WebMRIQC: A Web-Based Implementation of MRIQC for Accessible MRI Image Quality Assessment in Resource-Constrained Settings

Corrupted, inconsistent, or anomalous data silently threatens the safety and reliability of medical AI. Despite growing regulatory recognition of dataset quality assurance (QA) for high-risk medical AI, scalable automated detection remains underdeveloped. We employ unsupervised anomaly detection (AD) and out-of-distribution (OOD) detection as an automated dataset QA mechanism for multi-center dynamic contrast-enhanced breast MRI. We build a controlled AD benchmark of 17 realistic QA-relevant anomaly types from six public datasets (protocol violations, processing errors, incorrect anatomical regions) and propose a taxonomy of radiological image anomalies based on human visual perception, enabling fine-grained analysis of AD failure modes. The benchmark includes near-, medium-far-, far-OOD samples, as well as in-distribution and external normal data. Four methods are evaluated: a projection-based method extended with a domain-specific feature extractor and a novel positional encoding, a reconstruction-based approach extended to full 3D volumes with an augmented training objective, and two unmodified hybrid OOD detection methods. Medium-far- and far-OOD samples are detected reliably, whereas near-OOD samples and external normal data from unseen institutions expose method-specific differences. The 3D reconstruction-based approach best balances detection performance (AUROC: 0.936) and generalization to unseen institutions. The projection-based method with positional encoding achieves the highest overall detection performance (AUROC: 0.954). Both hybrid methods exhibit critical failure modes, confirming that methods validated for one modality or anatomy may not generalize without domain-specific adaptation. Implants and mastectomies remain an open challenge for all methods. Our results establish a foundation and practical guidance on scalable unsupervised QA in medical AI pipelines.

Clinical prostate multi-parametric MRI relies heavily on high-quality diffusion-weighted imaging (DWI), yet reading DWI is frequently compromised by geometric distortion, often caused by rectal air. Assessing quality via the PI-QUAL scoring system is an emerging clinical standard, but it is subjective, time-consuming and suffers from a class imbalance where low-quality cases are diverse and relatively scarce. Using the PRIME clinical trial as an example, there are $6\%$ images with PI-QUAL scores lower than 4, $87\%$ of DWI issues are due to distortion. Many of the other clinical quality issues are under-represented. To address this common dual-scarcity of annotated clinical data, we propose a few-shot biparametric prototypical network for automated image quality assessment (IQA). Our framework utilizes a dual-branch 3D ResNet to fuse T2-weighted and DWI features, providing anatomical context to distinguish true morphology from distortion. To handle real-world heterogeneity, we introduce feature-wise linear modulation (FiLM) and a gradient reversal layer (GRL) to align feature distributions conditioned on varying b-values while suppressing acquisition-related biases. We demonstrate that a model meta-trained solely on comparatively objective, readily obtainable distortion labels can effectively adapt to predicting complex, multi-factorial clinical quality scores such as PI-QUAL using only five representative samples. Experimental results on two datasets show that our method significantly outperforms few-shot learning baselines for this challenging IQA task, offering a practically feasible and data-efficient solution for standardizing prostate MRI quality control in clinical workflows.

We present NeuroQA, a large-scale benchmark for visual question answering in 3D brain magnetic resonance imaging (MRI), with 56,953 QA pairs from 12,977 subjects across 12 datasets. It spans ages 5-104 and five clinical domains: Alzheimer's, Parkinson's, tumors, white matter disease, and neurodevelopment. Unlike prior medical Visual Question Answering (VQA) efforts that operate on 2D slices or rely on narrow diagnostic labels, NeuroQA pairs every item with a full 3D volume. It evaluates 11 clinically grounded reasoning skills across Yes/No, multiple-choice, and open-ended formats. Of the 203 templates, 131 are image-grounded (answerable from a 3-plane viewer) and 72 are image-informed (ground truth from quantitative volumetry or clinical instruments). To remove text-only shortcuts, we apply answer-distribution refinement, reducing closed-format text-only accuracy from $>$80% to 44.6%; image necessity is assessed separately through an image-grounding protocol released with the benchmark. A 38-rule deterministic pipeline and two rounds of expert review verify every QA pair against FreeSurfer measurements, metadata, or radiology report fields, with zero same-subject contradictions across templates. We conduct a clinician evaluation in which two clinicians independently assess 100 frozen test items on a three-plane viewer. On closed-format (Yes/No + multiple-choice) test-public items, the best zero-shot vision-language model and a supervised 3D CNN baseline reach 47.5% and 43.7% accuracy respectively, both below the 49.4% text-only majority-template floor. NeuroQA adopts a two-tier release with public QA pairs for open-access datasets and reproducible generation scripts for datasets restricted by data use agreements (DUAs), plus subject-level splits, a held-out private test set, and an online leaderboard.