Quasi-Binarized Autoencoders: An Architecture-Independent Information Bottleneck for Medical Image Anomaly Detection

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.

Unsupervised medical anomaly detection learns normal anatomical patterns from healthy training images and identifies deviations at test time. Reconstruction-based and diffusion-based methods commonly use the difference between an input image and its reconstruction as anomaly evidence. However, this residual can be ambiguous. Expressive models may preserve pathological structures, while benign anatomical variation, imaging noise, and acquisition differences may also produce large reconstruction errors. We propose discriminative mask-guided diffusion (DMD), a medical anomaly detection framework that complements residual-based localization with reconstruction-shift discrimination. DMD first learns a compact quantized latent representation of normal images. Localized masks then perturb selected latent regions, and a latent diffusion model reconstructs the perturbed representations. The resulting reconstructions are paired with their original normal images to define a self-supervised classification task. At inference, the classifier provides a learned image-level anomaly score, while the residual between the input and its diffusion-based reconstruction yields a pixel-level anomaly map. Experiments on five datasets spanning brain MRI, breast ultrasound, and chest radiography show that DMD achieves the best overall performance among the state-of-the-art baseline methods.

We study a quantum autoencoder (QAE) for compression-driven anomaly detection in brain MRI data. The approach leverages angle encoding to map image patches into quantum states, followed by a variational encoder-decoder architecture trained to discard information via auxiliary trash qubits. Anomaly scores reflect the degree to which inputs resist compression relative to normal data, with higher scores corresponding to deviations from the learned normal manifold. Evaluated on publicly available brain MRI DICOM datasets, the method achieves a slice-level ROC-AUC of approximately 0.95 and a patch-level ROC-AUC of approximately 0.813, outperforming classical autoencoder and PCA baselines. Analysis of the learned parameters reveals a pronounced encoder-decoder asymmetry, where effective anomaly detection arises from structured information compression within the encoder rather than increased parameter magnitude or decoder expressivity. This results in a controlled compression-reconstruction trade-off with a clear operating regime that supports principled threshold selection. Qualitative evaluation further shows that the QAE produces spatially localized anomaly heatmaps aligned with tumorous regions. The results, supported by promising baseline performances, demonstrate that quantum autoencoders provide an interpretable and controllable mechanism for anomaly detection based on incompressibility with respect to a learned latent representation. This work highlights the potential of quantum autoencoders as a principled tool for studying compression dynamics in quantum machine learning, with promising implications for decision support in medical imaging workflows.