pyMEAL: A Multi-Encoder Augmentation-Aware-Learning Toolbox for Robust Medical Image Translation

Medical imaging plays a vital role in clinical diagnosis, yet AI-driven imaging methods remain challenged by patient variability, image artifacts, and limited robustness across acquisition conditions. Although deep learning has advanced medical image analysis, 3D image translation remains hindered by limited training data and variability arising from scanner differences, imaging protocols, and patient motion. Conventional data augmentation typically relies on a single transformation pipeline, overlooking augmentation-specific characteristics and limiting representation learning. To address these challenges, we propose Multi-Encoder Augmentation-Aware Learning (MEAL), which processes multiple augmentation variants through dedicated encoder pathways. Three feature integration strategies are investigated: encoder concatenation (MEAL-CC), fusion layer (MEAL-FL), and an adaptive controller block (MEAL-BD). By dynamically weighting augmentation-specific features before decoding, MEAL-BD preserves complementary representations and improves robustness to clinically relevant variability. We evaluate MEAL using CT-to-T1-weighted MRI translation, a clinically relevant task when MRI is unavailable, contraindicated, or delayed. Across predefined and unseen test datasets, MEAL-BD consistently outperformed competing approaches under both geometric perturbations and standard imaging conditions, achieving higher peak signal-to-noise ratio (PSNR) and structural similarity index measure (SSIM). By prioritizing structural fidelity over perceptual realism, MEAL supports clinical interpretation and downstream image analysis rather than replacing diagnostic MRI, demonstrating that augmentation-aware representation learning improves the robustness and clinical applicability of medical image translation.