Data Engineering in Medical Imaging: Third MICCAI Workshop, DEMI 2025, Held in Conjunction with MICCAI 2025, Daejeon, South Korea, September 27, 2025, Proceedings
Deep learning-based automated diagnosis of lung cancer has emerged as a crucial advancement that enables healthcare professionals to detect and initiate treatment earlier. However, these models require extensive training datasets with diverse case-specific properties. High-quality annotated data is particularly challenging to obtain, especially for cases with subtle pulmonary nodules that are difficult to detect even for experienced radiologists. This scarcity of well-labeled datasets can limit model performance and generalization across different patient populations. Digitally reconstructed radiographs (DRR) using CT-Scan to generate synthetic frontal chest X-rays with artificially inserted lung nodules offers one potential solution. However, this approach suffers from significant image quality degradation, particularly in the form of blurred anatomical features and loss of fine lung field structures. To overcome this, we introduce DiffusionXRay, a novel image restoration pipeline for Chest X-ray images that synergistically leverages denoising diffusion probabilistic models (DDPMs) and generative adversarial networks (GANs). DiffusionXRay incorporates a unique two-stage training process: First, we investigate two independent approaches, DDPM-LQ and GAN-based MUNIT-LQ, to generate low-quality CXRs, addressing the challenge of training data scarcity, posing this as a style transfer problem. Subsequently, we train a DDPM-based model on paired low-quality and high-quality images, enabling it to learn the nuances of X-ray image restoration. Our method demonstrates promising results in enhancing image clarity, contrast, and overall diagnostic value of chest X-rays while preserving subtle yet clinically significant artifacts, validated by both quantitative metrics and expert radiological assessment.
Development of an Unpaired Deep Neural Network for Synthesizing X-ray Fluoroscopic Images from Digitally Reconstructed Tomography in Image Guided Radiotherapy
Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology（量子科学技术研究开发机构量子医疗科学研究所）；Graduate School of Science and Engineering, Chiba University（千叶大学大学院理工学研究科）；Graduate School of Engineering, Chiba University（千叶大学大学院工学研究科）；QST hospital, National Institutes for Quantum Science and Technology（量子科学技术研究开发机构QST医院）
Harvard-MIT Health Sciences and Technology（哈佛-麻省理工卫生科学与技术部）；Massachusetts Institute of Technology（麻省理工学院）；Computer Science and Artificial Intelligence Laboratory（计算机科学与人工智能实验室）
The use of digitally reconstructed radiographs (DRRs) to solve inverse problems such as slice-to-volume registration and 3D reconstruction is well-studied in preoperative settings. In intraoperative imaging, the utility of DRRs is limited by the challenges in generating them in real-time and supporting optimization procedures that rely on repeated DRR synthesis. While immense progress has been made in accelerating the generation of DRRs through algorithmic refinements and GPU implementations, DRR-based optimization remains slow because most DRR generators do not offer a straightforward way to …
Automated infection measurement and COVID-19 diagnosis based on Chest X-ray (CXR) imaging is important for faster examination. We propose a novel approach, called DRR4Covid, to learn automated COVID-19 diagnosis and infection segmentation on CXRs from digitally reconstructed radiographs (DRRs). DRR4Covid comprises of an infection-aware DRR generator, a classification and/or segmentation network, and a domain adaptation module. The infection-aware DRR generator is able to produce DRRs with adjustable strength of radiological signs of COVID-19 infection, and generate pixel-level infection annota…
Perelman School of Medicine, University of Pennsylvania（宾夕法尼亚大学佩雷尔曼医学院）；Siemens Healthineers（西门子医疗）
Purpose: To leverage volumetric quantification of airspace disease (AD) derived from a superior modality (CT) serving as ground truth, projected onto digitally reconstructed radiographs (DRRs) to: 1) train a convolutional neural network to quantify airspace disease on paired CXRs; and 2) compare the DRR-trained CNN to expert human readers in the CXR evaluation of patients with confirmed COVID-19. Materials and Methods: We retrospectively selected a cohort of 86 COVID-19 patients (with positive RT-PCR), from March-May 2020 at a tertiary hospital in the northeastern USA, who underwent chest CT a…
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…
Rensselaer Polytechnic Institute（伦斯勒理工学院）；Massachusetts General Hospital（麻省总医院）；Harvard Medical School（哈佛医学院）
Although radiographs are the most frequently used worldwide due to their cost-effectiveness and widespread accessibility, the structural superposition along the x-ray paths often renders suspicious or concerning lung nodules difficult to detect. In this study, we apply "X-ray dissectography" to dissect lungs digitally from a few radiographic projections, suppress the interference of irrelevant structures, and improve lung nodule detectability. For this purpose, a collaborative detection network is designed to localize lung nodules in 2D dissected projections and 3D physical space. Our experime…
The abundance of overlapping anatomical structures appearing in chest radiographs can reduce the performance of lung pathology detection by automated algorithms (CAD) as well as the human reader. In this paper, we present a deep learning based image processing technique for enhancing the contrast of soft lung structures in chest radiographs using Fully Convolutional Neural Networks (FCNN). Two 2D FCNN architectures were trained to accomplish the task: The first performs 2D lung segmentation which is used for normalization of the lung area. The second FCNN is trained to extract lung structures.…
Newton-Wellesley Hospital and Harvard Medical School（牛顿-韦尔斯利医院与哈佛医学院）；Massachusetts General Hospital and Harvard Medical School（麻省总医院与哈佛医学院）
Registration of 3D anatomic structures to their 2D dual fluoroscopic X-ray images is a widely used motion tracking technique. However, deep learning implementation is often impeded by a paucity of medical images and ground truths. In this study, we proposed a transfer learning strategy for 3D-to-2D registration using deep neural networks trained from an artificial dataset. Digitally reconstructed radiographs (DRRs) and radiographic skull landmarks were automatically created from craniocervical CT data of a female subject. They were used to train a residual network (ResNet) for landmark detecti…
Machine-Learning Based Detection of Coronary Artery Calcification Using Synthetic Chest X-Rays
School of Computer Science and Engineering, University of New South Wales（新南威尔士大学计算机科学与工程学院）；School of Mechanical and Manufacturing Engineering, University of New South Wales（新南威尔士大学机械与制造工程学院）；Independent Researcher, Sydney, Australia（独立研究者）
Case Western Reserve University（凯斯西储大学）；Medical Imaging Technologies, Siemens Healthineers Technology Center（西门子医疗技术中心医学影像技术部）
Automatic parsing of anatomical objects in X-ray images is critical to many clinical applications in particular towards image-guided invention and workflow automation. Existing deep network models require a large amount of labeled data. However, obtaining accurate pixel-wise labeling in X-ray images relies heavily on skilled clinicians due to the large overlaps of anatomy and the complex texture patterns. On the other hand, organs in 3D CT scans preserve clearer structures as well as sharper boundaries and thus can be easily delineated. In this paper, we propose a novel model framework for lea…
University of North Carolina at Chapel Hill（北卡罗来纳大学教堂山分校）；Kitware, Inc.（Kitware公司）
Registration is widely used in image-guided therapy and image-guided surgery to estimate spatial correspondences between organs of interest between planning and treatment images. However, while high-quality computed tomography (CT) images are often available at planning time, limited angle acquisitions are frequently used during treatment because of radiation concerns or imaging time constraints. This requires algorithms to register CT images based on limited angle acquisitions. We, therefore, formulate a 3D/2D registration approach which infers a 3D deformation based on measured projections a…
Radboud University Medical Center（拉德堡德大学医学中心）；Netherlands Cancer Institute (NKI)（荷兰癌症研究所）；Z 2 Sky Technologies Inc.（Z 2 Sky 技术公司）；Johns Hopkins University（约翰斯·霍普金斯大学）；University of Science and Technology of China（中国科学技术大学）；Institute of Computing Technology, CAS（中国科学院计算技术研究所）
Clinical evidence has shown that rib-suppressed chest X-rays (CXRs) can improve the reliability of pulmonary disease diagnosis. However, previous approaches on generating rib-suppressed CXR face challenges in preserving details and eliminating rib residues. We hereby propose a GAN-based disentanglement learning framework called Rib Suppression GAN, or RSGAN, to perform rib suppression by utilizing the anatomical knowledge embedded in unpaired computed tomography (CT) images. In this approach, we employ a residual map to characterize the intensity difference between CXR and the corresponding ri…
