Magnetic Resonance Imaging

Purpose: Real-time (RT) bSSFP MRI enables fast free-breathing cardiovascular imaging but requires 10-16 slices for functional assessment, resulting in prolonged scan times. Simultaneous multi-slice (SMS) imaging can reduce acquisition time but when combined with non-Cartesian trajectories, it relies on iterative reconstructions that preclude online use. This study investigates deep artifact suppression to facilitate rapid, online reconstruction of RT-SMS. Methods: A spiral bSSFP SMS RT sequence with two simultaneously acquired slices was implemented at 1.5 T. Reconstruction used slice separation in k-space, followed by deep artifact suppression in image space using a 3D U-Net. Ten healthy volunteers were imaged. RT-SMS image quality and reconstruction time were compared between deep artifact suppression and compressed sensing (CS) reconstructions. Left (LV) and right (RV) ventricular volumes at end diastole (EDV) and end systole (ESV) and LV mass (LVM) were compared between RT-SMS with deep artifact suppression and reference-standard breath-hold (BH) imaging. Results: The RT-SMS acquisition was ~13x faster than BH imaging (15 s vs 3 min 15 s). RT-SMS reconstruction using deep artifact suppression was ~50x faster than CS (30 s vs 24 min 55 s). Deep artifact suppression consistently outperformed CS in quantitative and qualitative image quality (p<0.001). Functional agreement between BH and RT-SMS with deep artifact suppression was good (LVEDV: -7.5 +/- 6.8 ml, LVESV: -0.9 +/- 4.2 ml, RVEDV: -6.4 +/- 8.4 ml, RVESV: 0.2 +/- 10.7 ml, LVM: -10.3 +/- 11.0 g). Conclusion: Online deep artifact suppression reconstruction for RT-SMS bSSFP CMR enables free-breathing short-axis coverage with a substantial reduction in acquisition and reconstruction time while maintaining diagnostic image quality.

Segmenting vocal tract articulators in real-time MRI (rtMRI) is a challenging dynamic image segmentation problem characterized by low contrast, rapid motion, and limited spatial resolution. However, while rtMRI acquisitions may provide synchronized acoustic signals, existing methods discard this information, and the few multimodal approaches that incorporate audio cannot be deployed when audio is unavailable. We propose a three-stage framework that leverages acoustic and phonological supervision during training while requiring only the rtMRI image at inference: phonological representations are converted into spatial bounding-box priors for articulator localization, visual and acoustic encoders are aligned via dual-level cross-modal contrastive pretraining, and the learned representations are fused through a cross-attention decoder, effectively transferring multimodal knowledge into a single-modality inference pipeline. Evaluated on 75-Speaker~Annot-16 and USC-TIMIT datasets, our method outperforms existing unimodal and multimodal methods, demonstrating that multimodal supervision provides transferable benefits for precise and clinically deployable vocal tract segmentation.

Real-time magnetic resonance imaging (rtMRI) of speech production enables non-invasive visualization of dynamic vocal-tract motion and is valuable for speech science and clinical assessment. However, rtMRI is fundamentally constrained by trade-offs among spatial resolution, temporal resolution, and acquisition speed, often leading to undersampled k-space measurements and degraded reconstructions. We propose SIREM, a speech-informed MRI reconstruction framework that uses synchronized speech as a cross-modal prior. The central idea is that vocal-tract configurations during speech are correlated with the produced acoustics, making part of the image content predictable from audio. SIREM models each frame as a fusion of an audio-driven component and an MRI-driven component through a spatial weighting map. The audio branch predicts articulator-related structure from speech, while the MRI branch reconstructs complementary content from measured k-space data. We further introduce a learnable soft weighting profile over spiral arms, enabling a differentiable study of how k-space arm usage interacts with speech-informed fusion. This yields a unified multimodal formulation that combines audio-driven prediction, MRI reconstruction, and sampling adaptation. We evaluate SIREM on the USC speech rtMRI benchmark against standard baselines, including gridding, wavelet-based compressed sensing, and total variation. SIREM introduces a speech-informed reconstruction paradigm that operates in a substantially higher-throughput regime than iterative methods while preserving anatomically plausible vocal-tract structure. These results establish an initial benchmark for multimodal speech-informed rtMRI reconstruction and highlight the potential of synchronized speech as an auxiliary prior for fast reconstruction. The source code is available at https://github.com/mdhasanai/SIREM

Many modern datasets are large and carry complex structural relationships. Graph-based methods have traditionally been used to represent networked data, modeling individual elements as nodes and pairwise interactions as edges. Furthermore, Graph Signal Processing (GSP) has been developed to analyze signals on graph nodes, such as temperature measurements (node signals) across different regions of a country represented as a graph. Topological Signal Processing (TSP) is an emerging field that generalizes GSP, enabling the analysis of signals defined not only on nodes but also on edges, triangles, and higher-dimensional network elements, modeled as simplicial complexes and related topological structures. This makes TSP naturally well-suited for studying higher-order interactions in complex systems by extending classical signal processing concepts, such as filtering and Fourier transforms, to the topological level. Despite its versatility, TSP remains challenging for many practitioners. Therefore, we present an accessible overview of TSP foundations while drawing connections with application-oriented settings. We focus on processing techniques based on the combinatorial Hodge Laplacian, which generalizes the graph Laplacian to simplicial complexes. In particular, we review key TSP concepts, relate them to real-world examples, and discuss how higher-order structures and signals can be derived from datasets. For instance, we introduce an edge-level signal capturing lagged interactions between nodal signals, and demonstrate its use in a case study on TSP-based analysis of brain imaging data, revealing nontrivial interactions between sets of brain regions. Overall, we aim to promote a broader adoption of TSP by bridging methodological developments with applications, fostering its use among a wide community of theoretical and applied researchers.

Deploying multi-sequence magnetic resonance imaging (MRI) segmentation models to new clinical environments is challenging due to variations in scanners and acquisition protocols. Although existing TTA methods handle basic per-modality shifts, they often fail under a fundamental dual-shift problem, as their adaptation signals fail to capture modality-interaction shifts that disrupt inter-sequence consistency. To address this, we propose Variance-gated Inter-Sequence Test-time Adaptation (VISTA), a source-free framework that tackles modality-interaction shifts. First, we design an Inter-Sequence Intervention Generator (ISIG) that generates a set of consistency probes by swapping low-frequency spectra and entropy-localized patches across sequences, preserving anatomical semantics while challenging inter-sequence dependencies. Second, we introduce Cross-View Disagreement-Aware Pseudo Labeling (CDPL), which establishes a voxel-wise reliability metric using cross-view disagreement variance to dynamically gate self-training and enforce interventional consistency, encouraging the network to rely on robust anatomical semantics. Extensive experiments adapting from standard adult MRI (BraTS-GLI-Pre) to African low-field (BraTS-SSA) and pediatric (BraTS-PED) cohorts show improved performance over competing methods under clinical shifts, achieving absolute Dice improvements of +1.89% (SSA) and +2.82% (PED) over the source model. The code is available at https://github.com/dzp2095/VISTA.

To be useful for downstream applications, vision decoding models that are trained to reconstruct seen images from human brain activity must be able to generalize to internally generated visual representations, i.e., mental images. In an analysis of the recently released NSD-Imagery dataset, we demonstrated that while some modern vision decoders can perform quite well on mental image reconstruction, some fail, and that state-of-the-art (SOTA) performance on seen image reconstruction is no guarantee of SOTA performance on mental image reconstruction. Motivated by these findings, we developed MIRAGE, a method explicitly designed to train on vision datasets and cross-decode mental images from brain activity. MIRAGE employs a linear backbone and multi-modal text and image features as input to a diffusion model. Feature metrics and human raters establish MIRAGE as SOTA for mental image reconstruction on the NSD-Imagery benchmark. With ablation analysis we show that mental image reconstruction works best when decoders use image features with relatively few dimensions and include guidance from text-based and both high- and low-level image-based features. Our work indicates that--given the right architecture--existing large-scale datasets using external stimuli are viable training data for decoding mental images, and warrant optimism about the future success and utility of mental image reconstruction.

Brain tumor diagnosis is largely dependent on Magnetic Resonance Imaging (MRI) evaluation, which requires radiologists to synthesize thousands of images across multiple 3D sequences and longitudinal studies. This process requires advanced neuro-radiology training, poses substantial cognitive load, and is highly time-consuming. Despite increasing demands in radiology, this expertise is difficult to scale, straining the current health systems. Vision-Language Models (VLMs) provide an opportunity to reduce this burden through a semi-automated, interactive interpretation of complex brain MRIs. However, they are currently underutilized in neuro-oncology due to a lack of specialized benchmarks for evaluating them. We introduce a clinically relevant visual question answering (VQA) benchmark -- the UCSF-PDGM-VQA dataset -- consisting of 2,387 QA pairs from 473 glioma-related MRI studies in the public UCSF-PDGM dataset. We further establish a performance baseline for six state-of-the-art vision-language models (VLMs) and one large language model on this dataset. We find that current models are incapable of effectively processing multi-sequence, 3-dimensional MRI scans, thus resulting in a suppression of visual features and over-reliance on language priors, causing modality collapse. These findings underscore a critical deficiency in current model reliability and safety within clinical settings, necessitating the development of robust, domain-specific VLMs.

While AI-generated hallucinations pose considerable risks, the underlying cognitive mechanisms by which humans can successfully recognize or be misled by these hallucinations remain unclear. To address this problem, this paper explores humans' neural dynamics to characterize how the brain processes hallucinated content. We record EEG signals from 27 participants while they are performing a verification task to judge the correctness of image descriptions generated by a multi-modal large language model (MLLM). Based on an averaged event-related potential (ERP) study, we reveal that multiple cognitive processes, e.g., semantic integration, inferential processing, memory retrieval, and cognitive load, exhibit distinct patterns when humans process hallucinated versus non-hallucinated content. Notably, neural responses to hallucinations that were misjudged versus correctly judged by human participants showed significant differences. This indicates that misjudged AI-generated hallucinations failed to trigger the standard neurocognitive fact verification pathway.

Multimodal magnetic resonance imaging (MRI) is crucial for brain tumor segmentation, with many methods leveraging its four key modalities to capture complementary information for effective sub-region analysis. However, the absence of several modalities is very common in practice, leading to severe performance degradation in existing full-modality segmentation methods. Limited by the structured data model, recent works often adopt a multi-stage training strategy for full-modality and missing-modality scenarios, which increases training costs and inadequately addresses the interference of miss. In this work, we propose a graph-based one-stage framework for robust brain tumor segmentation with missing modalities. Specifically, we introduce modality-specific virtual nodes that serve as supplementary information sources to compensate for missing modalities. To enhance model robustness against arbitrary modality combinations, we leverage the inherent flexibility of graph networks to devise a dynamic connection strategy. This mechanism dynamically adjusts the adjacency matrix based on modality availability, preserving beneficial information flow while mitigating interference effects caused by missing modalities. Furthermore, we enhance the graph network through heterogeneous weight matrices, enhancing its adaptability to multimodal scenarios. Extensive experiments on the BRATS-2018 and BRATS-2020 datasets demonstrate that our method outperforms the state-of-the-art methods on almost all subsets of incomplete modalities.

Self-supervised learning (SSL) has advanced medical image analysis be enabling learning form large unlabelled data. However, in brain magnetic resonance imaging (MRI), most 3D models remain specialized for either segmentation of classification, limiting their ability to generalize across datasets, imaging protocols,, and downstream tasks. This lack of transferability constrains the clinical utility of 3D MRI models, despite the availability of unlabeled volumetric data. We present Volta-3D, a self-supervised 3D Vision Transformer framework designed to learn transferable volumetric representations. Volta-3D jointly aligns global class-style tokens and local patch tokens within a student-teacher paradigm and enforces fine-grained structural reconstruction. This combined global-local alignment addresses the limited semantic diversity and subtle anatomical characteristics of brain MRI, which challenges existing SSL approaches. We evaluate Volta-3D on multiple out-of-distribution downstream tasks, including hippocampal segmentation and classification of sex and Alzheimer's disease versus healthy controls. Across all tasks, representations learned by Volta-3D outperform randomly initialized baselines, demonstrating improved transferability and robustness under domain shift. Hence jointly enforcing global semantic consistency and local structural learning during pretraining enables broader concept learning from unlabeled brain MRI data. Overall VolTA-3D supports effective multi-task downstream performance with task-specific pertaining, a step towards generalizable and clinically viable 3D models.

Learning meaningful latent representations from nonlinear fMRI data remains a fundamental challenge in neuroimaging analysis. Traditional independent component analysis, widely used due to its ability to estimate interpretable functional brain networks, relies on a linear mixing assumption for latent sources, limiting its ability to capture the inherently nonlinear and complex organization of brain dynamics. More recently, deep representation learning methods have emerged as promising alternatives for modeling nonlinear latent structure. However, many of these approaches have been evaluated primarily on simulated datasets or natural image benchmarks, with comparatively limited validation on real-world neuroimaging data such as fMRI. In this work, we are motivated by the $β$-TCVAE (Total Correlation Variational Autoencoder), a refinement of the $β$-VAE framework for learning latent representations without introducing additional hyperparameters during training. We adapt and modify this model to fMRI data for nonlinear source disentanglement, aiming to separate mixed spatial and temporal brain signals into interpretable components. We show that the $β$-TCVAE framework can recover meaningful nonlinear spatial components with biological relevance, including well-established intrinsic connectivity networks such as the default mode network. Furthermore, we evaluate the learned representations using functional network connectivity, showing that the latent structure captures coherent and interpretable brain organization patterns. This study provides a pilot investigation that bridges nonlinear representation learning and fMRI analysis.

Clinical application of high-resolution diffusion MRI is hindered by hardware limitations and prohibitive scan times, motivating computational super-resolution. This study investigates the efficacy of a feature-based loss function in preserving diffusion signal consistency in deep learning super-resolution. Using 7T data from the human connectome project to generate pairs of low- and high-resolution diffusion weighted images (DWI), we trained UNets for 2D super-resolution. Ablation and isolation studies evaluated different VGG16-layers for feature-based losses against an image-based L1 baseline. Deeper layers and combinations thereof resulted in grid-like artifacts in super-resolution DWIs, which persisted in diffusion parameters like quantitative and fractional anisotropy. No such artifacts were present when using the shallowest layer. Downstream analysis for this layer showed great consistency with the ground truth, even for 9-fold super-resolution. Image SNR and used VGG16-layer depths modulated artifact appearance and severity, mandating careful selection of contributing layers for application in and beyond diffusion MRI.

Brain tumors exhibit high heterogeneity in morphology and multimodal contrast, making manual slice-by-slice de lineation time-consuming and experience-dependent, thus necessitating efficient and stable automated segmentation methods. To address the limitations of CNNs in modeling long-range dependencies, and the heavy computational and memory overhead and inter-block contextual in coherence of Transformers in 3D MRI, this paper proposes Multi-Head Mamba (MHMamba). This method combines a U-shaped architecture with a multi-head state-space model (Mamba), splitting the channel dimension into parallel SSM heads and aggregating them with residuals. This enhances long-range representation and improves the stability of multimodal training while maintaining linear complexity. To further align statistics and enhance lesion response, we designed a channel-space calibration module for multi-head outputs and introduced an adaptive fusion mechanism at skip connections to dynamically connect global semantics with local details, thereby improving boundary consistency and the detection of small-volume lesions. We conducted experiments and ablations on BraTS2021 and BraTS2023. The results showed that MHMamba achieved stable and significant improvements in overall accuracy, boundary smoothness, and sensitivity to tumor core and small-volume enhancement areas, while preserving the linear-complexity advantage of Mamba-based modeling, thus verifying the effectiveness and versatility of the method.

Recently, deep generative models have been used for posterior inference in inverse problems, including high-stakes applications in medical imaging and scientific discovery, where the uncertainty of a prediction can matter as much as the prediction itself. However, posterior uncertainty is difficult to interpret because it can mix ambiguity inherent to the forward operator with uncertainty propagated through inference. We introduce a structural decomposition of posterior uncertainty that isolates intrinsic ambiguity. A cascade formulation makes this ambiguity accessible for calibration analysis, enabling qualitative diagnostics and simulation-based calibration tests that reveal failure modes that remain hidden when models are selected by reconstruction quality alone. We first validate the approach on a Gaussian example with analytical posterior structure, then illustrate the decomposition on accelerated magnetic resonance imaging (MRI), and finally apply the calibration diagnostics to electroencephalography (EEG) source imaging.

Reconstructing dynamic visual experiences as videos from functional magnetic resonance imaging (fMRI) is pivotal for advancing the understanding of neural processes. However, current fMRI-to-video reconstruction methods are hindered by a semantic gap between noisy fMRI signals and the rich content of videos, stemming from a reliance on incomplete semantic embeddings that neither capture video-specific cues (e.g., actions) nor integrate prior knowledge. To this end, we draw inspiration from the dual-pathway processing mechanism in human brain and introduce CineNeuron, a novel hierarchical framework for semantically enhanced video reconstruction from fMRI signals with two synergistic stages. First, a bottom-up semantic enrichment stage maps fMRI signals to a rich embedding space that comprehensively captures textual semantics, image contents, action concepts, and object categories. Second, a top-down memory integration stage utilizes the proposed Mixture-of-Memories method to dynamically select relevant "memories" from previously seen data and fuse them with the fMRI embedding to refine the video reconstruction. Extensive experimental results on two fMRI-to-video benchmarks demonstrate that CineNeuron surpasses state-of-the-art methods across various metrics.

Precise segmentation of brain structures in magnetic resonance imaging (MRI) is essential for reliable neuroimaging analysis, yet voxel-wise deep models often yield anatomically inconsistent results that diverge from expert-defined boundaries. In this research, we propose a landmark-guided 3D brain segmentation approach that explicitly mimics the manual segmentation protocol of the Harvard--Oxford Atlas. A Global-to-Local network automatically detects 16 landmarks representing key subcortical reference points. Then, a semantic segmentation model produces a coarse segmentation of 12 anatomical labels, each grouping multiple subcortical regions. Finally, a landmark-driven post-processing step separates these 12 labels into 26 distinct structures by enforcing local anatomical constraints. Experimental results demonstrate consistent improvements in boundary accuracy. Overall, integrating learned landmarks aligns segmentations more closely with manual protocols.

Accurate 3D+t whole-heart mesh reconstruction from cine MRI is a clinically crucial yet technically challenging task. The difficulty of this task arises from two coupled factors: inherently sparse sampling of 3D cardiac anatomy by 2D image slices and the tight coupling between cardiac shape and motion. Current cardiac image-to-mesh approaches typically reconstruct only a subset of cardiac chambers or a single phase of the cardiac cycle. In this work, we propose CineMesh4D, a novel end-to-end 4D (3D+t) pipeline that directly reconstructs patient-specific whole-heart mesh from multi-view 2D cine MRI via cross-domain mapping. Specifically, we introduce a differentiable rendering loss that enables supervision of 3D+t whole-heart mesh from multi-view sparse contours of cine MRI. Furthermore, we develop a dual-context temporal block that fuses global and local cardiac temporal information to capture high-dimensional sequential patterns. In quantitative and qualitative evaluations, CineMesh4D outperforms existing approaches in terms of reconstruction quality and motion consistency, providing a practical pathway for personalized real-time cardiac assessment. The code will be publicly released once the manuscript is accepted.

Clinical diagnostic workups typically follow a modality escalation pathway: after initial clinical evaluation, clinicians begin with routine structural imaging (e.g., MRI), selectively add sequences such as FLAIR or T2 to refine the differential, and reserve molecular imaging (e.g., amyloid-PET) for cases that remain uncertain after standard evaluation. Consequently, patients are observed with heterogeneous and often incomplete modality subsets. However, most current AI models assume fixed data modalities as the model inputs. In this paper, we present BrainAnytime, a unified pretraining framework pretrained on 34,899 3D brain scans from five datasets that support brain image analysis under arbitrary modality availability spanning multi-sequence MRI and amyloid-PET. A single model accepts whatever imaging is available, from a lone T1 scan to a full multimodal workup. Pretraining learns structural-molecular correspondences between MRI and PET via cross-modal distillation (RCMD) and prioritizes disease-vulnerable anatomy via atlas-guided curriculum masking (PACM), all within a shared 3D masked autoencoder (Multi-MAE3D). Across four downstream tasks and five clinically motivated modality settings, BrainAnytime largely outperforms modality-specific models, missing-modality baselines, and large-scale brain MRI pretrained foundation models on most modality settings. Notably, it surpasses the strongest missing-modality baselines with relative improvements of 6.2% and 7.0% in average accuracy on CN vs. AD and CN vs. MCI classification, respectively. Code is available at https://github.com/SDH-Lab/BrainAnytime.

Structural MRI-to-amyloid PET synthesis has been proposed as a non-invasive alternative for amyloid assessment in Alzheimer's disease (AD). However, reported performance of identical models varies widely across studies, and increasingly complex architectures have not led to consistent gains. This inconsistency is thought to be caused by a fundamental biological ambiguity: MRI captures neurodegeneration, while PET measures amyloid pathology - two processes that are often temporally decoupled in AD. As a result, similar MRI patterns may correspond to different amyloid states, creating ambiguous one-to-many mappings. MRI-to-amyloid PET synthesis may therefore be intrinsically ill-posed; however, this idea has yet to be tested scientifically. The aim of this work is to test this hypothesis through two controlled experiments. We first control the training distribution by stratifying paired MRI-PET data by amyloid and neurodegeneration status. Using two standard synthesis models under a controlled design, we show that biologically unambiguous mappings are learnable in isolation, but performance collapses when data ambiguity is introduced. This demonstrates that ambiguity in the data distribution, rather than architectural capacity, constrains performance. Second, we show that introducing orthogonal biological information in the form of plasma biomarkers resolves this ambiguity. When multimodal inputs are incorporated, performance improves and stability is restored. Together, these findings suggest that limited and inconsistent performance in MRI-to-amyloid PET synthesis is explained by intrinsic biological ambiguity, and that stable, meaningful progress requires multimodal integration rather than architectural complexity.

Modern low-field magnetic resonance imaging (MRI) technology offers a compelling alternative to standard high-field MRI, with portable, low-cost systems. However, its clinical utility is limited by a low Signal-to-Noise Ratio (SNR), which hampers diagnostic image quality. A common approach to increase SNR is through repetitive signal acquisitions, known as NEX, but this results in excessively long scan durations. Although recent work has introduced methods to accelerate MRI scans through k-space sampling optimization, the NEX dimension remains unexploited; typically, a single sampling mask is used across all repetitions. Here we introduce NexOP, a deep-learning framework for joint optimization of the sampling and reconstruction in multi-NEX acquisitions, tailored for low-SNR settings. NexOP enables optimizing the sampling density probabilities across the extended k-space-NEX domain, under a fixed sampling-budget constraint, and introduces a new deep-learning architecture for reconstructing a single high-SNR image from multiple low-SNR measurements. Experiments with raw low-field (0.3T) brain data demonstrate that NexOP consistently outperforms competing methods, both quantitatively and qualitatively, across diverse acceleration factors and tissue contrasts. The results also demonstrate that NexOP yields non-uniform sampling strategies, with progressively decreasing sampling across repetitions, hence exploiting the NEX dimension efficiently. Moreover, we present a theoretical analysis supporting these numerical observations. Overall, this work proposes a sampling-reconstruction optimization framework highly suitable for low-field MRI, which can enable faster, higher-quality imaging with low-cost systems and contribute to advancing affordable and accessible healthcare.

Improving patient outcomes depends on the prompt and accurate diagnosis of brain tumors, but manual MRI scan analysis is still time-consuming and unreliable. Although deep learning has shown promise, many of the models that are now in use are computationally intensive and have difficulty handling the intrinsic complexity and variety of different types of brain tumors. In this work, we propose a lightweight yet high-performing Convolutional Neural Network (CNN) for multi-class brain tumor classification, employing MRI images to target gliomas, meningiomas, pituitary tumors, and healthy (no tumor) instances. The model was rigorously evaluated on two publicly accessible datasets from Figshare and Kaggle. Leveraging efficient feature extraction and optimized training strategies, our CNN achieved classification accuracies of 99.03% and 99.28%, along with ROC scores of 99.88% and 99.94% on Dataset 1 and Dataset 2, respectively-all while utilizing significantly fewer parameters than popular pre-trained architectures. In contrast to cutting-edge models like DenseNet201, MobileNetV2, VGG19, Xception, InceptionV3, and ResNet50, our approach consistently demonstrated superior performance with reduced computational overhead. These findings highlight the potential of the proposed model as a practical and reliable diagnostic aid in clinical environments.

Recently, diffusion models have attracted considerable attention for magnetic resonance image reconstruction due to their high sample quality. However, most existing methods rely on large networks with opaque time-conditioning mechanisms, and require offline coil sensitivity estimation. This results in limited interpretability of the reconstruction process and reduced flexibility in the acquisition setup. To address these limitations, we jointly reconstruct the image and the coil sensitivities by combining the parameter-efficient product-of-Gaussian-mixture diffusion model as an image prior with a classical smoothness prior on the coil sensitivities. The proposed method is fast and robust to both contrast and anatomical distribution shifts as well as changing k-space trajectories. Finally, we propose a more expressive parameterization of the image prior which improves results in denoising and magnetic resonance image reconstruction.

Quantitative cardiac magnetic resonance imaging (MRI) enables non-invasive myocardial tissue characterization but relies on robust motion correction within these variable-length, variable-contrast image sequences. Groupwise registration, which simultaneously aligns all images, has shown greater robustness than pairwise registration for motion correction. However, current deep-learning-based groupwise registration methods cannot generalize across MRI sequences: the architecture typically encodes input data as a fixed-length channel stack, which rigidly couples network design to protocol-specific sequence length, input ordering, and contrast dynamics. At inference time, any change in imaging protocols will render the network unusable. In this work, we introduce \emph{\AnyTwoReg}, a new set-based groupwise registration framework that takes a quantitative MRI sequence as an unordered set. This set formulation fundamentally decouples network design from sequence length and input ordering. By utilizing a shared encoder and correlation-guided feature aggregation, \emph{\AnyTwoReg} constructs a permutation-invariant canonical reference for registration, and learns a permutation-equivariant mapping from images to deformation fields. Additionally, we extract contrast-insensitive image features from an existing foundation model to handle extreme contrast variations. Trained exclusively on a single public $T_1$ mapping dataset (STONE, sequence length $L=11$), \AnyTwoReg generalizes to two unseen quantitative MRI datasets (MOLLI, ASL) with variable lengths ($L \in [11, 60]$) and different contrast dynamics. It achieves strong cross-protocol generalization in a zero-shot manner, and consistently improves downstream quantitative mapping quality. Notably, while designed for quantitative MRI sequences, our framework is directly applicable to Cine MRI sequences for inter-cardiac-phase registration.

Spatio-temporal fetal brain atlases are important for characterizing normative neurodevelopment and identifying congenital anomalies. However, existing atlas construction pipelines necessitate days for slice-to-volume reconstruction (SVR) to generate high-resolution 3D brain volumes and several additional days for iterative volume registration, thereby rendering atlas construction from large-scale cohorts prohibitively impractical. We address these limitations with INFANiTE, an Implicit Neural Representation (INR) framework for high-resolution Fetal brain spatio-temporal Atlas learNing from clinical Thick-slicE MRI scans, bypassing both the costly SVR and the iterative non-rigid registration steps entirely, thereby substantially accelerating atlas construction. Extensive experiments demonstrate that INFANiTE outperforms existing baselines in subject consistency, reference fidelity, intrinsic quality and biological plausibility, even under challenging sparse-data settings. Additionally, INFANiTE reduces the end-to-end processing time (i.e., from raw scans to the final atlas) from days to hours compared to the traditional 3D volume-based pipeline (e.g., SyGN), facilitating large-scale population-level fetal brain analysis. Code: https://github.com/hu2274898/INFANiTE

Prenatal germinal matrix-intraventricular hemorrhage (GMH-IVH) is a leading cause of infant mortality and neurodevelopmental impairment, yet its manual diagnosis and lesion segmentation on fetal brain MRI are labor-intensive and error-prone. Although supervised deep learning offers potential for automation, it typically requires large amounts of annotated GMH-IVH data, which are challenging to obtain for such a rare condition (0.5-0.9 per 1000 pregnancies). To address these problems, an annotation-free deep learning framework, FreeHemoSeg, was developed for automated detection and segmentation of GMH-IVH without any real patient annotations. Instead of learning from expert labels, FreeHemoSeg was trained on pseudo GMH-IVH images synthesized from normal fetal data guided by medical priors. The framework was evaluated in a retrospective multicentre study of 1,674 stacks of 2D T2-weighted MRI from 558 pregnant women, using data from one hospital for internal training and validation and two hospitals for external validation. FreeHemoSeg achieved the highest diagnostic and segmentation performance in both internal validation (AUROC: 0.959; AUPR: 0.928; sensitivity: 0.914; specificity: 0.966; DSC: 0.559) and external validation (AUROC: 0.930; AUPR: 0.884; sensitivity: 0.824; specificity: 0.943; DSC: 0.512), outperforming a supervised model trained on limited empirical data and unsupervised anomaly detection methods. Moreover, FreeHemoSeg assistance improved radiologists' sensitivity (from 0.882 to 0.941-1.000) and diagnostic confidence, while reducing interpretation time by 16.0-52.7%. We anticipate its immediate utility in supporting earlier diagnosis, prognostic counselling, and perinatal planning for fetal GMH-IVH. Code: https://github.com/Arktis2022/FreeHemoSeg.

Transforming neuroimaging data into clinically actionable biomarkers is a knowledge-intensive and labor-intensive process. Standardized workflows such as fMRIPrep have improved robustness and efficiency, but they are statically configured and cannot reason about downstream objectives, deliberate over alternative strategies, or close the loop between intermediate evidence and subsequent decisions in the way a human researcher would. This lack of closed-loop adaptation often leaves domain experts trapped in a cycle of manual trial-and-error to tune parameters and remediate pipeline failures, severely constraining the scalability of clinical biomarker development. To bridge this gap, we introduce NEXUS, an autonomous multi-agent framework that integrates neuroimaging workflow execution with scientific-objective understanding. Unlike conventional flat toolcalling agents, NEXUS adopts a code-centric execution paradigm where specialist agents collaboratively synthesize and optimize executable programs over composable domain-specific primitives. This design enables robust, long-horizon workflow construction that adapts dynamically to runtime observations. Furthermore, we propose a hierarchical verification framework for autonomous quality control, integrating cohort-level metric screening with agentic visual inspection to drive evidence-grounded workflow remediation. Experiments on ADHD-200 and ADNI demonstrate that NEXUS outperforms standard workflow-based baselines in predictive performance while exhibiting sophisticated agentic behaviors, including strategy exploration and adaptive refinement. The code is available at https://github.com/LearningKeqi/Virtual-Neuroscientist-NEXUS.

Purpose: To develop and evaluate cross-sequence transfer learning for automatic femoral cartilage segmentation, testing bidirectional transfer between dual-echo steady-state (DESS) and sagittal proton density-weighted 3D fast spin-echo (Cube) sequences. Materials and Methods: We optimized a modified 2D U-Net on 507 DESS images from the Osteoarthritis Initiative (OAI). We then established same-sequence baselines using subject-level cross-validation on a subset of 44 OAI DESS images and 44 Cube images acquired at the Istituto Ortopedico Rizzoli, Bologna, Italy. Each subset included 22 non-lesioned and 22 lesioned subjects. Finally, we performed transfer learning across sequences by fine-tuning the pretrained models on the target sequence with increasing training set sizes to study convergence, while keeping validation and test sets fixed. Segmentations were evaluated using Dice similarity coefficient (DSC) and average surface distance (ASD). Lesion effects were assessed with two-sided Mann-Whitney U tests with Bonferroni correction. Results: Same-sequence training yielded higher accuracy on DESS than Cube (DSC, $0.900$ vs $0.830$; $P < .001$). Cube-to-DESS transfer matched DESS performance (DSC, $0.903 \pm 0.032$ vs $0.900 \pm 0.027$), reaching a performance plateau at 9 training subjects. DESS-to-Cube yielded a lower combined DSC ($0.802 \pm 0.049$ vs $0.830 \pm 0.042$), reaching a plateau at 24 training subjects. Lesions did not affect DESS ($P \ge .39$) but reduced Cube accuracy (DSC, $0.805$ vs $0.856$; $P < .001$). Conclusion: Transfer learning across sequences can substantially reduce target-sequence annotation requirements for femoral cartilage segmentation, but performance is direction- and sequence-dependent, and the effects of lesions on segmentation may vary across MRI sequences.

Federated learning enables hospitals to collaboratively train segmentation models without sharing patient data. However, current evaluation protocols report only average performance across clients, masking failures at individual sites. In clinical deployment, a model that fails consistently at one hospital is a real safety risk that a good mean score can hide entirely. We introduce MedFL-Stress, a controlled stress-testing framework that exposes exactly this failure mode. Using 2D axial slices from BraTS 2020 distributed across four simulated hospital clients, we apply graded MRI appearance shifts (gamma contrast, scale-shift, and noise-plus-blur) reflecting scanner and acquisition variability in real multi-site deployments. Three federated baselines are evaluated: FedAvg, FedProx, and FedBN. Worst-hospital Dice and inter-hospital disparity are treated as primary metrics, not supplementary observations. FedAvg achieves the highest global mean Dice (0.8159) but conceals a 0.0850 gap between its best and worst-performing hospital. FedBN closes that gap by 41% (0.0850 to 0.0503) while sacrificing less than half a Dice point in mean accuracy (0.8159 to 0.8109), and the weakest hospital gains 3.5 Dice points outright (0.7309 to 0.7656). These findings demonstrate that robustness-oriented evaluation protocols are essential for reliable federated medical imaging deployment.

Deep vision models degrade sharply in low-data regimes, particularly in medical imaging where labeled samples are scarce. We show this arises not merely from overfitting but from a geometric failure: finite-sample noise corrupts the embedding covariance, collapsing the eigengap and limiting the number of recoverable signal-bearing modes. We develop a spectral theory of finite-sample representation learning that quantifies the recoverable dimension K(N), the number of eigenmodes that can be stably estimated from N samples. Using perturbation theory and concentration bounds, we show that only modes with eigenvalues above the noise floor $\|\hatΣ - Σ\|_{\mathrm{op}} \sim \sqrt{D/N}$ are reliable, yielding a truncated Mahalanobis energy that governs classification performance. Under a power-law spectral model, this energy can be approximated by a truncated Riemann zeta function, linking eigenvalue decay to data efficiency and AUC. Within this framework, multimodal learning acts as spectral stabilization: vision-language models impose low-rank constraints that suppress noise-dominated directions and preserve the eigengap, increasing K(N) under data scarcity. Across MNIST and multi-disease neuroimaging, we show that multimodal training maintains more stable modes and improves class separation, even when unimodal models achieve comparable few-shot accuracy. These results identify spectral collapse as a fundamental bottleneck in low-data learning. We use truncated Mahalanobis energy and K(N) to diagnose encoder quality, and introduce zeta-based spectral filtering as a principled approach to improve data efficiency.

Deep learning models in medical imaging typically operate as parametric memory, diagnosing patients by recalling fixed knowledge learned during training. This contrasts sharply with clinical practice, where physicians employ analogical reasoning to diagnose new cases by referencing similar records from past exemplars. While In-Context Learning (ICL) frameworks such as Tabular Prior-Fitted Networks (TabPFN) offer a promising diagnosis-by-reference paradigm, they are designed with tabular-specific inductive priors and rely on non-differentiable preprocessing pipelines, leading to manifold mismatch and gradient fracture when applied to heterogeneous multimodal data. To address these limitations, we propose PromptDx, a novel diagnosis-by-reference framework that leverages a pre-trained TabPFN as an ICL engine while enabling seamless integration with multimodal representations. Our core contribution is a Differentiable Prompt Tuning (DPT) mechanism that aligns a Masked Multimodal Modeling module with the pre-trained ICL engine. By training a lightweight adapter as a differentiable surrogate for the engine's non-differentiable preprocessors, we enable an end-to-end optimization of multimodal prompts within the ICL paradigm. We validate our method on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset using 3D MRI and tabular biomarkers. Experiments demonstrate that our approach outperforms traditional parametric baselines. Notably, our method achieves superior performance using only 1% context samples compared to 30% in standard ICL, demonstrating exceptional manifold condensation ability. We further validate the generalizability of our DPT framework across six tabular datasets with diverse scales. Overall, our method offers a more data-efficient and clinically aligned paradigm for Alzheimer's Disease diagnosis.

Deep learning and large public datasets have recently catalyzed the proliferation of AI models for processing brain recordings. However, systematically evaluating these models remains a challenge: not only do the preprocessing pipelines, training and finetuning approaches largely vary across studies, but their downstream evaluation is often limited to small sets of tasks and/or datasets. Here, we present NeuralBench: a unified framework for benchmarking AI models of brain activity. We accompany this framework with NeuralBench-EEG v1.0 -- a large EEG benchmark that includes 36 electroencephalography (EEG) tasks and 14 deep learning architectures, and is evaluated on 94 datasets accessed through a standardized interface. This first EEG-focused release already highlights two main findings. First, current foundation models only marginally outperform task-specific models. Second, a large set of tasks (e.g. cognitive decoding, clinical predictions) remain highly challenging, even for the best models. Critically, NeuralBench is designed for the integration of new tasks, datasets, models, and neuroimaging modalities, as illustrated by preliminary extensions to MEG and fMRI datasets and models. Through this white paper, we invite the community to expand this open-source framework and work together toward a unified benchmarking standard for neuroimaging models.

Recent advances in neuroimaging have deepened our understanding of the brain's complex functional and structural organization. Among these, functional Magnetic Resonance Imaging (fMRI) - particularly resting-state fMRI (rs-fMRI) - has emerged as a tool for identifying biomarkers of intrinsic brain connectivity and delineating large-scale neural networks. These networks are typically represented as volumetric spatial maps that capture functionally coherent brain regions and reflect individual differences in brain activity and structure. The spatial resolution of these maps plays an important role, as it determines the ability to localize functional units with precision, perform reliable brain parcellation, and detect subtle, spatially specific neurobiological alterations associated with development, aging, or disease. Therefore, improving the effective resolution of neuroimaging-derived maps holds significant promise for enabling more detailed insights into brain architecture and its relationship to behavior and pathology. To address this need, we propose NeuroGAN-3D, a novel 3D generative super-resolution model tailored to the computational demands of volumetric neuroimaging. Our model leverages a generative adversarial network architecture to enhance the spatial resolution of rs-fMRI spatial maps, significantly outperforming a conventional baseline.

Conventional MRI reconstruction methods treat images and coil sensitivities as discrete objects, leading to high memory demands and limited structural awareness that hamper effective regularization. These limitations hinder accurate reconstruction in highly undersampled scenarios, such as dynamic 3D cardiac magnetic resonance (CMR). We introduce a discretization-free, memory-efficient, model-based framework for dynamic 2D and 3D MRI reconstruction from highly undersampled data. We represent magnetization and coil sensitivities as continuous objects -- differentiable functions -- using tensor products of univariate neural fields. This tensor product structure enables scalable optimization in high-dimensional spatiotemporal settings. Our method outperforms state-of-the-art model-based reconstructions in dynamic 2D and 3D MR settings, preserving structure and motion even under aggressive undersampling (e.g., acceleration factor 16).

Precise molecular subtyping of gliomas, including isocitrate dehydrogenase (IDH) mutation and 1p/19q codeletion, directly guides surgical and therapeutic decisions, yet currently relies on invasive tissue sampling. Deep learning on structural MRI has emerged as a non-invasive alternative, but anatomy-only approaches cannot capture the hemodynamic signatures that distinguish molecular subtypes. Radiogenomics based on dynamic susceptibility contrast (DSC) MRI holds immense potential for non-invasively characterizing glioma molecular subtypes, yet clinical deployment has been hindered by inter-site variability and the limitations of voxel-wise analysis. We introduce HiPerfGNN, a framework that first learns discrete hemodynamic representations from raw time-intensity curves using a vector-quantized variational autoencoder (VQ-VAE). These quantized perfusion codes define coarse-level graph nodes representing functional tumor habitats, each of which is hierarchically subdivided into fine-level subregions guided by structural MRI. A hierarchical graph neural network then propagates information across scales for molecular prediction. On an internal cohort (n=475), the model achieved AUCs of 0.96 (IDH), 0.89 (1p/19q), and 0.84 (WHO grade), and maintained robust IDH performance (AUC 0.89) on an independent external cohort (n=397) without recalibration. Gradient-based saliency analysis confirms biologically grounded attention patterns aligned with known glioma pathophysiology. Our results demonstrate the added value of integrating perfusion dynamics into radiogenomic pipelines for glioma molecular subtyping. Code is available at https://github.com/janghana/HiPerfGNN.

Multimodal neuroimaging analysis often involves complex, modality-specific preprocessing workflows that require careful configuration, quality control, and coordination across heterogeneous toolchains. Beyond preprocessing, downstream statistical analysis and disease classification commonly require task-specific code, evaluation protocols, and data-format conventions, creating additional barriers between raw acquisitions and reproducible scientific analysis. We present NeuroAgent, an LLM-driven agentic framework that automates key preprocessing and analysis steps for heterogeneous neuroimaging data, including sMRI, fMRI, dMRI, and PET, and supports interactive downstream analysis through natural-language queries. NeuroAgent employs a hierarchical multi-agent architecture with a feedback-driven Generate-Execute-Validate engine: agents autonomously generate executable preprocessing code, detect and recover from runtime errors, and validate output integrity. We evaluate the system on 1,470 subjects pooled across all ADNI phases (CN=1,000, AD=470), where all subjects have sMRI and tabular data, with subsets also having Tau-PET (n=469), fMRI (n=278), and DTI ($n=620$). Pipeline ablation studies across multiple LLM backends show that capable models reach up to 100% intent-parsing accuracy, with the strongest backend (Qwen3.5-27B) reaching 84.8% end-to-end preprocessing step correctness. Automated recovery limits manual intervention to edge cases where human review is required via the Human-In-The-Loop interface. For Alzheimer's Disease classification using automatically preprocessed multimodal data, our agent ensemble achieves an AUC of 0.9518 with four modalities, outperforming all single-modality baselines. These results show that NeuroAgent can reduce the manual effort required for neuroimaging preprocessing and enable end-to-end automated analysis pipelines for neuroimaging research.

Self-supervised pretraining has become the mainstream approach for learning MRI representations from unlabeled scans. However, most existing objectives still treat each scan primarily as static aggregations of slices, patches or volumes. We ask whether there exists an intrinsic form of self-supervision signal that is different from reconstructing the masked patches, through transforming the 3D volumes into controllable 2D rendered sequences: by rendering slices at continuous positions, orientations, and scales, a 3D volume can be converted into dense video-action sequences whose controls are the action trajectories. We study this formulation with an action-conditioned pretraining objective, where a tokenizer encodes slice observations and a latent dynamics model predicts the evolution of latent features. Across representative anatomical and spatial downstream tasks, the proposed pretraining is evaluated against standard static-volume baselines, tokenizer-only pretraining, and dynamics variants without aligned actions. These results suggest that controllable MRI slice navigation provides a useful complementary pretraining interface for learning anatomical and spatial representations from large unlabeled MRI collections.

Cardiac magnetic resonance (CMR) segmentation underpins quantitative assessment of ventricular structure and function, yet reliable delineation remains difficult due to low tissue contrast, fuzzy boundaries, and inter scan variability. We present CardiacNAS, an evolutionary neural architecture search (NAS) framework that couples a UNet like supernet with a cardiac aware search space spanning depth width, kernel size, filter size, attention, fusion, activation, dropout, and residual scaling. The search is explicitly resource aware, jointly optimizing dice similarity coefficient (DSC) and 95th percentile Hausdorff distance (HD95) versus model size and floating point operations (FLOPs) under fixed compute budgets. Candidate architectures are instantiated from the supernet, trained with proxy budgets, and evolved through crossover, mutation, and elitist selection. We evaluate on the ACDC dataset and compare against six state of the art methods, using qualitative comparisons, learning curve analyses, and design factor correlation studies. The resulting model attains 93.22% average DSC and 4.73 mm HD95 with 3.58M parameters and 14.56 GFLOPs, demonstrating a favorable accuracy efficiency trade off. Analyses indicate that searched attention and fusion choices, together with residual scaling, contribute to improved boundary fidelity and stability. CardiacNAS offers a principled, resource aware approach to deployable CMR segmentation with transparent reporting of architectural complexity and compute budgets.

Although self-supervised pretraining is expected to learn broadly transferable representations, its effectiveness across imaging modalities substantially different from the pretraining domain, and on complex tumor-segmentation tasks, remains understudied. Evaluating CT-pretrained transformers on MRI rectal cancer segmentation, we identified two interacting failure modes in CT-to-MRI transfer: (a) inefficient token usage caused by zero-padding to match pretrained input dimensions, and (b) ineffective feature adaptation. We investigated these vulnerabilities using two primary CT-pretrained hierarchical shifted-window transformer backbones, SMIT and Swin UNETR, together with VoCo as a large-scale-pretrained supporting benchmark; these models differ in pretraining objectives and datasets. Mechanistic analysis leveraged an attention dilution index (ADI), an entropy-based metric quantifying attention diverted toward uninformative padding tokens, and centered kernel alignment (CKA) to measure feature reuse during MRI adaptation. ADI increased with zero-padding, while high feature reuse did not necessarily translate to improved downstream accuracy. To mitigate these issues, we introduced two interventions: a tumor-aware augmentation strategy to expand tumor appearance heterogeneity coverage, and an anisotropic cropping strategy to restore token efficiency. Fine-tuning with these strategies on identical rectal MRI datasets yielded detection rates of 91.1% (225/247) and 88.7% (219/247) for the primary SMIT and Swin UNETR backbones, with the supporting VoCo benchmark reaching 90.3% (223/247), demonstrating significantly improved robustness under CT-to-MRI transfer. This study is among the first to examine when pretrained transformers fail to transfer across imaging modalities and demonstrates how targeted mitigation strategies can systematically overcome cross-modality transfer limitations.

Background: Existing MRI LLM benchmarks rely mainly on review-book multiple-choice questions, where top proprietary models already score highly, limiting discrimination. No systematic benchmark has evaluated vendor-specific scanner operational knowledge central to research MRI practice. Purpose: We developed MRI-Eval, a tiered benchmark for relative model comparison on MRI physics and GE scanner operations knowledge using primary multiple-choice questions (MCQ), with stem-only and primed diagnostic conditions as complementary analyses. Methods: MRI-Eval includes 1365 scored items across nine categories and three difficulty tiers from textbooks, GE scanner manuals, programming course materials, and expert-generated questions. Five model families were evaluated (GPT-5.4, Claude Opus 4.6, Claude Sonnet 4.6, Gemini 2.5 Pro, Llama 3.3 70B). MCQ was primary; stem-only removed options and used an independent LLM judge; primed stem-only tested responses to incorrect user claims. Results: Overall MCQ accuracy was 93.2% to 97.1%. GE scanner operations was the lowest category for every model (88.2% to 94.6%). In stem-only, frontier-model accuracy fell to 58.4% to 61.1%, and Llama 3.3 70B fell to 37.1%; GE scanner operations stem-only accuracy was 13.8% to 29.8%. Conclusion: High MCQ performance can mask weak free-text recall, especially for vendor-specific operational knowledge. MRI-Eval is most informative as a relative comparison benchmark rather than an absolute competency measure and supports caution in using raw LLM outputs for GE-specific protocol guidance.

Automatic brain tumor segmentation from multi-modal MRI remains challenging because volumetric models often incur substantial computational cost. This paper presents DALight-3D, a compact 3D U-Net variant that combines depthwise separable 3D convolutions, identifier-conditioned normalization, cross-slice attention, and adaptive skip fusion. The method is evaluated on the Medical Segmentation Decathlon Task01 BrainTumour benchmark under matched optimization settings against standard 3D U-Net, Attention U-Net, Residual 3D U-Net, and V-Net baselines. In the reported 50-epoch comparison, DALight-3D achieves a mean Dice of 0.727 with 2.22M parameters, compared with 0.710 Dice and 3.20M parameters for Residual 3D U-Net. Component-wise ablations show consistent performance degradation when SepConv, identifier-conditioned normalization, CSA, or SSFB is removed. These results indicate that DALight-3D offers a favorable accuracy-efficiency trade-off within the present benchmark setting.

We propose a multimodal latent diffusion model that jointly synthesizes volumetric magnetic resonance imaging (MRI) and tabular clinical data within a shared latent space via cross-attention. This approach enables coherent joint representation learning of MRI and tabular modalities for generative modeling. Our model utilizes a variational autoencoder to fuse the two modalities before diffusion-based synthesis, allowing modality-appropriate reconstruction with separate decoders for MRI and tabular data. We evaluated the framework on data from the German National Cohort (NAKO Gesundheitsstudie), comprising over 10,000 participants with MRI scans and clinical tabular features such as age, sex, body measurements, and ethnicity. The generated MRI volumes exhibited anatomical plausibility and body composition consistent with the synthesized tabular attributes. Quantitative evaluation using Fréchet distance and precision-recall metrics confirmed high-fidelity image generation. In the tabular modality, our model outperformed CTGAN across standard evaluation metrics and achieved results comparable to TVAE, demonstrating competitive performance relative to established unimodal baselines. This work is, to our knowledge, the first to demonstrate the feasibility of jointly modeling MRI and mixed-type tabular data in a single latent diffusion framework, offering a proof-of-concept for generating coherent synthetic multimodal patient data and aligning with the broader goal of developing digital twins in healthcare.

The clinical integration of deep learning models for brain tumor diagnosis in neuro-oncology is severely constrained by limited expert-annotated MRI data and substantial inter-institutional domain shift arising from variations in scanners, imaging protocols, and contrast settings. These challenges significantly impair model generalization in real-world settings. To address this, we propose a novel orientation-aware unsupervised domain-adaptive framework for automated brain tumor classification using mixed 2D MRI slices. Initially, a CNN with large receptive field first categorizes input slices into axial, sagittal, and coronal views. For each orientation, a CNN architecture with ResNet50 backbone augmented with four fully connected layers is trained to extract discriminative features for tumor classification. To mitigate annotation scarcity and domain discrepancies, we introduce a slice-wise unsupervised domain adaptation strategy that transfers knowledge from the multi-modal such as T1, T2, and FLAIR source domain to the post-contrast T1 target domain. Feature-level alignment is enforced using maximum mean discrepancy loss, complemented by pseudo-label guided adaptation to preserve class discriminability. Extensive experiments demonstrate improved target-domain performance over prior approaches, highlighting the benefits of orientation-specific learning, multi-modal knowledge transfer, pseudo-label-guided adaptation, and unsupervised domain adaptation.

Magnetic Resonance Imaging (MRI) acquisition remains a time-intensive and patient-straining process, as prolonged scan dura- tions increase the likelihood of motion artifacts, which degrade image quality and frequently require repeated scans. To address these chal- lenges, we propose a novel framework with two models MK-ResRecon and IdentityRefineNet3D to reconstruct high-fidelity 3D MRI volumes from sparsely sampled 2D slices-requiring only 12.5% of the axial slices for full resolution 3D reconstruction. MK-ResRecon predicts missing in- termediate 2D slices using a multi-kernel texture-aware loss, preserving fine anatomical details. IdentityRefineNet3D refines the predicted slices and the original sparse slices as a single 3D volume to obtain a smooth anatomical structure. We train the models on a large T1-sequence POST- contrast brain MRI dataset and evaluate on a large heterogeneous brain MRI cohort. The work provides accurate, hallucination-free, generaliz- able and clinically validated framework for 3D MRI reconstruction from highly sparse inputs and enables a clinically viable path towards faster and more patient-friendly MRI imaging.

Deep learning-based medical image segmentation is increasingly used to support clinical diagnosis and develop new treatment strategies. However, model performance remains limited by the scarcity of high-quality annotated data and insufficient generalization across imaging protocols. This limitation is particularly evident in MRI and CT, where models are typically trained on a single acquisition sequence and exhibit reduced robustness when applied to unseen sequences or contrasts. Although data augmentation is widely used to improve general robustness on medical images, its impact on cross-modality generalization has not been quantitatively explored. In this work, we study a targeted set of data augmentation techniques designed to improve cross-modality transfer. We train three spine segmentation models, each on a single-modality/sequence dataset, and evaluate them across seven out-of-distribution datasets (spanning CT and MRI), reflecting a realistic single-sequence training and multi-sequence/contrast/modality deployment scenario. Our results demonstrate substantial performance gains on unseen domains (average Dice gain of 155 %) while preserving in-domain accuracy (average Dice decrease of 0.008 %), including effective transfer between CT and MRI. To mitigate the computational cost typically associated with strong data augmentation, we implement GPU-optimized augmentations that maintain, and even improve, training efficiency by approximately 10 %. We release our approach as an open-source toolbox, enabling seamless integration into commonly used frameworks such as nnUNet and MONAI. These augmentations significantly enhance robustness to heterogeneous clinical imaging scenarios without compromising training speed.

Existing cross-subject fMRI decoding methods typically train a model on multiple scanned subjects and then adapt it to a new subject using substantial paired fMRI-image data. However, in realistic scenarios, new-subject fMRI data are often limited due to costly data acquisition, and raw data from previous subjects may be inaccessible, leading existing methods to suffer performance degradation during new-subject adaptation. In this paper, we identify that this degradation stems from two key issues: brain-side instability caused by large subject differences in fMRI responses, and image-side supervision unreliability caused by fine-grained visual details that are not reliably supported by limited fMRI signals. To address these challenges, we propose StableMind, a regularized adaptation framework designed to improve brain-side representation stability and image-side supervision reliability. (1) To stabilize brain representations, StableMind reuses ridge projections from the pretrained model as adaptation priors to constrain limited-data new-subject adaptation, and applies Fourier-based feature-level brain augmentation to improve robustness to individual variability. (2) To improve image supervision reliability, StableMind introduces difficulty-aware image blur for brain-image alignment, reducing the influence of fine-grained visual details that are weakly supported by limited fMRI signals while preserving stable visual structure. Experiments on the Natural Scenes Dataset under a unified 1-hour adaptation protocol demonstrate that StableMind achieves 84.02% image retrieval accuracy and 81.66% brain retrieval accuracy averaged over four subjects, surpassing the state-of-the-art method by 5.71% brain retrieval accuracy with fewer trainable adaptation parameters. Our code is available at https://github.com/lingeringlight/StableMind.

Rotating-view thick-slice acquisition is highly SNR-efficient for mesoscale diffusion MRI (dMRI) but requires numerous rotating views to satisfy Nyquist sampling, resulting in long scan time. We propose a self-supervised Spatial-Angular Implicit Neural Representation (SA-INR) that reconstructs high-resolution dMRI from a single view per diffusion direction, representing a massive acceleration. Our model, an MLP conditioned on a b=0 structural prior and the b-direction via FiLM, is trained end-to-end on the anisotropic input. The framework not only accurately reconstructs the trained b-directions (spatial SR) but also learns a continuous q-space representation, enabling high-fidelity "zero-shot" synthesis of unseen b-directions (angular SR). On simulated data, our method achieved high fidelity for both trained (34.82 dB) and unseen (33.08 dB) directions. Most importantly, the synthesized angular data also improved the quantitative accuracy of downstream DTI model fitting. Our SA-INR framework breaks the classical sampling limits, paving the way for fast, quantitative high-resolution dMRI.

Classifying brain tumors using magnetic resonance imaging (MRI) is crucial for early diagnosis and treatment; however, tumor heterogeneity and a dearth of annotated datasets restrict the use of supervised deep learning approaches. In this work, we use self-supervised learning (SSL) to study multi-class brain tumor classification. Using a ResNet-50 backbone, we evaluate four SSL frameworks including SimCLR, BYOL, DINO, and Moco v3 on a publicly available dataset of 4,448 MRIs with 17 distinct tumor types. On the dataset, SimCLR achieved 99.64% accuracy, 99.64% precision, 99.64% recall, and 99.64% F1-score. The workflow includes preprocessing, fine-tuning, linear evaluation, and SSL pretraining with data augmentations. Results show that, when labels are limited, SSL-pretrained models outperform supervised baselines in terms of F1-score, recall, accuracy, and precision. Additionally, by providing visual insights into model decisions, Explainable AI techniques (Grad-CAM, Grad-CAM++, EigenCAM) enhance interpretability. These results demonstrate SSL's scalability and dependability in diagnosing brain tumors from unlabeled medical data.

In MRI, variations in scan parameters, sequence, or hardware can lead to discrepancies in image appearance, even for the same subject. These inconsistencies, known as domain shifts, can hinder image analysis and degrade the performance of deep learning models trained on data from specific target domains. MRI image harmonization aims to address these issues by aligning source domain images to the target domain images while preserving biological information such as anatomical structures. However, most existing harmonization approaches require access to both source and target domain data in training or test time. This dependence induces data sharing between institutions, raising concerns about patient privacy and substantially limiting the harmonization approaches that can be practically deployed in clinical settings. To overcome these limitations, we introduce TgtFreeHarmony, the harmonization framework tailored for target-free scenarios, eliminating the need for target domain data and any data sharing, enabling privacy-preserving harmonization directly within the source institution. Our approach estimates the target domain style by searching the manifold of MRI domain style constructed via a disentanglement-based generator using Bayesian optimization guided by the performance of a downstream task model, which is trained on target domain data. We evaluated our method on the brain tissue segmentation task across multiple institutes and demonstrated that it effectively harmonizes source images into target images, leading to improved downstream task performance. By enabling harmonization without any access to target-domain data, TgtFreeHarmony establishes a new direction of harmonization preserving data privacy that can be realistically deployed within clinical environments.

Self-supervised pretraining is promising for large-scale neuroimaging, yet the impact of region-aware masking and hybrid sequence modeling remains underexplored. In this work, we introduce Rhamba, a region-aware pretraining framework that integrates anatomically guided masking with hybrid Attention-Mamba architectures for resting state functional magnetic resonance imaging (fMRI) analysis. Models were pretrained on the ABIDE dataset using region-aligned patch embeddings and three masking strategies (Any, Majority, and Pure) with increasing spatial specificity. We evaluated four architectural variants: a Mamba only model, an Alternate architecture with interleaved Mamba and Attention blocks, and two hybrid encoder-decoder configurations (Attention-Mamba (AM) and Mamba-Attention (MA)). The pretrained models were fine-tuned on downstream classification tasks using the COBRE and ADHD-200 datasets for schizophrenia and attention-deficit/hyperactivity disorder discrimination. We employed Integrated Gradients, an explainable AI method, to identify the brain regions contributing to model predictions. Masking strategy strongly influenced reconstruction behavior, with reconstruction loss following a consistent ordering (Any > Majority > Pure). However, this trend did not directly translate into downstream performance, where differences were modest and dataset-dependent. The hybrid architecture with the MA configuration achieved the highest average AUROC across both datasets, and Rhamba outperformed state-of-the-art methods in comparative evaluation. Region-wise analysis showed that peak performance depends on the interaction between masking strategy and architecture rather than a single dominant configuration. Overall, Rhamba offers a flexible framework for balancing interpretability, scalability, and performance in large-scale fMRI representation learning.

Accelerated magnetic resonance imaging (MRI) enabled by the training of deep learning (DL)-based image recon. models requires large and diverse raw k-space datasets. In most clinical MRI applications, due to storage and patient privacy concerns, raw k-space data is discarded and magnitude-only images are the only component saved. Consequently, a large portion of the DL-based MRI recon. literature has either relied on small training datasets or has used one of the few available open-source k-space datasets. At the same time, the growing number of anonymized magnitude-only image registries/databases motivates the development of techniques that can use them as training datasets for generalizable DL-based recon. models. Here we propose to address this challenge by employing a generative approach based on conditional score-based diffusion models (SBDMs): given a magnitude-only MR image, it synthesizes a phase map (in the image domain) that realistically corresponds to the magnitude-only image. We evaluate its generative capabilities in a downstream DL-based recon. task whereby a large k-space dataset is generated by combining the SBDM-synthesized phase-maps and the corresponding magnitude-only images, and this k-space dataset is then used to train a DL model for accelerated MRI recon. We compare the performance of the resulting DL model versus those trained according to (a) a naive approach that uses smooth phase, (b) a k-space training dataset generated using synthesized phase maps derived from a generative adversarial network, and (c) the ground truth k-space data. Our results suggest that the DL model trained from SBDM-synthesized k-space data outperforms the other approaches in terms of quantitative metrics as well as qualitatively observed recon. fidelity, i.e., whether the reconstructed images include erroneous or hallucinated features that could adversely impact diagnostic accuracy.

Accurate synthesis of computed tomography (CT) images from magnetic resonance imaging (MRI) is clinically valuable for cranial applications such as attenuation correction, radiotherapy planning, and image-guided interventions. However, heterogeneity across MRI field strengths and acquisition protocols limits the generalizability of existing methods. In this study, we formulate cranial CT synthesis as a modular, structurally coupled problem and propose a deep learning framework to improve robustness across heterogeneous MRI conditions. The model is designed to adapt to variations in field strength and imaging protocols while preserving anatomical consistency. Experiments on multi-site datasets demonstrate improved performance and generalization compared with conventional approaches. The proposed method enables reliable CT synthesis across heterogeneous MRI settings, supporting broader clinical translation.

Brain MRI underpins a wide range of neuroscientific and clinical applications, yet most learning-based methods remain task-specific and require substantial labeled data. Here we show that a single self-supervised representation can generalize across heterogeneous brain MRI endpoints. We trained BrainDINO, a self-distilled foundation model, on approximately 6.6 million unlabeled axial slices from 20 datasets encompassing broad variation in population, disease, and acquisition setting. Using a frozen encoder with lightweight task heads, BrainDINO supported transfer across tumor segmentation, neurodegenerative and neurodevelopmental conditions classification, brain age estimation, post-stroke temporal prediction, molecular status prediction, MRI sequence classification, and survival modeling. Across tasks and supervision regimes, BrainDINO consistently equaled or exceeded natural-image and MRI-specific self-supervised baselines, with particularly strong advantages under label scarcity. Representation analyses further showed anatomically organized and pathology-sensitive feature structure in the absence of task-specific supervision. Our findings indicate that large-scale slice-wise self-supervised learning can yield a unified brain MRI representation that supports diverse neuroimaging tasks without volumetric pretraining or full-network fine-tuning, establishing a scalable foundation for robust and data-efficient brain imaging analysis. Code is available at https://github.com/mclwu22/BrainDINO

Cognitive decline is highly heterogeneous across individuals, which complicates prognosis, trial design, and treatment planning. We present the Personalized Cognitive Decline Assessment Digital Twin (PCD-DT), a multimodal and uncertainty-aware framework for modeling patient-specific disease trajectories from sparse, noisy, and irregular longitudinal data. The framework combines three methodological components: (1) latent state-space models for individualized temporal dynamics, (2) multimodal fusion for clinical, biomarker, and imaging features, and (3) uncertainty-aware validation and adaptive updating for robust digital twin operation. We also outline how conditional generative models can support data augmentation and stress testing for underrepresented progression patterns. As a preliminary feasibility study, we analyze longitudinal TADPOLE trajectories and show clear separation between cognitively normal and Alzheimer's disease cohorts in ADAS13, ventricle volume, and hippocampal volume over five years. We further conduct a multimodal next-visit prediction ablation using an LSTM sequence model on 3{,}003 visit-pair sequences derived from TADPOLE, where the combined cognitive plus MRI configuration achieves the lowest standardized RMSE for both ADAS13 (0.4419) and ventricle volume (0.5842), outperforming a Last Observation Carried Forward baseline. A Bayesian tensor modeling component for high-dimensional imaging fusion is also discussed. These results support the feasibility of the proposed architecture while also highlighting the need for stronger uncertainty calibration and longer-horizon predictive evaluation. The PCD-DT framework provides a principled starting point for personalized in silico modeling in neurodegenerative disease. This work positions PCD-DT as a foundational step toward clinically deployable, uncertainty-aware digital twin systems.

Despite being resource-intensive to train, 3D convolutional neural networks (CNNs) have been the standard approach to classify CT and MRI scans. Recent work suggests that deep multiple instance learning (MIL) may be a more efficient alternative for 3D brain scans, especially when the pre-trained image encoder used to embed each 2D slice is frozen and only the pooling operation and classifier are trained. In this paper, we provide a systematic comparison of simple MIL, attention-based MIL, 3D CNNs, and 3D ViTs across three CT and four MRI datasets, including two large datasets of at least 10,000 scans. Our goal is to help resource-constrained practitioners understand which neural networks work well for 3D neuroimages and why. We further compare design choices for attention-based MIL, including different encoders, pooling operations, and architectural orderings. We find that simple mean pooling MIL, without any learnable attention, matches or outperforms recent MIL or 3D CNN alternatives on 4 of 6 moderate-sized tasks. This baseline remains competitive on two large datasets while being 25x faster to train. To explain mean pooling's success, we examine per-slice attention quality and a semi-synthetic dataset where we can derive the best possible classifier via a Bayes estimator. This analysis reveals the limits of existing MIL approaches and suggests routes for future improvements.

We report our multi-stage framework designed for the problem of multi-class bi-atrial segmentation from 3D late gadolinium-enhanced (LGE) MRI of the human heart. The pipeline consists of a preprocessing step using multidimensional contrast limited adaptive histogram equalization (MCLAHE); coarse region segmentation from MCLAHE-enhanced and down-sampled MRI using a V-Net family model; and fine segmentation from the coarse region using another V-Net model. Asymmetric loss is adopted to optimize the model weights.

Accurate brain lesion segmentation in MRI is vital for effective clinical diagnosis and treatment planning. Due to high annotation costs and strict data privacy regulations, universal models require employing Continual Learning (CL) to adapt to evolving clinical tasks without losing previously acquired knowledge. However, existing CL paradigms often suffer from capacity limits or redundant parameter growth, and even advanced dynamic methods rely mostly on image-perception strategies that struggle to handle the substantial pathological and multimodal heterogeneity inherent in brain imaging. To address this issue, we propose Concept-Reasoning Expansion (CoRE) framework, which establishes a joint decision-making mechanism by integrating visual features with structured concepts. Through the alignment of image tokens with a hierarchical concept library, CoRE simulates clinical reasoning to guide both interpretable expert routing and demand-based model growth. This collaborative process ensures model evolution is grounded in clinical priors, preventing redundant parameter expansion while maximizing knowledge reuse. Extensive evaluations across 12 sequential brain lesion MRI tasks demonstrate that CoRE achieves state-of-the-art performance and provides a high knowledge starting point for efficient future adaptation. Its superior few-shot transferability and clinical interpretability further validate its effectiveness in managing non-stationary clinical data streams. Our code will be released soon.

Clinical abnormality grounding for rare diseases is often hindered by data scarcity, making supervised fine-tuning impractical and single-pass inference highly unstable. We propose Dynamic Decision Learning (DDL), a framework that enables frozen large vision-language models (LVLMs) to refine their decisions across both language and visual spaces by optimizing instructions and consolidating predictions under visual perturbations. This process improves localization quality and produces a consensus-based reliability score that quantifies model confidence. Results on brain imaging benchmarks, including a rare-disease dataset with 281 pathology types across models ranging from 3B to 72B parameters, show that DDL improves mAP@75 by up to 105% on rare-disease cases and outperforms adaptation baselines and supervised fine-tuning. Furthermore, DDL demonstrates stronger calibration between reliability scores and localization accuracy under severe distribution shifts and increasing task difficulty. Code is available at: https://lijunrio.github.io/DDL/

Encoding models provide a powerful framework for linking continuous stimulus features to neural activity; however, traditional voxelwise approaches are limited by measurement noise, inter-subject variability, and redundancy arising from spatially correlated voxels encoding overlapping neural signals. Here, we propose an independent component (IC)-based encoding framework that dissociates stimulus-driven and noise-driven signals in fMRI data. We decompose continuous fMRI data from naturalistic story listening into ICs using one subset of the data, and train encoding models on independent data to predict IC time series from large language model representations of linguistic input. Across subjects, a subset of ICs exhibited consistently high predictivity. These ICs were spatially and temporally consistent across subjects and included cognitive networks known to respond during story listening (auditory and language). Auditory component time series were strongly correlated with acoustic stimulus features, highlighting the interpretability of identified component time series. Components identified as noise or motion-related artifacts by ICA-AROMA showed uniformly poor predictive performance, confirming that highly predicted components reflect genuine stimulus-related neural signals rather than confounds. Overall, IC-based encoding models enable analyses at the level of functional networks, accommodating the variability in network locations across individuals and providing interpretable results that are easy to compare across subjects. Code provided at: https://github.com/kamyahari/IC-Encoding-Models.git

Segmentation models such as Segment Anything Model (SAM) and SAM2 achieve strong prompt-driven zero-shot performance. However, their training on natural images limits domain transfer to medical data. Consequently, accurate segmentation typically requires extensive fine-tuning and expert-designed prompts. We propose DiffuSAM, a diffusion-based adaptation of SAM2 for prompt-free medical image segmentation. Our framework synthesizes SAM2-compatible segmentation mask-like embeddings via a lightweight diffusion-prior from off-the-shelf frozen SAM2 image features. The generated embeddings are integrated into SAM2's mask decoder to produce accurate segmentations, thereby eliminating the need for user prompts. The diffusion prior is further conditioned on previously segmented slices, enforcing spatial consistency across volumes. Evaluated on the BTCV and CHAOS datasets for CT and MRI under Source-Free Unsupervised Domain Adaptation (SF-UDA) and Few-Shot settings, DiffuSAM achieves competitive performance with efficient training and inference. Code is available upon request from the corresponding author.

Agentic artificial intelligence systems promise to accelerate scientific workflows, but neuroimaging poses unique challenges: heterogeneous modalities (sMRI, fMRI, dMRI, EEG), long multi-stage pipelines, and persistent reproducibility risks. To address this gap, we present NeuroClaw, a domain-specialized multi-agent research assistant for executable and reproducible neuroimaging research. NeuroClaw operates directly on raw neuroimaging data across formats and modalities, grounding decisions in dataset semantics and BIDS metadata so users need not prepare curated inputs or bespoke model code. The platform combines harness engineering with end-to-end environment management, including pinned Python environments, Docker support, automated installers for common neuroimaging tools, and GPU configuration. In practice, this layer emphasizes checkpointing, post-execution verification, structured audit traces, and controlled runtime setup, making toolchains more transparent while improving reproducibility and auditability. A three-tier skill/agent hierarchy separates user-facing interaction, high-level orchestration, and low-level tool skills to decompose complex workflows into safe, reusable units. Alongside the NeuroClaw framework, we introduce NeuroBench, a system-level benchmark for executability, artifact validity, and reproducibility readiness. Across multiple multimodal LLMs, NeuroClaw-enabled runs yield consistent and substantial score improvements compared with direct agent invocation. Project homepage: https://cuhk-aim-group.github.io/NeuroClaw/index.html