A unified deeplearning framework for contrast-phase-specific virtual monochromatic imaging

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is essential for breast cancer management, but reliance on gadolinium-based contrast agents (GBCAs) restricts use in contraindicated populations, prolongs scan protocols, and presents environmental toxicity concerns. Contrast synthesis offers a non-invasive alternative; however, existing approaches struggle to balance spatial realism with temporal continuity, suffer from slow iterative sampling, underutilize structural priors, and lack clinical validation. We propose a novel conditioned latent transport framework that predicts contrast enhancement in a single forward pass. By anchoring the latent trajectory to the pre-contrast anatomy and applying continuous time conditioning, the model synthesizes patient-specific contrast evolution at any acquisition time. The proposed approach outperforms baseline and the state-of-the-art models across spatial, perceptual, temporal, and distributional metrics. Evaluated on an independent external cohort, the method demonstrates robustness to domain shifts induced by scanner noise as well as differing acquisition protocol. Furthermore, our synthetic contrast enhancement significantly improved downstream tumor segmentation performance, yielding a 22.4% relative increase in Dice coefficient (0.60 vs. 0.49 baseline pre-contrast, p < 0.01), reducing boundary segmentation error by over 39%, while outperforming all other generative model baselines. Finally, a reader study involving four breast radiologists evaluated the image quality, kinetic fidelity, and diagnostic viability of our synthesized sequences across 40 randomly selected cases. The results demonstrated that in 70% of cases, synthesized images provided sufficient clinical information to support the same management decisions as real DCE-MRI, suggesting a path toward safer and faster contrast-free or contrast-reduced imaging workflows.

Multi-phase Contrast-Enhanced Computed Tomography (CECT) plays a central role in the diagnosis and characterization of focal lesions by capturing temporal enhancement patterns across multiple acquisition phases. Accurate lesion segmentation from such data remains challenging because clinically relevant contrast kinetics are distributed across phases, while anatomical inconsistencies, respiratory motion, and incomplete acquisitions often lead to inter-phase misalignment and interrupted temporal information. Conventional segmentation frameworks typically process each phase independently or rely on simple fusion strategies, limiting their temporal reasoning capability. To address these challenges, we propose DynoDINO, a unified framework tailored to address the core challenges of multi-phase medical image segmentation. DynoDINO first performs slice-level alignment to establish inter-phase anatomical correspondence and then employs a Multi-phase Fusion Model to jointly enhance temporal correlations across phases. Our fusion model incorporates a Mix-attention (MA) mechanism for efficient multi-phase feature calibration and an Adaptive Gating Mechanism with difference-based residual learning to selectively preserve diagnostically relevant contrast variations while suppressing artifacts caused by residual misalignment. In addition, the adaptive gating mechanism improves training stability by preventing feature degradation caused by unguided subtraction operations. Experiments on three large-scale datasets, including LiTS, PLC-CECT, and WAW-TACE, demonstrate that DynoDINO consistently improves boundary delineation and structural fidelity under standard, shifted, and missing-phase conditions.

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is central to breast cancer imaging, but gadolinium administration increases scan burden and motivates contrast-reduced alternatives, including synthetic contrast generation. We propose a latent bridge matching (LBM) framework for synthesizing peak-enhanced breast DCE-MRI from pre-contrast images in the MAMA-SYNTH challenge setting. Instead of starting from Gaussian noise as in conventional latent diffusion models (LDMs), the proposed model learns a conditional bridge between paired pre-contrast and peak-enhanced VAE latents. A latent UNet predicts the remaining correction from intermediate bridge states to the peak-enhanced latent, enabling iterative refinement while keeping the trajectory anchored to patient-specific anatomy. We evaluated two LBM conditioning variants on 91 DUKE validation cases. For the tumor-conditioned variant, tumor masks were used as conditioning inputs. Tumor-conditioning improved performance compared with pre-contrast conditioning, reducing MSE from 1.023 to 0.940 and FRD from 7.523 to 4.716, while increasing tumor SSIM from 0.355 to 0.429. The tumor-conditioned LBM also outperformed the evaluated LDM baseline on this validation cohort. These results suggest that latent bridge matching is a promising pre-contrast-anchored formulation for virtual contrast enhancement, while further work is needed to validate generalization and remove dependence on ground-truth tumor masks at inference.