Awaken, Then Scale: Tiny Adaptation for MRI Reconstruction

Real-world MRI reconstruction systems face the open-world challenge: test data from unseen imaging centers, anatomical structures, or acquisition protocols can differ drastically from training data, causing severe performance degradation. Existing methods struggle with this challenge. To address this, we propose BiasRecon, a bias-calibrated adaptation framework grounded in the minimal intervention principle: preserve what transfers, calibrate what does not. Concretely, BiasRecon formulates open-world adaptation as an alternating optimization framework that jointly optimizes three components: (1) frequency-guided prior calibration that introduces layer-wise calibration variables to selectively modulate frequency-specific features of the pre-trained score network via self-supervised k-space signals, (2) score-based denoising that leverages the calibrated generative prior for high-fidelity image reconstruction, and (3) adaptive regularization that employs Stein's Unbiased Risk Estimator to dynamically balance the prior-measurement trade-off, matching test-time noise characteristics without requiring ground truth. By intervening minimally and precisely through this alternating scheme, BiasRecon achieves robust adaptation with fewer than 100 tunable parameters. Extensive experiments across four datasets demonstrate state-of-the-art performance on open-world reconstruction tasks.

MRI reconstruction is an inherently ill-posed inverse problem, since incomplete measurements admit many plausible solutions. This ambiguity becomes more severe under high acceleration, where pixel-domain continuous predictors tend to average over feasible reconstructions and suppress high-frequency anatomy. We address this limitation by moving reconstruction to discrete multi-scale latent space and posing it as autoregressive next-acceleration-scale prediction. Leveraging discrete priors proven effective in visual autoregressive modeling, our method restricts the solution to compact sequences of codebook tokens, enabling sharp reconstructions even from extremely sparse measurements. This discrete autoregressive formulation also aligns naturally with modern large language model post-training techniques. Building on this observation, we introduce on-policy privileged information distillation for visual autoregressive modeling, where a teacher is provided training only privileged context that is unavailable at inference, in our case fully sampled acquisitions, and supervises a student trained on its own rollouts, leading to consistent reconstruction gains. Through extensive experiments on the fastMRI benchmark, we show that our approach delivers improved reconstruction performance across diverse sampling patterns under extreme undersampling. Project website is here.

Deep unrolled models (DUM) have become the state-of-the-art for accelerated MRI reconstruction, yet their robustness under domain shift remains a critical barrier to clinical adoption. In this work, we identify coil sensitivity map (CSM) estimation as the primary bottleneck limiting generalization. To address this, we propose UEPS, a novel DUM architecture featuring three key designs: (i) an Unrolled Expanded (UE) design that eliminates CSM dependency by reconstructing each coil independently; (ii) progressive resolution, which leverages k-space-to-image mapping for efficient coarse-to-fine refinement; and (iii) sparse attention tailored to MRI's 1D undersampling nature. These physics-grounded designs enable gains in robustness and computational efficiency. We construct a large-scale zero-shot transfer benchmark comprising 10 out-of-distribution (OOD) test sets spanning diverse clinical shifts, anatomy, view, contrast, vendor, field strength, and coil configurations. Extensive experiments demonstrate that UEPS consistently and substantially outperforms existing DUM, end-to-end, diffusion, and untrained methods across all OOD tests, achieving state-of-the-art robustness with low-latency inference suitable for real-time deployment.