Beyond Training from Scratch: Foundation Models for Data-Efficient and Generalizable Cardiac MRI Reconstruction

The emergence of large-scale pretrained foundation models has transformed computer vision, enabling strong performance across diverse downstream tasks. However, their potential for physics-based inverse problems, such as accelerated cardiac MRI reconstruction, remains largely underexplored. In this work, we investigate whether natural-domain foundation models can serve as effective image priors for accelerated cardiac MRI reconstruction, and compare the performance obtained against domain-specific counterparts such as BiomedCLIP. We propose an unrolled reconstruction framework that incorporates pretrained, frozen visual encoders, such as CLIP, DINOv2, and BiomedCLIP, within each cascade to guide the reconstruction process. Through extensive experiments, we show that while task-specific state-of-the-art reconstruction models such as E2E-VarNet achieve superior performance in standard in-distribution settings, foundation-model-based approaches remain competitive. More importantly, in challenging cross-domain scenarios, where models are trained on cardiac MRI and evaluated on anatomically distinct knee and brain datasets--foundation models exhibit improved robustness, particularly under high acceleration factors and limited low-frequency sampling. We further observe that natural-image-pretrained models, such as CLIP, learn highly transferable structural representations, while domain-specific pretraining (BiomedCLIP) provides modest additional gains in more ill-posed regimes. Overall, our results suggest that pretrained foundation models offer a promising source of transferable priors, enabling improved robustness and generalization in accelerated MRI reconstruction.

Cardiac magnetic resonance (CMR) imaging provides complementary information on cardiac anatomy, function, and tissue characterization across multiple sequences and views. In this work, we investigate foundation model pretraining for 2D CMR and introduce CMRVision, a CMR-specific foundation model trained using DINOv3-style self-supervised learning on a multi-center, multi-sequence cohort of 36 million CMR images. We systematically evaluate architectural and training design choices for domain-specific pretraining. CMRVision is evaluated on two downstream tasks: multi-task segmentation across cine, late gadolinium enhancement (LGE), and mapping sequences, and cine view classification. Our experiments show that CMR-specific pretraining, smaller patch sizes, and patch-level objectives consistently improve downstream performance. Across a multi-task segmentation benchmark, CMRVision achieved the strongest overall performance, outperforming prior natural-image (NI), medical-image, supervised, and CMR foundation model baselines. Improvements were modest but consistent across structures and sequences, with Dice scores ranging from 0.940-0.967 for LV and 0.855-0.905 for myocardium, and reaching 0.929 for RV, 0.920 for LA, and 0.931 for RA. The largest gains were observed for myocardium segmentation in LGE and mapping images. In a zero-shot segmentation task on unseen LGE long-axis views, the model achieved an average Dice score of 0.692, demonstrating cross-view generalization. For cine view classification, CMRVision achieved the highest average accuracy (0.906), compared to prior methods reported in the literature. These results highlight the potential of CMRVision to support robust and generalizable cardiac MRI analysis across multiple sequences and views.

Cardiac cine Magnetic Resonance Imaging (MRI) is a critical diagnostic tool that provides dynamic insights for radiologists. To accelerate acquisition, under-sampled k-space data is often used, requiring reconstruction methods that combine coil sensitivity encoding with prior information to recover missing data. Deep learning approaches have gained more attention for leveraging data-adaptive priors. While supervised learning approaches are a common choice, they depend on fully sampled reference data, which is not always available. Unsupervised methods eliminate the need for fully sampled reference data, which can be advantageous in cardiac cine MRI reconstruction. Among them, implicit neural representations (INRs) have shown great potential due to their simple architecture and good quality reconstructions. In this work, we propose an image-domain dual-branch INR framework, termed I-FP-INR, which extends the original INR design by introducing an additional feature-processing branch. This design aims to extract complementary feature embeddings to enhance the overall representation, thereby benefiting reconstruction. Extensive evaluations on both public datasets and in-house data show consistent improvements over baseline methods in reconstruction quality, with strong robustness across varied scenarios.