Enabling Real-Time Volumetric Imaging in Interventional Radiology Suits via a Deep Learning Framework Robust to C-arm Tilt

arXiv:2511.13980v1 Announce Type: new
Abstract: Contemporary interventional imaging lacks the real-time 3D guidance needed for the precise localization of mobile thoracic targets. While Cone-Beam CT (CBCT) provides 3D data, it is often too slow for dynamic motion tracking. Deep learning frameworks that reconstruct 3D volumes from sparse 2D projections offer a promising solution, but their performance under the geometrically complex, non-zero tilt acquisitions common in interventional radiology is unknown. This study evaluates the robustness of a patient-specific deep learning framework, designed to estimate 3D motion, to a range of C-arm cranial-caudal tilts. Using a 4D digital phantom with a simulated respiratory cycle, 2D X-ray projections were simulated at five cranial-caudal tilt angles across 10 breathing phases. A separate deep learning model was trained for each tilt condition to reconstruct 3D volumetric images. The framework demonstrated consistently high-fidelity reconstruction across all tilts, with a mean Structural Similarity Index (SSIM) > 0.980. While statistical analysis revealed significant differences in performance between tilt groups (p