Clinical Metadata Guided Limited-Angle CT Image Reconstruction.

Limited-angle computed tomography (LACT) offers improved temporal resolution and reduced radiation dose for cardiac imaging, but suffers from severe artifacts due to truncated projections. To address the ill-posedness of LACT reconstruction, we propose a two-stage diffusion framework guided by structured clinical metadata. In the first stage, a transformer-based diffusion model conditioned exclusively on metadata, including acquisition parameters, patient demographics, and diagnostic impressions, generates coarse anatomical priors from noise. The second stage further refines the images by integrating both the coarse prior and metadata to produce high-fidelity results. Physics-based data consistency is enforced at each sampling step in both stages using an Alternating Direction Method of Multipliers module, ensuring alignment with the measured projections. Extensive experiments on both synthetic and real cardiac CT datasets demonstrate that incorporating metadata significantly improves reconstruction fidelity, particularly under severe angular truncation. Compared to existing metadata-free baselines, our method achieves superior performance in SSIM, PSNR, nMI, and PCC. Ablation studies confirm that different types of metadata contribute complementary benefits, particularly diagnostic and demographic priors under limited-angle conditions. These findings highlight the dual role of clinical metadata in improving both reconstruction quality and efficiency, supporting their integration into future metadata-guided medical imaging frameworks.