Cone-beam computed tomography (CBCT) is widely used in image-guided radiotherapy. Reconstructing CBCTs from limited-angle acquisitions (LA-CBCT) is highly desired for improved imaging efficiency, dose reduction, and better mechanical clearance. LA-CBCT reconstruction, however, suffers from severe under-sampling artifacts, making it a highly ill-posed inverse problem. Diffusion models can generate data/images by reversing a data-noising process through learned data distributions; and can be incorporated as a denoiser/regularizer in LA-CBCT reconstruction. In this study, we developed a diffusion model-based framework, prior frequency-guided diffusion model (PFGDM), for robust and structure-preserving LA-CBCT reconstruction. PFGDM uses a conditioned diffusion model as a regularizer for LA-CBCT reconstruction, and the condition is based on high-frequency information extracted from patient-specific prior CT scans which provides a strong anatomical prior for LA-CBCT reconstruction. Specifically, we developed two variants of PFGDM (PFGDM-A and PFGDM-B) with different conditioning schemes. PFGDM-A applies the high-frequency CT information condition until a pre-optimized iteration step, and drops it afterwards to enable both similar and differing CT/CBCT anatomies to be reconstructed. PFGDM-B, on the other hand, continuously applies the prior CT information condition in every reconstruction step, while with a decaying mechanism, to gradually phase out the reconstruction guidance from the prior CT scans. The two variants of PFGDM were tested and compared with current available LA-CBCT reconstruction solutions, via metrics including PSNR and SSIM. PFGDM outperformed all traditional and diffusion model-based methods. PFGDM reconstructs high-quality LA-CBCTs under very-limited gantry angles, allowing faster and more flexible CBCT scans with dose reductions.

通过条件扩散模型和高频CT信息，我们开发了一种用于限制角度下CBCT重建的鲁棒且具有结构保持特性的方法(PFGDM)，实验证明PFGDM在有限的转台角度下能够重建高质量的LA-CBCT，实现更快速、更灵活和剂量减少的CBCT扫描。

有限视角（LA）CBCT重建的先验频率引导扩散模型