From Sparse X-rays to 3D CT: Training-Free Reconstruction with Diffusion Priors
About
Solving 3D medical inverse problems typically requires training dedicated supervised models for each specific task and measurement setting. To break this dependency, we present TF-PRDiT: a training-free conditional sampling framework that converts a frozen voxel-level 3D Diffusion Transformer prior into a versatile inverse medical problem solver. Building on the posterior-sampling view of diffusion inverse solvers, TF-PRDiT enforces measurement consistency during sampling via a task-specific forward operator rather than updating model weights, enabling a single pretrained prior to be reused across diverse conditional settings. Our method combines a predictor-corrector sampler with likelihood-based guidance on the denoised prediction, providing stable data-fidelity correction while preserving the underlying 3D anatomical prior. We highlight our framework's capability on the challenging task of X-ray-to-CT reconstruction by integrating a differentiable DRR projector to allow gradients to propagate directly from projection space back to voxels without any retraining. Experiments on LIDC-IDRI demonstrate that TF-PRDiT achieves strong reconstruction quality and uniquely scales to an arbitrary number of input X-rays (1-12) under a unified model, with performance improving consistently as additional views are provided. Beyond X-ray-to-CT, we show that simply swapping the forward operator extends the same frozen model to 3D super-resolution, volumetric infilling, and deblurring without any task-specific retraining, demonstrating that a single 3D diffusion prior can serve as a universal solver for volumetric medical inverse problems.