# Distilling Photon-Counting CT into Routine Chest CT through Clinically Validated Degradation Modeling

arXiv: https://arxiv.org/abs/2604.07329 · HTML: https://mlsanity.com/paper/2604.07329/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 24 of its 38 references that are in the map.
- First posted on arXiv 8 Apr 2026.

## Builds on (most cited first, 24 of 24)

- [High-Resolution Image Synthesis with Latent Diffusion Models](https://mlsanity.com/paper/2112.10752/) (2021)
- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [Photo-Realistic Single Image Super-Resolution Using a Generative Adversarial Network](https://mlsanity.com/paper/1609.04802/) (2016)
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- [MONAI: An open-source framework for deep learning in healthcare](https://mlsanity.com/paper/2211.02701/) (2022)
- [Med3D: Transfer Learning for 3D Medical Image Analysis](https://mlsanity.com/paper/1904.00625/) (2019)
- [Validation, comparison, and combination of algorithms for automatic detection of pulmonary nodules in computed tomography images: the LUNA16 challenge](https://mlsanity.com/paper/1612.08012/) (2016)
- [Generalist Foundation Models from a Multimodal Dataset for 3D Computed Tomography](https://mlsanity.com/paper/2403.17834/) (2024)
- [Swin2SR: SwinV2 Transformer for Compressed Image Super-Resolution and Restoration](https://mlsanity.com/paper/2209.11345/) (2022)
- [VISTA3D: A Unified Segmentation Foundation Model For 3D Medical Imaging](https://mlsanity.com/paper/2406.05285/) (2024)
- [Evaluate the Malignancy of Pulmonary Nodules Using the 3D Deep Leaky Noisy-or Network](https://mlsanity.com/paper/1711.08324/) (2017)
- [CoreDiff: Contextual Error-Modulated Generalized Diffusion Model for Low-Dose CT Denoising and Generalization](https://mlsanity.com/paper/2304.01814/) (2023)
- [3D MedDiffusion: A 3D Medical Latent Diffusion Model for Controllable and High-quality Medical Image Generation](https://mlsanity.com/paper/2412.13059/) (2024)
- [Medical World Model: Generative Simulation of Tumor Evolution for Treatment Planning](https://mlsanity.com/paper/2506.02327/) (2025)
- [LNDb: A Lung Nodule Database on Computed Tomography](https://mlsanity.com/paper/1911.08434/) (2019)
- [Diffusion Probabilistic Priors for Zero-Shot Low-Dose CT Image Denoising](https://mlsanity.com/paper/2305.15887/) (2023)
- [MAISI-v2: Accelerated 3D High-Resolution Medical Image Synthesis with Rectified Flow and Region-specific Contrastive Loss](https://mlsanity.com/paper/2508.05772/) (2025)
- [MedSegFactory: Text-Guided Generation of Medical Image-Mask Pairs](https://mlsanity.com/paper/2504.06897/) (2025)
- [Text2CT: Towards 3D CT Volume Generation from Free-text Descriptions Using Diffusion Model](https://mlsanity.com/paper/2505.04522/) (2025)
- [Deep Learning for Lung Cancer Detection: Tackling the Kaggle Data Science Bowl 2017 Challenge](https://mlsanity.com/paper/1705.09435/) (2017)
- [Noise-Inspired Diffusion Model for Generalizable Low-Dose CT Reconstruction](https://mlsanity.com/paper/2506.22012/) (2025)
- [Are Pixel-Wise Metrics Reliable for Sparse-View Computed Tomography Reconstruction?](https://mlsanity.com/paper/2506.02093/) (2025)
- [See More, Change Less: Anatomy-Aware Diffusion for Contrast Enhancement](https://mlsanity.com/paper/2512.07251/) (2025)
- [Photon-Counting CT in Cancer Radiotherapy: Technological Advances and Clinical Benefits](https://mlsanity.com/paper/2410.20236/) (2024)

## Abstract (arXiv)

Photon-counting CT (PCCT) provides superior image quality with higher spatial resolution and lower noise compared to conventional energy-integrating CT (EICT), but its limited clinical availability restricts large-scale research and clinical deployment. To bridge this gap, we propose SUMI, a simulated degradation-to-enhancement method that learns to reverse realistic acquisition artifacts in low-quality EICT by leveraging high-quality PCCT as reference. Our central insight is to explicitly model realistic acquisition degradations, transforming PCCT into clinically plausible lower-quality counterparts and learning to invert this process. The simulated degradations were validated for clinical realism by board-certified radiologists, enabling faithful supervision without requiring paired acquisitions at scale. As outcomes of this technical contribution, we: (1) train a latent diffusion model on 1,046 PCCTs, using an autoencoder first pre-trained on both these PCCTs and 405,379 EICTs from 145 hospitals to extract general CT latent features that we release for reuse in other generative medical imaging tasks; (2) construct a large-scale dataset of over 17,316 publicly available EICTs enhanced to PCCT-like quality, with radiologist-validated voxel-wise annotations of airway trees, arteries, veins, lungs, and lobes; and (3) demonstrate substantial improvements: across external data, SUMI outperforms state-of-the-art image translation methods by 15% in SSIM and 20% in PSNR, improves radiologist-rated clinical utility in reader studies, and enhances downstream top-ranking lesion detection performance, increasing sensitivity by up to 15% and F1 score by up to 10%. Our results suggest that emerging imaging advances can be systematically distilled into routine EICT using limited high-quality scans as reference.