# Human-Guided Shade Artifact Suppression in CBCT-to-MDCT Translation via Schr"odinger Bridge with Conditional Diffusion

arXiv: https://arxiv.org/abs/2507.11025 · HTML: https://mlsanity.com/paper/2507.11025/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 26 of its 36 references that are in the map.
- First posted on arXiv 15 Jul 2025.

## Builds on (most cited first, 26 of 26)

- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [The Unreasonable Effectiveness of Deep Features as a Perceptual Metric](https://mlsanity.com/paper/1801.03924/) (2018)
- [Score-Based Generative Modeling through Stochastic Differential Equations](https://mlsanity.com/paper/2011.13456/) (2020)
- [Diffusion Models Beat GANs on Image Synthesis](https://mlsanity.com/paper/2105.05233/) (2021)
- [Direct Preference Optimization: Your Language Model is Secretly a Reward Model](https://mlsanity.com/paper/2305.18290/) (2023)
- [Deep Unsupervised Learning using Nonequilibrium Thermodynamics](https://mlsanity.com/paper/1503.03585/) (2015)
- [Classifier-Free Diffusion Guidance](https://mlsanity.com/paper/2207.12598/) (2022)
- [Adding Conditional Control to Text-to-Image Diffusion Models](https://mlsanity.com/paper/2302.05543/) (2023)
- [Deep reinforcement learning from human preferences](https://mlsanity.com/paper/1706.03741/) (2017)
- [Learning to summarize from human feedback](https://mlsanity.com/paper/2009.01325/) (2020)
- [Image Super-Resolution via Iterative Refinement](https://mlsanity.com/paper/2104.07636/) (2021)
- [Diffusion Schr"odinger Bridge with Applications to Score-Based Generative Modeling](https://mlsanity.com/paper/2106.01357/) (2021)
- [Tackling the Generative Learning Trilemma with Denoising Diffusion GANs](https://mlsanity.com/paper/2112.07804/) (2021)
- [Come-Closer-Diffuse-Faster: Accelerating Conditional Diffusion Models for Inverse Problems through Stochastic Contraction](https://mlsanity.com/paper/2112.05146/) (2021)
- [Diffusion Models for Medical Anomaly Detection](https://mlsanity.com/paper/2203.04306/) (2022)
- [I2SB: Image-to-Image Schr"odinger Bridge](https://mlsanity.com/paper/2302.05872/) (2023)
- [Unsupervised Medical Image Translation with Adversarial Diffusion Models](https://mlsanity.com/paper/2207.08208/) (2022)
- [Low Dose CT Image Denoising Using a Generative Adversarial Network with Wasserstein Distance and Perceptual Loss](https://mlsanity.com/paper/1708.00961/) (2017)
- [Unleashing Transformers: Parallel Token Prediction with Discrete Absorbing Diffusion for Fast High-Resolution Image Generation from Vector-Quantized Codes](https://mlsanity.com/paper/2111.12701/) (2021)
- [Cross-modality image synthesis from unpaired data using CycleGAN: Effects of gradient consistency loss and training data size](https://mlsanity.com/paper/1803.06629/) (2018)
- [Zero-shot Medical Image Translation via Frequency-Guided Diffusion Models](https://mlsanity.com/paper/2304.02742/) (2023)
- [Towards More Accurate Diffusion Model Acceleration with A Timestep Tuner](https://mlsanity.com/paper/2310.09469/) (2023)
- [HiDiff: Hybrid Diffusion Framework for Medical Image Segmentation](https://mlsanity.com/paper/2407.03548/) (2024)
- [Preference-Based Alignment of Discrete Diffusion Models](https://mlsanity.com/paper/2503.08295/) (2025)
- [Cascaded Multi-path Shortcut Diffusion Model for Medical Image Translation](https://mlsanity.com/paper/2405.12223/) (2024)
- [Diffusion Schr"odinger Bridge Models for High-Quality MR-to-CT Synthesis for Head and Neck Proton Treatment Planning](https://mlsanity.com/paper/2404.11741/) (2024)

## Abstract (arXiv)

We present a novel framework for CBCT-to-MDCT translation, grounded in the Schrodinger Bridge (SB) formulation, which integrates GAN-derived priors with human-guided conditional diffusion. Unlike conventional GANs or diffusion models, our approach explicitly enforces boundary consistency between CBCT inputs and pseudo targets, ensuring both anatomical fidelity and perceptual controllability. Binary human feedback is incorporated via classifier-free guidance (CFG), effectively steering the generative process toward clinically preferred outcomes. Through iterative refinement and tournament-based preference selection, the model internalizes human preferences without relying on a reward model. Subtraction image visualizations reveal that the proposed method selectively attenuates shade artifacts in key anatomical regions while preserving fine structural detail. Quantitative evaluations further demonstrate superior performance across RMSE, SSIM, LPIPS, and Dice metrics on clinical datasets -- outperforming prior GAN- and fine-tuning-based feedback methods -- while requiring only 10 sampling steps. These findings underscore the effectiveness and efficiency of our framework for real-time, preference-aligned medical image translation.