Large-Scale Pretraining for Improving Deep Learning-Based Geometric Distortion Correction of Diffusion-Weighted Imaging

Single-shot echo-planar prostate diffusion-weighted imaging (DWI) is frequently complicated by geometric distortions, which impact the ability to derive reliable diagnoses from such images. Developing automated correction methods is challenged by the absence of paired distorted and undistorted clinical scans. In this paper, we first propose a novel weakly-supervised image quality transfer (IQT) framework from undistorted to distorted images that utilizes image quality assessment (IQA) signals to supervise the transfer process. Unlike traditional methods that require expensive, voxel-wise paired data or resort to developing unpaired algorithms, our approach utilizes image-level quality labels (here, distorted vs. undistorted) to establish latent quality prototypes within a pre-trained feature space. Recognizing that simulating realistic distortions is more reliable than direct unpaired correction, we describe a weakly-supervised prototype flow matching algorithm to explicitly regularize generative trajectories towards distorted prototypes, producing realistic susceptibility artifacts that mimic clinical degradations. By synthesizing these realistic pairs, we enable a second IQT model to be trained in the forward direction for distortion correction. Experimental results demonstrate that our generated images successfully mimic the diagnostic interference of real-world artifacts, which leads to more capable distortion correction IQT models. In addition to qualitative comparisons, we also conduct exhaustive quantitative evaluations that compare our approach with existing unpaired approaches (e.g., CycleGAN, UNIT-DDPM, and OT-FM) - as either forward or reverse alternatives - by assessing clinical downstream task performance in PI-RADS and Gleason score classification, using both in-distribution and external data sets.

Diffusion MRI (dMRI) relies on diffusion-weighted echo-planar imaging, which is highly susceptible to eddy-current-induced geometric distortions. These distortions vary across diffusion volumes according to gradient strength and direction, causing between-volume misalignment that can bias downstream microstructural analyses. Current state-of-the-art correction methods, such as FSL Eddy, achieve high-quality correction through iterative prediction-correction schemes but are computationally expensive. We propose Eddeep, a deep-learning framework for fast eddy-current distortion correction in dMRI. Eddeep decomposes the problem into two stages. First, a supervised image translation network standardises the appearance of diffusion-weighted and b=0 images, removing contrast differences that hinder reliable registration. Second, an unsupervised registration network estimates both eddy-current distortion and between-volume head motion parameters under a physics-constrained quadratic distortion model, enabling correction in a single forward pass. The method was trained on UK Biobank data and evaluated on both in-domain (UK Biobank) and out-of-domain (Memodyn) datasets. Across a range of complementary metrics, including between-volume jitter, diffusion kurtosis imaging residuals, signal irregularity, and mutual information, Eddeep achieved correction quality comparable to that of FSL Eddy while substantially reducing inference time. These results demonstrate that deep learning can provide accurate and efficient eddy-current distortion correction without relying on iterative optimisation, supporting the development of faster diffusion MRI processing pipelines for large-scale studies and clinical deployment. The code is available at: https://github.com/CIG-UCL/eddeep.

Diffusion-weighted imaging (DWI) is acquired as part of bi-parametric prostate MRI, but suffers from artifacts that degrade downstream quantitative and diagnostic performance. While DWI preprocessing is standard in brain imaging, its adoption in prostate imaging remains limited and lacks standardized pipelines. This study investigated the effect of different DWI preprocessing strategies on apparent diffusion coefficient (ADC) estimation and automatic Prostate Imaging Reporting and Data System (PI-RADS) classification. 268 cases were derived from the fastMRI prostate cohort by sequentially applying denoising, Gibbs-ringing correction, and diffeomorphic registration for susceptibility distortion correction. ADC maps were compared using linear least squares (LLS) and iteratively-weighted LLS (IWLLS). A 3-class DenseNet classifier was trained to predict PI-RADS scores from multi-channel MRI inputs. ADC analysis revealed statistically significant differences across preprocessing pipelines, with LLS and IWLLS producing numerically equivalent maps. Linear relationships between ADC values were preserved across most datasets (PCC ~0.99), while distortion correction realigned DWI to T2w anatomy and altered ADC values accordingly (PCC ~0.90). Classification showed the best AUROC and sensitivity for high-risk PI-RADS classes in the fully processed dataset. False-negative analysis revealed this dataset produced the least overconfident incorrect predictions on high-risk classes, which is a desirable property for clinical triage. DWI preprocessing, particularly distortion correction, enhances both ADC map quality and the predictive power of deep learning models for PI-RADS classification, supporting the need for optimized preprocessing pipelines in prostate MRI.