhen University（深圳大学）；Shenzhen Research Institute of Big Data（深圳大数据研究院）；Hangzhou Institute of Advanced Technology（杭州高等研究院）
Imperial College London（帝国理工学院）；University of Chinese Academy of Sciences（中国科学院大学）；Institute of Computing Technology, CAS（中国科学院计算技术研究所）；Peng Cheng Laboratory（鹏城实验室）；Southest University（东南大学）；Nankai University（南开大学）
Although chest X-ray (CXR) offers a 2D projection with overlapped anatomies, it is widely used for clinical diagnosis. There is clinical evidence supporting that decomposing an X-ray image into different components (e.g., bone, lung and soft tissue) improves diagnostic value. We hereby propose a decomposition generative adversarial network (DecGAN) to anatomically decompose a CXR image but with unpaired data. We leverage the anatomy knowledge embedded in CT, which features a 3D volume with clearly visible anatomies. Our key idea is to embed CT priori decomposition knowledge into the latent spa…
In this paper, we present a deep learning-based image processing technique for extraction of bone structures in chest radiographs using a U-Net FCNN. The U-Net was trained to accomplish the task in a fully supervised setting. To create the training image pairs, we employed simulated X-Ray or Digitally Reconstructed Radiographs (DRR), derived from 664 CT scans belonging to the LIDC-IDRI dataset. Using HU based segmentation of bone structures in the CT domain, a synthetic 2D "Bone x-ray" DRR is produced and used for training the network. For the reconstruction loss, we utilize two loss functions…
University of Maryland（马里兰大学）；PAII Inc.（PAII公司）；Alibaba Group DAMO Academy（阿里巴巴集团达摩院）；Xpeng Motors（小鹏汽车）；Ping An Technology（平安科技）；Chang Gung Memorial Hospital（长庚纪念医院）
Osteoporosis is a common chronic metabolic bone disease often under-diagnosed and under-treated due to the limited access to bone mineral density (BMD) examinations, e.g. via Dual-energy X-ray Absorptiometry (DXA). This paper proposes a method to predict BMD from Chest X-ray (CXR), one of the most commonly accessible and low-cost medical imaging examinations. Our method first automatically detects Regions of Interest (ROIs) of local CXR bone structures. Then a multi-ROI deep model with transformer encoder is developed to exploit both local and global information in the chest X-ray image for ac…
National Library of Medicine, National Institutes of Health（美国国立卫生研究院国家医学图书馆）
Chest X-ray (CXR) is a widely performed radiology examination that helps to detect abnormalities in the tissues and organs in the thoracic cavity. Detecting pulmonary abnormalities like COVID-19 may become difficult due to that they are obscured by the presence of bony structures like the ribs and the clavicles, thereby resulting in screening/diagnostic misinterpretations. Automated bone suppression methods would help suppress these bony structures and increase soft tissue visibility. In this study, we propose to build an ensemble of convolutional neural network models to suppress bones in fro…
National Library of Medicine, National Institutes of Health（美国国立卫生研究院国家医学图书馆）；Clinical Center, National Institutes of Health（美国国立卫生研究院临床中心）；Saint Louis University（圣路易斯大学）
Chest X-rays are the most commonly performed diagnostic examination to detect cardiopulmonary abnormalities. However, the presence of bony structures such as ribs and clavicles can obscure subtle abnormalities, resulting in diagnostic errors. This study aims to build a deep learning-based bone suppression model that identifies and removes these occluding bony structures in frontal CXRs to assist in reducing errors in radiological interpretation, including DL workflows, related to detecting manifestations consistent with tuberculosis (TB). Several bone suppression models with various deep archi…
GL-LCM: Global-Local Latent Consistency Models for Fast High-Resolution Bone Suppression in Chest X-Ray Images
Hangzhou Dianzi University（杭州电子科技大学）；The Chinese University of Hong Kong（香港中文大学）；University of Electronic Science and Technology of China（电子科技大学）；City University of Hong Kong（香港城市大学）；Shenzhen University（深圳大学）；Shenzhen Research Institute of Big Data（深圳大数据研究院）
University of Science, VNU-HCM（越南胡志明市国家大学科学大学）；Institute for Clarity in Documentation（文档清晰度研究所）；Inria Paris-Rocquencourt（法国国家信息与自动化研究所巴黎-罗克库尔中心）；Rajiv Gandhi University（拉吉夫·甘地大学）；Tsinghua University（清华大学）；Palmer Research Laboratories（帕尔默研究实验室）
Chest X-ray examination plays an important role in lung disease detection. The more accuracy of this task, the more experienced radiologists are required. After ChestX-ray14 dataset containing over 100,000 frontal-view X-ray images of 14 diseases was released, several models were proposed with high accuracy. In this paper, we develop a work flow for lung disease diagnosis in chest X-ray images, which can improve the average AUROC of the state-of-the-art model from 0.8414 to 0.8445. We apply image preprocessing steps before feeding to the 14 diseases detection model. Our project includes three …
Florida International University（佛罗里达国际大学）；Technical University of Munich（慕尼黑工业大学）；Stanford University（斯坦福大学）
Chest X-ray radiography is one of the earliest medical imaging technologies and remains one of the most widely-used for diagnosis, screening, and treatment follow up of diseases related to lungs and heart. The literature in this field of research reports many interesting studies dealing with the challenging tasks of bone suppression and organ segmentation but performed separately, limiting any learning that comes with the consolidation of parameters that could optimize both processes. This study, and for the first time, introduces a multitask deep learning model that generates simultaneously t…
University of Maryland College Park（马里兰大学学院公园分校）；PAII Inc.（PAII公司）；Chang Gung Memorial Hospital（长庚纪念医院）；Ping An Technology（平安科技）
Osteoporosis is a common chronic metabolic bone disease that is often under-diagnosed and under-treated due to the limited access to bone mineral density (BMD) examinations, Dual-energy X-ray Absorptiometry (DXA). In this paper, we propose a method to predict BMD from Chest X-ray (CXR), one of the most common, accessible, and low-cost medical image examinations. Our method first automatically detects Regions of Interest (ROIs) of local and global bone structures from the CXR. Then a multi-ROI model is developed to exploit both local and global information in the chest X-ray image for accurate …
Investigating the impact of kernel harmonization and deformable registration on inspiratory and expiratory chest CT images for people with COPD
Vanderbilt University（范德堡大学）；Insitro；Vanderbilt University Medical Center（范德堡大学医学中心）；Department of Veterans Affairs Medical Center（退伍军人事务部医疗中心）；Vanderbilt University Institute of Imaging Science（范德堡大学成像科学研究所）
针对 COPD 患者吸呼气 CT 因重建核差异导致定量分析误差的问题，提出两阶段流程：先用循环 GAN 进行核 harmonization，再进行可变形配准，显著降低肺气肿测量不一致性并提高配准精度。
Suppression of thoracic bone shadows on chest X-rays (CXRs) has been indicated to improve the diagnosis of pulmonary disease. Previous approaches can be categorized as unsupervised physical and supervised deep learning models. Nevertheless, with physical models able to preserve morphological details but at the cost of extremely long processing time, existing DL methods face challenges of gathering sufficient/qualitative ground truth (GT) for robust training, thus leading to failure in maintaining clinically acceptable false positive rates. We hereby propose a generalizable yet efficient workfl…
Osaka City University（大阪市立大学）；Osaka City University Hospital（大阪市立大学医院）
Background: Although there are many studies on the application of artificial intelligence (AI) models to medical imaging, there is no report of an AI model that determines the accumulation of ribs in bone metastases and trauma only using the anterior image of thorax of bone scintigraphy. In recent years, a method for visualizing diagnostic grounds called Gradient-weighted Class Activation Mapping (Grad-CAM) has been proposed in the area of diagnostic images using Deep Convolutional Neural Network (DCNN). As far as we have investigated, there are no reports of visualization of the diagnostic ba…
A knee cannot have lung disease: out-of-distribution detection with in-distribution voting using the medical example of chest X-ray classification
Munich Institute of Biomedical Engineering（慕尼黑生物医学工程研究所）；School of Computation, Information, and Technology（计算、信息与技术学院）；Technical University of Munich（慕尼黑工业大学）；Institute for History and Ethics in Medicine（医学史与医学伦理学研究所）；Munich School of Technology in Society（慕尼黑技术与社会学院）
Carnegie Mellon University（卡内基梅隆大学）；Faculty of Engineering of the University of Porto（波尔图大学工程学院）；INESC TEC（葡萄牙国家工程与系统创新研究所科技中心）
Advances in data-driven deep learning for chest X-ray image analysis underscore the need for explainability, privacy, large datasets and significant computational resources. We frame privacy and explainability as a lossy single-image compression problem to reduce both computational and data requirements without training. For Cardiomegaly detection in chest X-ray images, we propose HeartSpot and four spatial bias priors. HeartSpot priors define how to sample pixels based on domain knowledge from medical literature and from machines. HeartSpot privatizes chest X-ray images by discarding up to 97…
University of Technology Sydney（悉尼科技大学）；IBM Australia Limited（IBM澳大利亚有限公司）；University of New England（新英格兰大学）；King Abdulaziz University（阿卜杜勒阿齐兹国王大学）；Universiti Kebangsaan Malaysia（马来西亚国立大学）；Charles Sturt University（查尔斯特大学）；Westmead Hospital（韦斯特米德医院）；Singapore University of Social Sciences（新加坡社科大学）；Cogninet Australia（Cogninet澳大利亚）；University of Southern Queensland（南昆士兰大学）；Ngee Ann Polytechnic（义安理工学院）；Asia University（亚洲大学）
Lung cancer is the leading cause of cancer death worldwide and a good prognosis depends on early diagnosis. Unfortunately, screening programs for the early diagnosis of lung cancer are uncommon. This is in-part due to the at-risk groups being located in rural areas far from medical facilities. Reaching these populations would require a scaled approach that combines mobility, low cost, speed, accuracy, and privacy. We can resolve these issues by combining the chest X-ray imaging mode with a federated deep-learning approach, provided that the federated model is trained on homogenous data to ensu…
Full-resolution Lung Nodule Segmentation from Chest X-ray Images using Residual Encoder-Decoder Networks
University of Technology Sydney（悉尼科技大学）；IBM Australia Limited（IBM澳大利亚有限公司）；University of New England（新英格兰大学）；Universiti Kebangsaan Malaysia（马来西亚国民大学）；Charles Sturt University（查尔斯斯特大学）；Westmead Hospital（韦斯特米德医院）；Cogninet Australia（科尼尼特澳大利亚公司）；University of Southern Queensland（南昆士兰大学）；Data Science Institute, University of Technology Sydney（悉尼科技大学数据科学学院）
