CTForensics: A Comprehensive Dataset and Method for AI-Generated CT Image Detection

Recent advances in generative AI have made synthetic Computed Tomography (CT) images increasingly realistic, enabling promising applications in medical data augmentation while raising serious concerns about clinical safety and data trustworthiness. Detecting AI-generated CT images remains challenging for two key reasons: existing benchmarks cover only limited generation sources, and many detectors are adapted from natural-image forensics without explicitly modeling CT-specific imaging properties. In this paper, we introduce CTForensics, a dataset for detecting AI-generated CT images. CTForensics contains 75,990 2D CT images, including a dedicated test benchmark of 29,990 balanced authentic and generated samples from ten representative CT generative models spanning GAN-based and diffusion-based paradigms. We further propose the Enhanced Spatial-Frequency CT Forgery Detector (ESF-CTFD), a CT-oriented CNN framework built around a Wavelet-Enhanced Central Stem, Multi-Scale Spatial Aggregation, and a Frequency-Aware Prediction Block. The Wavelet-Enhanced Central Stem enhances local intensity correlations and high-frequency residuals, Multi-Scale Spatial Aggregation aligns anatomical features across resolutions with lightweight residual units, and the Frequency-Aware Prediction Block models global spectral artifacts. Extensive experiments on CTForensics show that ESF-CTFD achieves 96.01% mAcc and 99.96% mAP, outperforming existing methods and maintaining strong robustness under realistic perturbations with only a 0.99% average drop. Codes will be available at https://github.com/liyih/CTForensics.