Deep Learning for MRI Slice Interpolation: The Critical Role of Problem Formulation

Head computed tomography (CT) typically uses sub-millimeter in-plane resolution but 2-5 mm through-plane spacing, creating substantial anisotropy that degrades multiplanar reconstructions, volumetric measurements such as hematoma volume estimation, and downstream algorithms that assume near-isotropic voxels. We present a deep learning system that synthesizes intermediate CT slices from pairs of neighboring axial slices, halving the effective through-plane spacing. The system improves three-dimensional visualization while simultaneously producing inherently denoised outputs, yielding two complementary benefits from a single inference pass. To build a reliable system, we systematically evaluate pixel-wise losses, namely mean squared error (MSE) and mean absolute error (L1); structural-similarity losses, namely the structural similarity index (SSIM) and its multi-scale variant (MS-SSIM); and hybrid combinations. On a held-out test set, all converged models outperform classical interpolation baselines and pretrained video frame interpolation methods (RIFE, FILM) on all structural measures, with MS-SSIM+L1 offering the strongest balanced profile. We also document training instability in SSIM-family losses and identify partial remedies: the standard numerical fixes eliminate the dominant failure mode but leave residual divergence at smaller batch sizes. All results are reported with patient-level bootstrap confidence intervals and paired statistical tests. As an illustration, we apply the system to an out-of-distribution head CT series from Hospital Universitario Virgen del Rocío: the model synthesizes intermediate slices and exhibits on the real slices the implicit-denoising signature predicted by our theoretical analysis, supporting in a single external case that interpolation quality and implicit denoising are not confined to the training distribution.

Magnetic Resonance Imaging (MRI) is often acquired with anisotropic resolution to reduce scan time, producing stair-step artifacts along the through-plane direction. In through-plane MRI super-resolution, an efficiency-fidelity trade-off arises: feed-forward regressors are fast but oversmooth at large slice-thicknesses, while sampling-based methods improve fidelity at high inference cost. We propose DRIFT, a two-stage thickness-conditioned rectified flow framework for through-plane MRI super-resolution with continuous input slice-thickness. Stage 1 employs an Anatomical Projection Network (APN) to map low-resolution patches to a coarse high-resolution manifold, providing a deterministic anatomical initialization that shortens the residual transport of Stage 2 and stabilizes slice-wise refinement. Stage 2 refines details via rectified flow and introduces a Physics-Aware Difficulty (PAD) metric derived from slice-thickness induced through-plane bandwidth deficit to guide an Adaptive Integration Scheduler (AIS), allocating ODE steps by thickness. A Consistent Endpoint Trajectory Alignment (CETA) loss enforces thickness-consistent reconstructions. Experiments show that DRIFT outperforms super-resolution baselines while reducing inference cost. Code, models, and interactive demos are available at https://yoonseokchoi-ai.github.io/drift-eccv2026/.

Brain-MRI inpainting replaces a masked region of a scan with synthesized, anatomically plausible healthy tissue, so that analysis tools built for healthy brains can be applied to images they would otherwise reject. On the BraTS local-synthesis benchmark, which ranks submissions on the structural similarity index (SSIM), the peak signal-to-noise ratio, and the mean squared error (MSE) jointly, the strongest recent models are accurate, but several report blurry synthesized regions and attribute this to the mean-seeking behavior of the $\ell_1$ and MSE terms in their training losses. We address this in post-processing, forming a deep ensemble of the two co-first-place 2025 models and training a lightweight residual refiner on the ensemble's own outputs under an $\ell_1$ loss augmented with a structural-similarity term whose weight $λ$ we vary. At a moderate $λ$ the refiner improves SSIM over the ensemble, from $0.8767$ to $0.8780$ on a held-out reproduction of the official scorer and from $0.8555$ to $0.8572$ on the official validation leaderboard, with essentially no change in MSE. The gain is small but consistent, improving $62.6\%$ of the held-out cases with a signed-rank $p=2.2\times10^{-7}$, whereas over-weighting the structural term reverses it. Two ablations bound the effect. Adding any third model to the two-model ensemble degrades it, and classical unsharp masking fails to improve SSIM at any strength (best $0.8765$ against $0.8767$), so the gain reflects learned rather than indiscriminate sharpening. The result is a cheap, reproducible post-processing stage that improves an already strong ensemble without any large-scale retraining.