# Are Pixel-Wise Metrics Reliable for Sparse-View Computed Tomography Reconstruction?

arXiv: https://arxiv.org/abs/2506.02093 · HTML: https://mlsanity.com/paper/2506.02093/

## Key facts

- Cited by 6 papers in the map (data through 14 Oct 2026).
- Builds on 30 of its 66 references that are in the map.
- First posted on arXiv 2 Jun 2025.

## Builds on (most cited first, 30 of 30)

- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [High-Resolution Image Synthesis with Latent Diffusion Models](https://mlsanity.com/paper/2112.10752/) (2021)
- [The Unreasonable Effectiveness of Deep Features as a Perceptual Metric](https://mlsanity.com/paper/1801.03924/) (2018)
- [Image Super-Resolution via Iterative Refinement](https://mlsanity.com/paper/2104.07636/) (2021)
- [Demystifying MMD GANs](https://mlsanity.com/paper/1801.01401/) (2018)
- [TensoRF: Tensorial Radiance Fields](https://mlsanity.com/paper/2203.09517/) (2022)
- [clDice -- A Novel Topology-Preserving Loss Function for Tubular Structure Segmentation](https://mlsanity.com/paper/2003.07311/) (2020)
- [nnU-Net Revisited: A Call for Rigorous Validation in 3D Medical Image Segmentation](https://mlsanity.com/paper/2404.09556/) (2024)
- [CLIP-Driven Universal Model for Organ Segmentation and Tumor Detection](https://mlsanity.com/paper/2301.00785/) (2023)
- [Gradient Magnitude Similarity Deviation: A Highly Efficient Perceptual Image Quality Index](https://mlsanity.com/paper/1308.3052/) (2013)
- [MedNeXt: Transformer-driven Scaling of ConvNets for Medical Image Segmentation](https://mlsanity.com/paper/2303.09975/) (2023)
- [NAF: Neural Attenuation Fields for Sparse-View CBCT Reconstruction](https://mlsanity.com/paper/2209.14540/) (2022)
- [STU-Net: Scalable and Transferable Medical Image Segmentation Models Empowered by Large-Scale Supervised Pre-training](https://mlsanity.com/paper/2304.06716/) (2023)
- [Structure-Aware Sparse-View X-ray 3D Reconstruction](https://mlsanity.com/paper/2311.10959/) (2023)
- [R2-Gaussian: Rectifying Radiative Gaussian Splatting for Tomographic Reconstruction](https://mlsanity.com/paper/2405.20693/) (2024)
- [Towards Generalizable Tumor Synthesis](https://mlsanity.com/paper/2402.19470/) (2024)
- [AbdomenAtlas: A Large-Scale, Detailed-Annotated, & Multi-Center Dataset for Efficient Transfer Learning and Open Algorithmic Benchmarking](https://mlsanity.com/paper/2407.16697/) (2024)
- [Medformer: A Multi-Granularity Patching Transformer for Medical Time-Series Classification](https://mlsanity.com/paper/2405.19363/) (2024)
- [Universal and Extensible Language-Vision Models for Organ Segmentation and Tumor Detection from Abdominal Computed Tomography](https://mlsanity.com/paper/2405.18356/) (2024)
- [Touchstone Benchmark: Are We on the Right Way for Evaluating AI Algorithms for Medical Segmentation?](https://mlsanity.com/paper/2411.03670/) (2024)
- [Stable Diffusion Segmentation for Biomedical Images with Single-step Reverse Process](https://mlsanity.com/paper/2406.18361/) (2024)
- [Text-Driven Tumor Synthesis](https://mlsanity.com/paper/2412.18589/) (2024)
- [DIFR3CT: Latent Diffusion for Probabilistic 3D CT Reconstruction from Few Planar X-Rays](https://mlsanity.com/paper/2408.15118/) (2024)
- [Global-Local Image Perceptual Score (GLIPS): Evaluating Photorealistic Quality of AI-Generated Images](https://mlsanity.com/paper/2405.09426/) (2024)
- [X-LRM: X-ray Large Reconstruction Model for Extremely Sparse-View Computed Tomography Recovery in One Second](https://mlsanity.com/paper/2503.06382/) (2025)
- [EAGLE: An Edge-Aware Gradient Localization Enhanced Loss for CT Image Reconstruction](https://mlsanity.com/paper/2403.10695/) (2024)
- [MSDiff: Multi-Scale Diffusion Model for Ultra-Sparse View CT Reconstruction](https://mlsanity.com/paper/2405.05814/) (2024)
- [Enhancing signal detectability in learning-based CT reconstruction with a model observer inspired loss function](https://mlsanity.com/paper/2402.10010/) (2024)
- [Arbitrarily large iterative tomographic reconstruction on multiple GPUs using the TIGRE toolbox](https://mlsanity.com/paper/1905.03748/) (2019)
- [CT-SDM: A Sampling Diffusion Model for Sparse-View CT Reconstruction across All Sampling Rates](https://mlsanity.com/paper/2409.01571/) (2024)

## Built on by (most cited first, 6 of 6)

- [Scaling Tumor Segmentation: Best Lessons from Real and Synthetic Data](https://mlsanity.com/paper/2510.14831/) (2025)
- [MedGS: Gaussian Splatting for Multi-Modal 3D Medical Imaging](https://mlsanity.com/paper/2509.16806/) (2025)
- [See More, Change Less: Anatomy-Aware Diffusion for Contrast Enhancement](https://mlsanity.com/paper/2512.07251/) (2025)
- [Auditing Significance, Metric Choice, and Demographic Fairness in Medical AI Challenges](https://mlsanity.com/paper/2512.19091/) (2025)
- [Inference-Time Search Using Side Information for Diffusion-Based Image Reconstruction](https://mlsanity.com/paper/2510.03352/) (2025)
- [Distilling Photon-Counting CT into Routine Chest CT through Clinically Validated Degradation Modeling](https://mlsanity.com/paper/2604.07329/) (2026)

## Abstract (arXiv)

Widely adopted evaluation metrics for sparse-view CT reconstruction--such as Structural Similarity Index Measure and Peak Signal-to-Noise Ratio--prioritize pixel-wise fidelity but often fail to capture the completeness of critical anatomical structures, particularly small or thin regions that are easily missed. To address this limitation, we propose a suite of novel anatomy-aware evaluation metrics designed to assess structural completeness across anatomical structures, including large organs, small organs, intestines, and vessels. Building on these metrics, we introduce CARE, a Completeness-Aware Reconstruction Enhancement framework that incorporates structural penalties during training to encourage anatomical preservation of significant structures. CARE is model-agnostic and can be seamlessly integrated into analytical, implicit, and generative methods. When applied to these methods, CARE substantially improves structural completeness in CT reconstructions, achieving up to +32% improvement for large organs, +22% for small organs, +40% for intestines, and +36% for vessels.