Magnetic Resonance Imaging

Tau positron emission tomography supports Alzheimer's disease staging but is difficult to scale because of tracer, scanner, and radiation constraints. Synthesis from structural MRI is therefore attractive, but it is a particularly difficult setting. T1-weighted and FLAIR MRI provide anatomy and disease correlated morphology, but they do not directly measure Tau-PET relevant signal. We introduce SFL-Net, a multi-input synthesis framework that predicts Tau-PET from T1-weighted and FLAIR MRI. SFL-Net factorizes the latent representation into shared, T1-specific, FLAIR-specific, and complementary pathways and preserves anatomical detail through latent structural conditioning rather than direct encoder-decoder connections. We evaluated SFL-Net and baseline models using 605 training and 83 validation subjects from ADNI-3 and OASIS-3 datasets. Evaluation included raw image fidelity, standardized uptake value ratio agreement, high uptake overlap, regional Bland-Altman bias, braak derived stage agreement, non-inferiority sensitivity analysis, and latent component Shapley attribution. SFL-Net performed competitively on both clinically relevant and reconstruction metrics, while also delivering explicit source level auditability that conventional UNet derived models lack.

State-of-the-art learned reconstruction methods often rely on black-box modules that, despite their strong performance, raise questions about their interpretability and robustness. Here, we build on a recently proposed image reconstruction method, which is based on embedding data-driven information into a model-based convolutional dictionary regularization via neural network-inferred spatially adaptive sparsity level maps. By means of improved network design and dedicated training strategies, we extend the method to achieve filter-permutation invariance as well as the possibility to change the convolutional dictionary at inference time. We apply our method to low-field MRI and compare it to several other recent deep learning-based methods, also on in vivo data, where the benefit of using a different dictionary is demonstrated. We further assess the method's robustness when tested on in- and out-of-distribution data. When tested on the latter, the proposed method suffers less from the data distribution shift compared to the other learned methods, which we attribute to its reduced reliance on training data due to its underlying model-based reconstruction component.

Retrospective MRI harmonization is limited by poor scalability across modalities and reliance on traveling subject datasets. To address these challenges, we introduce IHF-Harmony, a unified invertible hierarchy flow framework for multi-modality harmonization using unpaired data. By decomposing the translation process into reversible feature transformations, IHF-Harmony guarantees bijective mapping and lossless reconstruction to prevent anatomical distortion. Specifically, an invertible hierarchy flow (IHF) performs hierarchical subtractive coupling to progressively remove artefact-related features, while an artefact-aware normalization (AAN) employs anatomy-fixed feature modulation to accurately transfer target characteristics. Combined with anatomy and artefact consistency loss objectives, IHF-Harmony achieves high-fidelity harmonization that retains source anatomy. Experiments across multiple MRI modalities demonstrate that IHF-Harmony outperforms existing methods in both anatomical fidelity and downstream task performance, facilitating robust harmonization for large-scale multi-site imaging studies. Code is available at https://github.com/Idea89560041/IHF-Harmony.

Magnetic Resonance Imaging (MRI) is a crucial non-invasive imaging modality. In routine clinical practice, multi-stack thick-slice acquisitions are widely used to reduce scan time and motion sensitivity, particularly in challenging scenarios such as fetal brain imaging. However, the resulting severe through-plane anisotropy compromises volumetric analysis and downstream quantitative assessment, necessitating robust reconstruction of isotropic high-resolution volumes. Implicit neural representation methods, while achieving high quality, suffer from computational inefficiency due to complex network structures. We present M-Gaussian, adapting 3D Gaussian Splatting to MRI reconstruction. Our contributions include: (1) Magnetic Gaussian primitives with physics-consistent volumetric rendering, (2) neural residual field for high-frequency detail refinement, and (3) multi-resolution progressive training. Our method achieves an optimal balance between quality and speed. On the FeTA dataset, M-Gaussian achieves 40.31 dB PSNR while being 14 times faster, representing the first successful adaptation of 3D Gaussian Splatting to multi-stack MRI reconstruction.

Musculoskeletal disorders represent a significant global health burden and are a leading cause of disability worldwide. While MRI is essential for accurate diagnosis, its interpretation remains exceptionally challenging. Radiologists must identify multiple potential abnormalities within complex anatomical structures across different imaging planes, a process that requires significant expertise and is prone to variability. We developed OrthoDiffusion, a unified diffusion-based foundation model designed for multi-task musculoskeletal MRI interpretation. The framework utilizes three orientation-specific 3D diffusion models, pre-trained in a self-supervised manner on 15,948 unlabeled knee MRI scans, to learn robust anatomical features from sagittal, coronal, and axial views. These view-specific representations are integrated to support diverse clinical tasks, including anatomical segmentation and multi-label diagnosis. Our evaluation demonstrates that OrthoDiffusion achieves excellent performance in the segmentation of 11 knee structures and the detection of 8 knee abnormalities. The model exhibited remarkable robustness across different clinical centers and MRI field strengths, consistently outperforming traditional supervised models. Notably, in settings where labeled data was scarce, OrthoDiffusion maintained high diagnostic precision using only 10% of training labels. Furthermore, the anatomical representations learned from knee imaging proved highly transferable to other joints, achieving strong diagnostic performance across 11 diseases of the ankle and shoulder. These findings suggest that diffusion-based foundation models can serve as a unified platform for multi-disease diagnosis and anatomical segmentation, potentially improving the efficiency and accuracy of musculoskeletal MRI interpretation in real-world clinical workflows.

Magnetic resonance spectroscopy (MRS) is used to quantify metabolites in vivo and estimate biomarkers for conditions ranging from neurological disorders to cancers. Quantifying low-concentration metabolites such as GABA ($γ$-aminobutyric acid) is challenging due to low signal-to-noise ratio (SNR) and spectral overlap. We investigate and validate deep learning for quantifying complex, low-SNR, overlapping signals from MEGA-PRESS spectra, devise a convolutional neural network (CNN) and a Y-shaped autoencoder (YAE), and select the best models via Bayesian optimisation on 10,000 simulated spectra from slice-profile-aware MEGA-PRESS simulations. The selected models are trained on 100,000 simulated spectra. We validate their performance on 144 spectra from 112 experimental phantoms containing five metabolites of interest (GABA, Glu, Gln, NAA, Cr) with known ground truth concentrations across solution and gel series acquired at 3 T under varied bandwidths and implementations. These models are further assessed against the widely used LCModel quantification tool. On simulations, both models achieve near-perfect agreement (small MAEs; regression slopes $\approx 1.00$, $R^2 \approx 1.00$). On experimental phantom data, errors initially increased substantially. However, modelling variable linewidths in the training data significantly reduced this gap. The best augmented deep learning models achieved a mean MAE for GABA over all phantom spectra of 0.151 (YAE) and 0.160 (FCNN) in max-normalised relative concentrations, outperforming the conventional baseline LCModel (0.220). A sim-to-real gap remains, but physics-informed data augmentation substantially reduced it. Phantom ground truth is needed to judge whether a method will perform reliably on real data.

Synthesizing missing modalities in multi-modal magnetic resonance imaging (MRI) is vital for ensuring diagnostic completeness, particularly when full acquisitions are infeasible due to time constraints, motion artifacts, and patient tolerance. Recent unified synthesis models have enabled flexible synthesis tasks by accommodating various input-output configurations. However, their training and evaluation are typically restricted to a single dataset, limiting their generalizability across diverse clinical datasets and impeding practical deployment. To address this limitation, we propose PMM-Synth, a personalized MRI synthesis framework that not only supports various synthesis tasks but also generalizes effectively across heterogeneous datasets. PMM-Synth is jointly trained on multiple multi-modal MRI datasets that differ in modality coverage, disease types, and intensity distributions. It achieves cross-dataset generalization through three core innovations: a Personalized Feature Modulation module that dynamically adapts feature representations based on dataset identifier to mitigate the impact of distributional shifts; a Modality-Consistent Batch Scheduler that facilitates stable and efficient batch training under inconsistent modality conditions; and a selective supervision loss to ensure effective learning when ground truth modalities are partially missing. Evaluated on four clinical multi-modal MRI datasets, PMM-Synth consistently outperforms state-of-the-art methods in both one-to-one and many-to-one synthesis tasks, achieving superior PSNR and SSIM scores. Qualitative results further demonstrate improved preservation of anatomical structures and pathological details. Additionally, downstream tumor segmentation and radiological reporting studies suggest that PMM-Synth holds potential for supporting reliable diagnosis under real-world modality-missing scenarios.

Clinical MRI contrast acquisition suffers from inefficient information yield, which presents as a mismatch between the risky and costly acquisition protocol and the fixed and sparse acquisition sequence. Applying world models to simulate the contrast enhancement kinetics in the human body enables continuous contrast-free dynamics. However, the low temporal resolution in MRI acquisition restricts the training of world models, leading to a sparsely sampled dataset. Directly training a generative model to capture the kinetics leads to two limitations: (a) Due to the absence of data on missing time, the model tends to overfit to irrelevant features, leading to content distortion. (b) Due to the lack of continuous temporal supervision, the model fails to learn the continuous kinetics law over time, causing temporal discontinuities. For the first time, we propose MRI Contrast Enhancement Kinetics World model (MRI CEKWorld) with SpatioTemporal Consistency Learning (STCL). For (a), guided by the spatial law that patient-level structures remain consistent during enhancement, we propose Latent Alignment Learning (LAL) that constructs a patient-specific template to constrain contents to align with this template. For (b), guided by the temporal law that the kinetics follow a consistent smooth trend, we propose Latent Difference Learning (LDL) which extends the unobserved intervals by interpolation and constrains smooth variations in the latent space among interpolated sequences. Extensive experiments on two datasets show our MRI CEKWorld achieves better realistic contents and kinetics. Codes will be available at https://github.com/DD0922/MRI-Contrast-Enhancement-Kinetics-World-Model.

Super-resolution is widely used in medical imaging to enhance low-quality data, reducing scan time and improving abnormality detection. Conventional super-resolution approaches typically rely on paired datasets of downsampled and original high resolution images, training models to reconstruct high resolution images from their artificially degraded counterparts. However, in real-world clinical settings, low resolution data often arise from acquisition mechanisms that differ significantly from simple downsampling. As a result, these inputs may lie outside the domain of the training data, leading to poor model generalization due to domain shift. To address this limitation, we propose a distributional deep learning framework that improves model robustness and domain generalization. We develop this approch for enhancing the resolution of 4D Flow MRI (4DF). This is a novel imaging modality that captures hemodynamic flow velocity and clinically relevant metrics such as vessel wall stress. These metrics are critical for assessing aneurysm rupture risk. Our model is initially trained on high resolution computational fluid dynamics (CFD) simulations and their downsampled counterparts. It is then fine-tuned on a small, harmonized dataset of paired 4D Flow MRI and CFD samples. We derive the theoretical properties of our distributional estimators and demonstrate that our framework significantly outperforms traditional deep learning approaches through real data applications. This highlights the effectiveness of distributional learning in addressing domain shift and improving super-resolution performance in clinically realistic scenarios.

Quantitative imaging methods, such as magnetic resonance fingerprinting (MRF), aim to extract interpretable pathology biomarkers by estimating biophysical tissue parameters from signal evolutions. However, the pattern-matching algorithms or neural networks used in such inverse problems often lack principled uncertainty quantification, which limits the trustworthiness and transparency, required for clinical acceptance. Here, we describe a physics-structured variational autoencoder (PS-VAE) designed for rapid extraction of voxelwise multi-parameter posterior distributions. Our approach integrates a differentiable spin physics simulator with self-supervised learning, and provides a full covariance that captures the inter-parameter correlations of the latent biophysical space. The method was validated in a multi-proton pool chemical exchange saturation transfer (CEST) and semisolid magnetization transfer (MT) molecular MRF study, across in-vitro phantoms, tumor-bearing mice, healthy human volunteers, and a subject with glioblastoma. The resulting multi-parametric posteriors are in good agreement with those calculated using a brute-force Bayesian analysis, while providing an orders-of-magnitude acceleration in whole brain quantification. In addition, we demonstrate how monitoring the multi-parameter posterior dynamics across progressively acquired signals provides practical insights for protocol optimization and may facilitate real-time adaptive acquisition.

Metal implants in MRI cause severe artifacts that degrade image quality and hinder clinical diagnosis. Traditional approaches address metal artifact reduction (MAR) and accelerated MRI acquisition as separate problems. We propose MASC, a unified reinforcement learning framework that jointly optimizes metal-aware k-space sampling and artifact correction for accelerated MRI. To enable supervised training, we construct a paired MRI dataset using physics-based simulation, generating k-space data and reconstructions for phantoms with and without metal implants. This paired dataset provides simulated 3D MRI scans with and without metal implants, where each metal-corrupted sample has an exactly matched clean reference, enabling direct supervision for both artifact reduction and acquisition policy learning. We formulate active MRI acquisition as a sequential decision-making problem, where an artifact-aware Proximal Policy Optimization (PPO) agent learns to select k-space phase-encoding lines under a limited acquisition budget. The agent operates on undersampled reconstructions processed through a U-Net-based MAR network, learning patterns that maximize reconstruction quality. We further propose an end-to-end training scheme where the acquisition policy learns to select k-space lines that best support artifact removal while the MAR network simultaneously adapts to the resulting undersampling patterns. Experiments demonstrate that MASC's learned policies outperform conventional sampling strategies, and end-to-end training improves performance compared to using a frozen pre-trained MAR network, validating the benefit of joint optimization. Cross-dataset experiments on FastMRI with physics-based artifact simulation further confirm generalization to realistic clinical MRI data. The code and models of MASC have been made publicly available: https://github.com/hrlblab/masc

To develop a deep-learning method for achieving fast high-resolution MR elastography from highly undersampled data without the need of high-quality training dataset. We first framed the deep neural network representation as a nonlinear extension of the linear subspace model, then used it to represent and reconstruct MRE image repetitions from undersampled k-space data. The network weights were learned using a multi-level k-space consistent loss. To further enhance reconstruction quality, phase-contrast specific magnitude and phase priors were incorporated, including the similarity of anatomical structures and smoothness of wave-induced harmonic displacement. Experiments were conducted using both 3D gradient-echo spiral and multi-slice spin-echo spiral MRE datasets. Compared to the conventional linear subspace-based approaches, the nonlinear network representation method was able to produce superior image reconstruction with suppressed noise and artifacts from a single in-plane spiral arm per MRE repetition (e.g., 2mm isotropic resolution in 1 min with a total R=10), yielding comparable stiffness estimation to the fully sampled data. This work demonstrated the feasibility of using deep network representations to model and reconstruct MRE images from highly-undersampled data, a nonlinear extension of the subspace-based approaches.

MRI sequence synthesis aims to recover missing image contrast while preserving patient-specific anatomy. The choice of generation mechanism affects both optimization and the way source information reaches the synthesized image. In this study, we propose SRUG, a supervised standalone fusion-driven generator that learns a deterministic source-to-target mapping for paired MRI synthesis. Its direct reconstruction formulation removes generator-discriminator competition and requires neither variational latent sampling nor iterative diffusion denoising. To support structural fidelity within this formulation, SRUG uses a residual encoder adapted for image reconstruction, with a full-resolution convolutional stem, pooling-separated feature stages, and channel recalibration embedded in the residual branches. A nested multi-scale decoder (NMD) repeatedly fuses the resulting spatial features and predicts the target sequence through a single output head. L1 loss and Multi-Scale Structural Loss (MSS loss) jointly supervise the prediction, connecting the direct generation objective to anatomical detail recovery. Experiments on BraTS 2023 show competitive reconstruction fidelity and structural consistency across three MRI translation tasks. Architecture ablations assess the effects of channel recalibration, NMD, and structural supervision within the same generator framework. Additional evaluation on IXI supports applicability to another dataset and modality pair, while zero-shot testing on BraTS 2019 provides preliminary evidence of cross-dataset transferability. These results support direct supervised generation as a practical approach to paired MRI sequence synthesis, with the adapted encoding and reconstruction pathway providing the basis for structural preservation. The SRUG implementation is publicly available at https://github.com/RisingRich/SRUG.

We present E(3)-Pose, a novel fast pose estimation method that jointly and explicitly models rotation equivariance and object symmetry. Our work is motivated by the challenging problem of accounting for fetal head motion during a diagnostic MRI scan. We aim to enable automatic adaptive prescription of diagnostic 2D MRI slices with 6-DoF head pose estimation, supported by rapid low-resolution 3D MRI volumes acquired before each 2D slice. Existing pose estimation methods struggle to generalize to clinical volumes due to pose ambiguities induced by inherent anatomical symmetries, as well as low resolution, noise, and artifacts. In contrast, E(3)-Pose captures anatomical symmetries and rigid pose equivariance by construction, and yields robust estimates of the fetal head pose. Our experiments on publicly available and representative clinical fetal MRI datasets demonstrate the superior robustness and generalization of our method across domains. Crucially, E(3)-Pose achieves state-of-the-art accuracy on clinical MRI volumes, supporting future clinical translation. Our implementation is publicly available at github.com/MedicalVisionGroup/E3-Pose.

Reconstructing cardiac motion from CMR sequences is critical for diagnosis, prognosis, and intervention. Existing methods rely on complete CMR stacks to infer full heart motion, limiting their applicability during intervention when only sparse observations are available. We present TetHeart, the first end-to-end framework for unified 4D heart mesh recovery from both offline full-stack and intra-procedural sparse-slice observations. Our method leverages deformable tetrahedra to capture shape and motion in a coherent space shared across cardiac structures. Before a procedure, it initializes detailed, patient-specific heart meshes from high-quality full stacks, which can then be updated using whatever slices can be obtained in real-time, down to a single one during the procedure. TetHeart incorporates several key innovations: (i) an attentive slice-adaptive 2D-3D feature assembly mechanism that integrates information from arbitrary numbers of slices at any position; (ii) a distillation strategy to ensure accurate reconstruction under extreme sparsity; and (iii) a weakly supervised motion learning scheme requiring annotations only at keyframes, such as the end-diastolic and end-systolic phases. Trained and validated on three large public datasets and evaluated zero-shot on additional private interventional and public datasets without retraining, TetHeart achieves state-of-the-art accuracy and strong generalization in both pre- and intra-procedural settings. Code and dataset is available at https://github.com/Scalsol/TetHeart.

Biophysical diffusion MRI models like Neurite Exchange Imaging (NEXI) are essential for probing gray matter microstructure, estimating compartment diffusivities, neurite fraction, and exchange time. However, NEXI's multi-shell, multi-diffusion-time requirements cause prohibitively long acquisitions. Leveraging the Connectome 2.0 ultra-high gradient scanner, we developed a time-efficient protocol using an Explainable AI (XAI) framework. Combining XGBoost, SHAP, and Recursive Feature Elimination trained on synthetic signals, XAI identified an optimal 8-feature subset, cutting scan time from 27 to 14 minutes. Validated in vivo in seven healthy participants, the XAI protocol was benchmarked against the full 15-feature acquisition, a Cram'er-Rao Lower Bound (CRLB) theoretical optimum, and two heuristics ("Mid-Range" and "Corner"). It robustly reproduced parameter estimates and maintained test-retest reproducibility. Remarkably, the XAI selection converged to the CRLB optimum. This validates XAI's optimality while highlighting its main advantage: achieving gold-standard optimization without complex analytical Jacobians, making it easily adaptable to numerical models or complex noise where CRLB is intractable. Furthermore, XAI showed superior in vivo robustness over heuristics: "Mid-Range" sampling yielded biased exchange time estimates from insufficient temporal diversity, while "Corner" sampling gave unstable intra-neurite diffusivity estimates (5-fold higher CV) due to noise sensitivity. Ultimately, this robust 14-minute protocol accelerates exchange-sensitive microstructural mapping, establishing a model-agnostic optimization framework adaptable to future ultra-high gradient systems and existing clinical scanners.

Ultra-high resolution 7 tesla (7T) magnetic resonance imaging (MRI) provides detailed anatomical views, offering better signal-to-noise ratio, resolution and tissue contrast than 3T MRI, though at the cost of accessibility. We present an advanced deep learning model for synthesizing 7T brain MRI from 3T brain MRI. Paired 7T and 3T T1-weighted images were acquired from 172 participants (124 cognitively unimpaired, 48 impaired) from the Swedish BioFINDER-2 study. To synthesize 7T MRI from 3T images, we trained two models: a specialized U-Net, and a U-Net integrated with a generative adversarial network (GAN U-Net). Our models outperformed two previous state-of-the-art 3T-to-7T models in image-based evaluation metrics. Four blinded MRI professionals judged our synthetic 7T images as comparable in detail to real 7T images, and superior in subjective visual quality to 7T images, due to the reduction of artifacts. Using both SynthSeg and NextBrain, automated segmentations of the synthetic 7T images were more similar to real 7T segmentations than automated segmentations from the 3T images that were used to synthesize the 7T images. Finally, synthetic 7T images showed similar performance to real 3T images in downstream prediction of cognitive status using MRI derivatives (n=3,168). In all, we show that synthetic T1-weighted brain images approaching 7T quality can be generated from 3T images, which may improve image quality and segmentation, without compromising performance in downstream tasks. Future directions, possible clinical use cases, and limitations are discussed.

Cerebrovascular research heavily relies on quantitative analysis of intracranial arteries from time-of-flight magnetic resonance angiography, yet existing processing pipelines remain limited by inconsistent artery labeling and a high manual correction burden. We present ArteryX, a toolbox for extracting features that standardizes artery classification across proximal and distal vascular territories. It integrates segmentation handling, isotropic processing, vessel-fused graph construction, and constrained landmark-based classification within a unified artery-specific feature reporting and reproducible workflow. The toolbox extracts morphological, topological, and complexity features including total length, mean radius, volume, surface area, branch count, tortuosity, and fractal dimensionality for standardized artery-segments. Test-and-validation were performed using three complementary datasets: (1)TopBrain-Challenge benchmarking with annotated arteries, (2)synthetic known-reference validation, and (3)exploratory in-vivo cohort of cerebral small vessel disease. In TopBrain analyses, ArteryX with supervised nnUnet segmentation showed minimal bias, while iCafe showed the highest bias and a large limit-of-agreement. ArteryX consistently demonstrated robust downstream quantification performance across segmentation sources (unsupervised/supervised). Agreement analyses showed minimal bias for radius and good sensitivity of extent-dependent metrics throughout the noisier segmentations compared to the state-of-the-art iCafe-toolbox. Furthermore, a stage-wise human-in-the-loop protocol showed lower intervention time than iCafe. In an in-vivo-cohort (48CSVD+, 20CSVD-), ArteryX-derived distal and territory-level features showed group-level differences, not evident with iCafe. To facilitate adoption-and-reproducibility, ArteryX is designed with versioned builds, tutorials, and documentation.