Knowledge-Guided 3D CT Generation: A Conditioning-Centric Taxonomy

Controllable generation guided by external knowledge is a key requirement in modern generative deep learning applications, enabling the synthesis of samples with explicit constraints on semantic content, structural properties, and variability. In 3D Computed Tomography (CT), such control is essential for clinical applications, including data augmentation, privacy-preserving data sharing, and the simulation of specific anatomical or pathological scenarios. While research on conditional 3D CT generation has expanded rapidly, the diversity of existing approaches makes systematic comparison difficult and obscures fundamental design choices. In this survey, we propose a conditioning-centric taxonomy that organizes the literature along three orthogonal dimensions: the type of external knowledge (K), the knowledge integration paradigm (I), and the generative architecture (A). This factorization defines an explicit design space (K x I x A) that provides a unified perspective on prior work. Using this framework, we systematize existing methods, identify dominant trends and recurring design patterns, and highlight underexplored regions of the design space that point toward promising directions for future research.

Pixel-Level Residual Diffusion Transformer: Scalable 3D CT Volume Generation

Generating high-resolution 3D CT volumes with fine details remains challenging due to substantial computational demands and optimization difficulties inherent to existing generative models. In this paper, we propose the Pixel-Level Residual Diffusion Transformer (PRDiT), a scalable generative framework that synthesizes high-quality 3D medical volumes directly at voxel-level. PRDiT introduces a two-stage training architecture comprising 1) a local denoiser in the form of an MLP-based blind estimator operating on overlapping 3D patches to separate low-frequency structures efficiently, and 2) a global residual diffusion transformer employing memory-efficient attention to model and refine high-frequency residuals across entire volumes. This coarse-to-fine modeling strategy simplifies optimization, enhances training stability, and effectively preserves subtle structures without the limitations of an autoencoder bottleneck. Extensive experiments conducted on the LIDC-IDRI and RAD-ChestCT datasets demonstrate that PRDiT consistently outperforms state-of-the-art models, such as HA-GAN, 3D LDM and WDM-3D, achieving significantly lower 3D FID, MMD and Wasserstein distance scores.