NEMESIS: Noise-suppressed Efficient MAE with Enhanced Superpatch Integration Strategy

Training deep learning models for three-dimensional (3D) medical imaging, such as Computed Tomography (CT), is fundamentally challenged by the scarcity of labeled data. While pre-training on natural images is common, it results in a significant domain shift, limiting performance. Self-Supervised Learning (SSL) on unlabeled medical data has emerged as a powerful solution, but prominent frameworks often fail to exploit the inherent 3D nature of CT scans. These methods typically process 3D scans as a collection of independent 2D slices, an approach that fundamentally discards critical axial coherence and the 3D structural context. To address this limitation, we propose the autoencoder for enhanced self-supervised medical image learning(MAESIL), a novel self-supervised learning framework designed to capture 3D structural information efficiently. The core innovation is the 'superpatch', a 3D chunk-based input unit that balances 3D context preservation with computational efficiency. Our framework partitions the volume into superpatches and employs a 3D masked autoencoder strategy with a dual-masking strategy to learn comprehensive spatial representations. We validated our approach on three diverse large-scale public CT datasets. Our experimental results show that MAESIL demonstrates significant improvements over existing methods such as AE, VAE and VQ-VAE in key reconstruction metrics such as PSNR and SSIM. This establishes MAESIL as a robust and practical pre-training solution for 3D medical imaging tasks.

Transformer architectures, including nnFormer,have demonstrated promising results in volumetric medical image segmentation by being able to capture long-range spatial interactions. Although they have high performance, these models need large quantities of labeled training data and are also likely to overfit and become training unstable. This is a serious practical problem because it is not only time-consuming but also expensive to obtain medical images that are annotated by experts. Moreover, fully supervised traditional training pipelines do not take advantage of the available large amounts of unlabeled medical imaging data that can be easily obtained in the clinics. We have solved these drawbacks by advancing the efficiency of the nnFormer with a self-supervised pretraining framework, which is based on the Masked Autoencoders (MAE). In this method, the model is pretrained on unlabeled volumetric medical images to reconstruct randomly masked parts of the input. This allows the encoder to learn meaningful anatomical and structural representations . The encoder is then further fine-tuned on a labeled dataset on the downstream segmentation task. Conducted Experiment shows that the offered method leads to a higher segmentation performance on the count of Dice score, a quicker convergence rate on the course of the fine-tuning procedure, and a superior generalization on the basis of limited labeled data . These findings validate that self-supervised learning combined with transformer-based segmentation models is an appropriate approach to the problem of data shortage in medical image analysis.

Recent breakthroughs in self-supervised learning (SSL), such as the Latent-Euclidean Joint-Embedding Predictive Architecture (LeJEPA), alongside successes in integrating visual encoders with language models, have driven the demand for adaptable, high-capacity vision encoders in Computed Tomography (CT). In this work, we explore 2D slice-based architectures as a flexible alternative to native 3D models for processing volumetric CT data. Using the CT-RATE dataset, we trained DALE-CT (Depth-Aware Latent-Euclidean Computed Tomography), a 2D model family built entirely from scratch using LeJEPA, and compared its performance against a continually pre-trained DINOv2 baseline. To enhance representation quality, we developed a novel 3D depth-aware pre-training strategy anchored by dense auxiliary supervision from both automated anatomical masks and human-annotated abnormalities. Under linear probe evaluation with Multiple Instance Learning (MIL) for multi-abnormality detection, the frozen backbone of this dual-supervised model (DALE-CT-2S) achieves a Macro AUROC of 0.833. This performance demonstrates near-parity with state-of-the-art 3D vision-language models, achieved entirely from scratch with significantly less data and no textual supervision. To ensure reproducibility, all training code, evaluation scripts, and model weights have been made publicly available.