# 3D Ultrasound-Derived Pseudo-CT Synthesis Using a Transformer-Augmented Residual Network for Real-Time Operator Guidance

arXiv: https://arxiv.org/abs/2605.04856 · HTML: https://mlsanity.com/paper/2605.04856/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 10 of its 33 references that are in the map.
- First posted on arXiv 6 May 2026.

## Builds on (most cited first, 10 of 10)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [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)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Can Spatiotemporal 3D CNNs Retrace the History of 2D CNNs and ImageNet?](https://mlsanity.com/paper/1711.09577/) (2017)
- [ResViT: Residual vision transformers for multi-modal medical image synthesis](https://mlsanity.com/paper/2106.16031/) (2021)
- [Cross-conditioned Diffusion Model for Medical Image to Image Translation](https://mlsanity.com/paper/2409.08500/) (2024)
- [cWDM: Conditional Wavelet Diffusion Models for Cross-Modality 3D Medical Image Synthesis](https://mlsanity.com/paper/2411.17203/) (2024)
- [TRUSTED: The Paired 3D Transabdominal Ultrasound and CT Human Data for Kidney Segmentation and Registration Research](https://mlsanity.com/paper/2310.12646/) (2023)
- [Deep Regression 2D-3D Ultrasound Registration for Liver Motion Correction in Focal Tumor Thermal Ablation](https://mlsanity.com/paper/2410.02579/) (2024)

## Abstract (arXiv)

Computed tomography (CT) is indispensable for clinical diagnosis and image-guided interventions but exposes patients to ionizing radiation, motivating the development of safer imaging alternatives. Ultrasound (US) is non-ionizing and widely accessible; however, it is highly operator dependent and lacks quantitative tissue characterization, often leading to diagnostic uncertainty and unnecessary CT examinations. This work presents a 3D ultrasound-derived pseudo-CT (UD-pCT) framework that generates CT-like anatomical reference volumes inferred from US, without aiming to reproduce physically accurate Hounsfield Units. Paired 3D kidney US and CT volumes from the TRUSTED dataset are first spatially aligned using a landmark-based multimodal registration pipeline, creating high-quality paired inputs for supervised training of an adversarial framework. The proposed Bottleneck Transformer Residual U-Net3D (BT-ResUNet3D) model employs a 3D residual encoder-decoder generator augmented with a transformer bottleneck, enabling effective modeling of fine-grained local anatomical structures as well as long-range volumetric dependencies, while a 3D Conditional PatchGAN discriminator enforces local structural realism in the synthesized pseudo-CT volumes. Quantitative evaluation using PSNR and SSIM demonstrates that the proposed method outperforms established baselines in structural fidelity and perceptual image quality. The UD-pCT volumes provide real-time anatomical reference for operator guidance, potentially reducing acquisition variability and unnecessary CT use. A limitation of this study is the relatively small paired dataset, which may limit the generalizability of the proposed model.