Neuroimaging

The scarcity of labeled clinical data in oncology makes Few-Shot Learning (FSL) a critical framework for Computer Aided Diagnostics, but we observed that standard Prototypical Networks often struggle with the "prototype instability" caused by morphological noise and high intra-class variance in brain tumor scans. Our work attempts to minimize this by integrating a non-linear Logistic Chaos Module into a fine-tuned ResNet-18 backbone creating the Chaos-Enhanced ProtoNet(CE-ProtoNet). Using the deterministic ergodicity of the logistic chaos map we inject controlled perturbations into support features during episodic training-essentially for "stress testing" the embedding space. This process makes the model to converge on noise-invariant representations without increasing computational overhead. Testing this on a 4-way 5-shot brain tumor classification task, we found that a 15% chaotic injection level worked efficiently to stabilize high-dimensional clusters and reduce class dispersion. Our method achieved a peak test accuracy of 84.52%, outperforming standard ProtoNet. Our results suggest the idea of using chaotic perturbation as an efficient, low-overhead regularization tool, for the data-scarce regimes.

The accurate quantification of brain age from MRI has emerged as an important biomarker of brain health. However, existing approaches are often restricted to narrow age ranges and single-modality MRI data, limiting their capacity to capture the coordinated macro- and microstructural changes that unfold across the human lifespan. To address these limitations, we develop a multi-modal brain age framework to characterize the integrated evolution of brain morphology and white matter organization. Our model adopts a two-stage architecture, where modalities are processed independently and integrated via late fusion in both stages: first to estimate a probability distribution over six developmental stages, and then to predict age via probability-weighted stage-specialized experts. Experiments on nine datasets spanning fetal to elderly stages demonstrate competitive in-domain performance and out-of-domain generalization, with our method reducing MAE by 13% and 78% over existing baselines and multi-modal integration yielding 12-13% gains. Analysis of ADNI clinical groups further suggests the potential of the predicted brain age gap to characterize Alzheimer's-related brain aging.

Latent diffusion models have emerged as powerful generative models in medical imaging, enabling the synthesis of high quality brain magnetic resonance imaging scans. In particular, predicting the evolution of a patients brain can aid in early intervention, prognosis, and treatment planning. In this study, we introduce CLIMB, Controllable Longitudinal brain Image generation via state space based latent diffusion model, an advanced framework for modeling temporal changes in brain structure. CLIMB is designed to model the structural evolution of the brain structure over time, utilizing a baseline MRI scan and its acquisition age as foundational inputs. Additionally, multiple conditional variables, including projected age, gender, disease status, genetic information, and brain structure volumes, are incorporated to enhance the temporal modeling of anatomical changes. Unlike existing LDM methods that rely on self attention modules, which effectively capture contextual information from input images but are computationally expensive, our approach leverages state space, a state space model architecture that substantially reduces computational overhead while preserving high-quality image synthesis. Furthermore, we introduce a Gaussian-aligned autoencoder that extracts latent representations conforming to prior distributions without the sampling noise inherent in conventional variational autoencoders. We train and evaluate our proposed model on the Alzheimers Disease Neuroimaging Initiative dataset, consisting of 6,306 MRI scans from 1,390 participants. By comparing generated images with real MRI scans, CLIMB achieves a structural similarity index of 0.9433, demonstrating notable improvements over existing methods.

Alzheimer's disease (AD) confirmation often relies on positron emission tomography (PET) or cerebrospinal fluid (CSF) analysis, which are costly and invasive. Consequently, structural MRI biomarkers such as cortical thickness (CT) are widely used for non-invasive AD screening. Multiscale structural mapping (MSSM) was recently proposed to integrate gray-white matter contrasts (GWCs) with CT from a single T1-weighted MRI (T1w) scan. Building on this framework, we propose MSSM+, together with surface supervertex mapping (SSVM) and a Supervertex Vision Transformer (SV-ViT). 3D T1w images from individuals with AD and cognitively normal (CN) controls were analyzed. MSSM+ extends MSSM by incorporating sulcal depth and cortical curvature at the vertex level. SSVM partitions the cortical surface into supervertices (surface patches) that effectively represent inter- and intra-regional spatial relationships. SV-ViT is a Vision Transformer architecture operating on these supervertices, enabling anatomically informed learning from surface mesh representations. Compared with MSSM, MSSM+ identified more spatially extensive and statistically significant group differences between AD and CN. In AD vs. CN classification, MSSM+ achieved a 3%p higher area under the precision-recall curve than MSSM. Vendor-specific analyses further demonstrated reduced signal variability and consistently improved classification performance across MR manufacturers relative to CT, GWCs, and MSSM. These findings suggest that MSSM+ combined with SV-ViT is a promising MRI-based imaging marker for AD detection prior to CSF/PET confirmation.

Recent progress in visual brain decoding from fMRI has been enabled by large-scale datasets such as the Natural Scenes Dataset (NSD) and powerful diffusion-based generative models. While current pipelines are primarily optimized for perception, their performance under mental-imagery remains less well understood. In this work, we study how a state-of-the-art (SOTA) perception decoder (DynaDiff) can be adapted to reconstruct imagined content from the NSD-Imagery benchmark. We propose a latent functional alignment (LFA) approach that maps imagery-evoked activity to the pretrained model's semantic content-enriched conditioning space, by adding a simple alignment module, while keeping the original remaining components frozen. To mitigate the limited amount of matched imagery-perception supervision, we further introduce a neural retrieval-based augmentation strategy that selects semantically related NSD perception trials from the same participants. Across four subjects, LFA consistently improves high-level semantic reconstruction metrics relative to the frozen pretrained baseline and a voxel-space ridge alignment baseline, and enables above-chance decoding from multiple cortical regions. These results suggest that semantic structure learned from perception can be leveraged to stabilize and improve visual imagery decoding under out-of-distribution conditions.

Functional magnetic resonance imaging (fMRI) is widely used for studying and diagnosing brain disorders, with functional connectivity (FC) matrices providing powerful representations of large-scale neural interactions. However, existing diagnostic models are trained either on a single site or under full multi-site access, making them unsuitable for real-world scenarios where clinical data arrive sequentially from different institutions. This results in limited generalization and severe catastrophic forgetting. This paper presents the first continual learning framework specifically designed for fMRI-based diagnosis across heterogeneous clinical sites. Our framework introduces a structure-aware variational autoencoder that synthesizes realistic FC matrices for both patient and control groups. Built on this generative backbone, we develop a multi-level knowledge distillation strategy that aligns predictions and graph representations between new-site data and replayed samples. To further enhance efficiency, we incorporate a hierarchical contextual bandit scheme for adaptive replay sampling. Experiments on multi-site datasets for major depressive disorder (MDD), schizophrenia (SZ), and autism spectrum disorder (ASD) show that the proposed generative model enhances data augmentation quality, and the overall continual learning framework substantially outperforms existing methods in mitigating catastrophic forgetting. Our code is available at https://github.com/4me808/FORGE.

Current fMRI foundation models primarily rely on a limited range of brain states and mismatched pretraining tasks, restricting their ability to learn generalized representations across diverse brain states. We present Brain-DiT, a universal multi-state fMRI foundation model pretrained on 349,898 sessions from 24 datasets spanning resting, task, naturalistic, disease, and sleep states. Unlike prior fMRI foundation models that rely on masked reconstruction in the raw-signal space or a latent space, Brain-DiT adopts metadata-conditioned diffusion pretraining with a Diffusion Transformer (DiT), enabling the model to learn multi-scale representations that capture both fine-grained functional structure and global semantics. Across extensive evaluations and ablations on 7 downstream tasks, we find consistent evidence that diffusion-based generative pretraining is a stronger proxy than reconstruction or alignment, with metadata-conditioned pretraining further improving downstream performance by disentangling intrinsic neural dynamics from population-level variability. We also observe that downstream tasks exhibit distinct preferences for representational scale: ADNI classification benefits more from global semantic representations, whereas age/sex prediction comparatively relies more on fine-grained local structure.

Major depressive disorder (MDD) is a prevalent mental disorder associated with complex neurobiological changes that cannot be fully captured using a single imaging modality. The use of multimodal magnetic resonance imaging (MRI) provides a more comprehensive understanding of brain changes by combining structural and functional data. Despite this, the effective integration of these modalities remains challenging. In this study, we propose a dual cross-attention-based multimodal fusion framework that explicitly models bidirectional interactions between structural MRI (sMRI) and resting-state functional MRI (rs-fMRI) representations. The proposed approach is tested on the large-scale REST-meta-MDD dataset using both structural and functional brain atlas configurations. Numerous experiments conducted under a 10-fold stratified cross-validation demonstrated that the proposed fusion algorithm achieves robust and competitive performance across all atlas types. The proposed method consistently outperforms conventional feature-level concatenation for functional atlases, while maintaining comparable performance for structural atlases. The most effective dual cross-attention multimodal model obtained 84.71% accuracy, 86.42% sensitivity, 82.89% specificity, 84.34% precision, and 85.37% F1-score. These findings emphasize the importance of explicitly modeling cross-modal interactions for multimodal neuroimaging-based MDD classification.

Predicting post-surgical seizure outcomes in pharmacoresistant epilepsy is a clinical challenge. Conventional deep-learning approaches operate on static, single-timepoint pre-operative scans, omitting longitudinal morphological changes. We propose Neuro-Oracle, a three-stage framework that: (i) distils pre-to-post-operative MRI changes into a compact 512-dimensional trajectory vector using a 3D Siamese contrastive encoder; (ii) retrieves historically similar surgical trajectories from a population archive via nearest-neighbour search; and (iii) synthesises a natural-language prognosis grounded in the retrieved evidence using a quantized Llama-3-8B reasoning agent. Evaluations are conducted on the public EPISURG dataset ($N{=}268$ longitudinally paired cases) using five-fold stratified cross-validation. Since ground-truth seizure-freedom scores are unavailable, we utilize a clinical proxy label based on the resection type. We acknowledge that the network representations may potentially learn the anatomical features of the resection cavities (i.e., temporal versus non-temporal locations) rather than true prognostic morphometry. Our current evaluation thus serves mainly as a proof-of-concept for the trajectory-aware retrieval architecture. Trajectory-based classifiers achieve AUC values between 0.834 and 0.905, compared with 0.793 for a single-timepoint ResNet-50 baseline. The Neuro-Oracle agent (M5) matches the AUC of purely discriminative trajectory classifiers (0.867) while producing structured justifications with zero observed hallucinations under our audit protocol. A Siamese Diversity Ensemble (M6) of trajectory-space classifiers attains an AUC of 0.905 without language-model overhead.

Visual decoding from brain signals is a key challenge at the intersection of computer vision and neuroscience, requiring methods that bridge neural representations and computational models of vision. A field-wide goal is to achieve generalizable, cross-subject models. A major obstacle towards this goal is the substantial variability in neural representations across individuals, which has so far required training bespoke models or fine-tuning separately for each subject. To address this challenge, we introduce a meta-optimized approach for semantic visual decoding from fMRI that generalizes to novel subjects without any fine-tuning. By simply conditioning on a small set of image-brain activation examples from the new individual, our model rapidly infers their unique neural encoding patterns to facilitate robust and efficient visual decoding. Our approach is explicitly optimized for in-context learning of the new subject's encoding model and performs decoding by hierarchical inference, inverting the encoder. First, for multiple brain regions, we estimate the per-voxel visual response encoder parameters by constructing a context over multiple stimuli and responses. Second, we construct a context consisting of encoder parameters and response values over multiple voxels to perform aggregated functional inversion. We demonstrate strong cross-subject and cross-scanner generalization across diverse visual backbones without retraining or fine-tuning. Moreover, our approach requires neither anatomical alignment nor stimulus overlap. This work is a critical step towards a generalizable foundation model for non-invasive brain decoding.

Dynamic neuroimaging data, such as emission tomography measurements of radiotracer transport in blood or cerebrospinal fluid, often exhibit diffusion-like properties. These introduce distance-dependent temporal delays, scale-differences, and stretching effects that limit the effectiveness of conventional linear modeling and decomposition methods. To address this, we present the shift- and stretch-invariant non-negative matrix factorization framework. Our approach estimates both integer and non-integer temporal shifts as well as temporal stretching, all implemented in the frequency domain, where shifts correspond to phase modifications, and where stretching is handled via zero-padding or truncation. The model is implemented in PyTorch (https://github.com/anders-s-olsen/shiftstretchNMF). We demonstrate on synthetic data and brain emission tomography data that the model is able to account for stretching to provide more detailed characterization of brain tissue structure.

MLE-Toolbox is a comprehensive open-source MATLAB toolbox for end-to-end analysis of magnetoencephalography (MEG) and electroencephalography (EEG) data. Inspired by widely used neuroimaging platforms such as Brainstorm and FieldTrip, it integrates the full analysis pipeline within a unified and user-friendly graphical interface (GUI), covering raw data import, preprocessing, source localization, functional connectivity, oscillatory analysis, and machine learning-based classification. The toolbox includes automated artifact rejection methods, including independent component analysis (ICA), signal-space projection (SSP), and signal-space separation (SSS); multiple source localization approaches, including minimum norm estimation (MNE), dynamic statistical parametric mapping (dSPM), standardized low-resolution brain electromagnetic tomography (sLORETA), and beamforming; multi-atlas parcellation with anatomical visualization; spectral power analysis with frequency-band brain mapping; phase-amplitude coupling (PAC); graph-theoretic brain network analysis; and integrated machine learning and deep learning classifiers. MLE-Toolbox also provides native interoperability with Brainstorm, FieldTrip, EEGLAB, and FreeSurfer, allowing researchers to build on established workflows while benefiting from additional automation, interactive visualization, and one-click academic report generation. Freely available for non-commercial use, MLE-Toolbox is designed to lower the barrier to rigorous, reproducible MEG/EEG research.

Representation learning on large-scale unstructured volumetric and surface meshes poses significant challenges in neuroimaging, especially when models must incorporate diverse vertex-level morphometric descriptors, such as cortical thickness, curvature, sulcal depth, and myelin content, which carry subtle disease-related signals. Current approaches either ignore these clinically informative features or support only a single mesh topology, restricting their use across imaging pipelines. We introduce a hierarchical transformer framework designed for heterogeneous mesh analysis that operates on spatially adaptive tree partitions constructed from simplicial complexes of arbitrary order. This design accommodates both volumetric and surface discretizations within a single architecture, enabling efficient multi-scale attention without topology-specific modifications. A feature projection module maps variable-length per-vertex clinical descriptors into the spatial hierarchy, separating geometric structure from feature dimensionality and allowing seamless integration of different neuroimaging feature sets. Self-supervised pretraining via masked reconstruction of both coordinates and morphometric channels on large unlabeled cohorts yields a transferable encoder backbone applicable to diverse downstream tasks and mesh modalities. We validate our approach on Alzheimer's disease classification and amyloid burden prediction using volumetric brain meshes from ADNI, as well as focal cortical dysplasia detection on cortical surface meshes from the MELD dataset, achieving state-of-the-art results across all benchmarks.

Learning a robust Variational Autoencoder (VAE) is a fundamental step for many deep learning applications in medical image analysis, such as MRI synthesizes. Existing brain VAEs predominantly focus on single-modality data (i.e., T1-weighted MRI), overlooking the complementary diagnostic value of other modalities like T2-weighted MRIs. Here, we propose a modality-aware and anatomically grounded 3D vector-quantized VAE (VQ-VAE) for reconstructing multi-modal brain MRIs. Called NeuroQuant, it first learns a shared latent representation across modalities using factorized multi-axis attention, which can capture relationships between distant brain regions. It then employs a dual-stream 3D encoder that explicitly separates the encoding of modality-invariant anatomical structures from modality-dependent appearance. Next, the anatomical encoding is discretized using a shared codebook and combined with modality-specific appearance features via Feature-wise Linear Modulation (FiLM) during the decoding phase. This entire approach is trained using a joint 2D/3D strategy in order to account for the slice-based acquisition of 3D MRI data. Extensive experiments on two multi-modal brain MRI datasets demonstrate that NeuroQuant achieves superior reconstruction fidelity compared to existing VAEs, enabling a scalable foundation for downstream generative modeling and cross-modal brain image analysis.

Understanding how brain structure and function interact is key to explaining intelligence yet modeling them jointly is challenging as the structural and functional connectome capture complementary aspects of organization. We introduced Multi-scale Adaptive Graph Network (MAGNet), a Transformer-style graph neural network framework that adaptively learns structure-function interactions. MAGNet leverages source-based morphometry from structural MRI to extract inter-regional morphological features and fuses them with functional network connectivity from resting-state fMRI. A hybrid graph integrates direct and indirect pathways, while local-global attention refines connectivity importance and a joint loss simultaneously enforces cross-modal coherence and optimizes the prediction objective end-to-end. On the ABCD dataset, MAGNet outperformed relevant baselines, demonstrating effective multimodal integration for advancing our understanding of cognitive function.

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder whose neuroimaging-based diagnosis remains challenging due to complex time-varying disruptions in brain connectivity. Functional MRI (fMRI) provides a powerful non-invasive modality for identifying functional alterations. Existing deep learning (DL) studies employ diverse neuroimaging features; however, static functional connectivity remains widely used, whereas dynamic connectivity modeling is comparatively underexplored. Moreover, many DL models lack interpretability. In this work, we propose D-GATNet, an interpretable temporal graph-based framework for automated ADHD classification using dynamic functional connectivity (dFC). Sliding-window Pearson correlation constructs sequences of functional brain graphs with regions of interest as nodes and connectivity strengths as edges. Spatial dependencies are learned via a multi-layer Graph Attention Network, while temporal dynamics are modeled using 1D convolution followed by temporal attention. Interpretability is achieved through graph attention weights revealing dominant ROI interactions, ROI importance scores identifying influential regions, and temporal attention emphasizing informative connectivity segments. Experiments on the Peking University site of the ADHD-200 dataset using stratified 10-fold cross-validation with a 5-seed ensemble achieved 85.18% +_5.64 balanced accuracy and 0.881 AUC, outperforming state-of-the-art methods. Attention analysis reveals cerebellar and default mode network disruptions, indicating potential neuroimaging biomarkers.

Implicit neural representations (INRs) offer continuous coordinate-based encodings for atlas registration, cross-modality resampling, sparse-view completion, and compact sharing of neuroanatomical data. Yet reproducible evaluation is lacking for high-resolution larval zebrafish microscopy, where preserving neuropil boundaries and fine neuronal processes is critical. We present a reproducible INR benchmark for the MapZebrain larval zebrafish brain atlas. Using a unified, seed-controlled protocol, we compare SIREN, Fourier features, Haar positional encoding, and a multi-resolution grid on 950 grayscale microscopy images, including atlas slices and single-neuron projections. Images are normalized with per-image (1,99) percentiles estimated from 10% of pixels in non-held-out columns, and spatial generalization is tested with a deterministic 40% column-wise hold-out along the X-axis. Haar and Fourier achieve the strongest macro-averaged reconstruction fidelity on held-out columns (about 26 dB), while the grid is moderately behind. SIREN performs worse in macro averages but remains competitive on area-weighted micro averages in the all-in-one regime. SSIM and edge-focused error further show that Haar and Fourier preserve boundaries more accurately. These results indicate that explicit spectral and multiscale encodings better capture high-frequency neuroanatomical detail than smoother-bias alternatives. For MapZebrain workflows, Haar and Fourier are best suited to boundary-sensitive tasks such as atlas registration, label transfer, and morphology-preserving sharing, while SIREN remains a lightweight baseline for background modelling or denoising.

Recent advances in multimodal large language models enable new possibilities for image-based decision support. However, their reliability and operational trade-offs in neuroimaging remain insufficiently understood. We present a comprehensive benchmarking study of vision-enabled large language models for 2D neuroimaging using curated MRI and CT datasets covering multiple sclerosis, stroke, brain tumors, other abnormalities, and normal controls. Models are required to generate multiple outputs simultaneously, including diagnosis, diagnosis subtype, imaging modality, specialized sequence, and anatomical plane. Performance is evaluated across four directions: discriminative classification with abstention, calibration, structured-output validity, and computational efficiency. A multi-phase framework ensures fair comparison while controlling for selection bias. Across twenty frontier multimodal models, the results show that technical imaging attributes such as modality and plane are nearly solved, whereas diagnostic reasoning, especially subtype prediction, remains challenging. Tumor classification emerges as the most reliable task, stroke is moderately solvable, while multiple sclerosis and rare abnormalities remain difficult. Few-shot prompting improves performance for several models but increases token usage, latency, and cost. Gemini-2.5-Pro and GPT-5-Chat achieve the strongest overall diagnostic performance, while Gemini-2.5-Flash offers the best efficiency-performance trade-off. Among open-weight architectures, MedGemma-1.5-4B demonstrates the most promising results, as under few-shot prompting, it approaches the zero-shot performance of several proprietary models, while maintaining perfect structured output. These findings provide practical insights into performance, reliability, and efficiency trade-offs, supporting standardized evaluation of multimodal LLMs in neuroimaging.

Capturing dynamic spatiotemporal neural activity is essential for understanding large-scale brain mechanisms. Functional magnetic resonance imaging (fMRI) provides high-resolution cortical representations that form a strong basis for characterizing fine-grained brain activity patterns. The high acquisition cost of fMRI limits large-scale applications, therefore making high-quality fMRI reconstruction a crucial task. Electroencephalography (EEG) offers millisecond-level temporal cues that complement fMRI. Leveraging this complementarity, we present an EEG-conditioned framework for reconstructing dynamic fMRI as continuous neural sequences with high spatial fidelity and strong temporal coherence at the cortical-vertex level. To address sampling irregularities common in real fMRI acquisitions, we incorporate a null-space intermediate-frame reconstruction, enabling measurement-consistent completion of arbitrary intermediate frames and improving sequence continuity and practical applicability. Experiments on the CineBrain dataset demonstrate superior voxel-wise reconstruction quality and robust temporal consistency across whole-brain and functionally specific regions. The reconstructed fMRI also preserves essential functional information, supporting downstream visual decoding tasks. This work provides a new pathway for estimating high-resolution fMRI dynamics from EEG and advances multimodal neuroimaging toward more dynamic brain activity modeling.

2D visual foundation models, such as DINOv3, a self-supervised model trained on large-scale natural images, have demonstrated strong zero-shot generalization, capturing both rich global context and fine-grained structural cues. However, an analogous 3D foundation model for downstream volumetric neuroimaging remains lacking, largely due to the challenges of 3D image acquisition and the scarcity of high-quality annotations. To address this gap, we propose to adapt the 2D visual representations learned by DINOv3 to a 3D biomedical segmentation model, enabling more data-efficient and morphologically faithful neuronal reconstruction. Specifically, we design an inflation-based adaptation strategy that inflates 2D filters into 3D operators, preserving semantic priors from DINOv3 while adapting to 3D neuronal volume patches. In addition, we introduce a topology-aware skeleton loss to explicitly enforce structural fidelity of graph-based neuronal arbor reconstruction. Extensive experiments on four neuronal imaging datasets, including two from BigNeuron and two public datasets, NeuroFly and CWMBS, demonstrate consistent improvements in reconstruction accuracy over SoTA methods, with average gains of 2.9% in Entire Structure Average, 2.8% in Different Structure Average, and 3.8% in Percentage of Different Structure. Code: https://github.com/yy0007/NeurINO.

Image-domain Poisson perturbation may alter normalized NCCT appearance and downstream models. We evaluated classification of ischemic core/penumbra-bearing non-contrast CT (NCCT) slices under five simulated settings. The source cohort was CPAISD (112 hyperacute ischemic stroke patients); the test partition contained 10 patients and 809 slices. First, a fixed-checkpoint audit compared direct ResNet-18 classification (P1) with residual U-Net denoising followed by the classifier (P2). P1 average precision (AP) ranged from 0.694 to 0.901, whereas P2 AP ranged from 0.509 to 0.797 (substantially lower at settings 10-40). The fixed 0.5 threshold had 0-12.8% sensitivity for P1 and 0% for P2. Second, a prospectively locked de novo experiment compared direct noisy classification (DNC), joint denoising-classification (JDC-0), and the same joint model with privileged training-only lesion-boundary supervision (JDC-B). Across-setting mean AP was 0.861 +/- 0.028 for DNC, 0.840 +/- 0.038 for JDC-0, and 0.856 +/- 0.031 for JDC-B. Hierarchical paired-bootstrap differences were -0.021 (95% CI -0.063 to 0.019) for JDC-0 minus DNC, 0.016 (-0.019 to 0.054) for JDC-B minus JDC-0, and -0.005 (-0.041 to 0.026) for JDC-B minus DNC; none excluded zero. A frozen stress test on the 52-patient AISD partition also showed limited transportability. Thus, ordinary joint training did not demonstrate a classification benefit, and the boundary term recovered part of its point-estimate loss without a statistically supported advantage. Image fidelity, ranking, calibration, and clinical utility must be evaluated separately. This study does not validate acquired low-dose, portable, or cone-beam CT, nor patient-level stroke diagnosis.

Integrating structural and functional connectomes remains challenging because their relationship is non-linear and organized over nested modular hierarchies. We propose a hierarchical multiscale structure-function coupling framework for connectome integration that jointly learns individualized modular organization and hierarchical coupling across structural connectivity (SC) and functional connectivity (FC). The framework includes: (i) Prototype-based Modular Pooling (PMPool), which learns modality-specific multiscale communities by selecting prototypical ROIs and optimizing a differentiable modularity-inspired objective; (ii) an Attention-based Hierarchical Coupling Module (AHCM) that models both within-hierarchy and cross-hierarchy SC-FC interactions to produce enriched hierarchical coupling representations; and (iii) a Coupling-guided Clustering loss (CgC-Loss) that regularizes SC and FC community assignments with coupling signals, allowing cross-modal interactions to shape community alignment across hierarchies. We evaluate the model's performance across four cohorts for predicting brain age, cognitive score, and disease classification. Our model consistently outperforms baselines and other state-of-the-art approaches across three tasks. Ablation and sensitivity analyses verify the contributions of key components. Finally, the visualizations of learned coupling reveal interpretable differences, suggesting that the framework captures biologically meaningful structure-function relationships.

Contrast-enhanced magnetic resonance imaging (CE-MRI) plays a crucial role in brain tumor assessment; however, its acquisition requires gadolinium-based contrast agents (GBCAs), which increase costs and raise safety concerns. Consequently, synthesizing CE-MRI from non-contrast MRI (NC-MRI) has emerged as a promising alternative. Early Generative Adversarial Network (GAN)-based approaches suffered from instability and mode collapse, while diffusion models, despite impressive synthesis quality, remain computationally expensive and often fail to faithfully reproduce critical tumor contrast patterns. To address these limitations, we propose Tumor-Biased Latent Bridge Matching (TuLaBM), which formulates NC-to-CE MRI translation as Brownian bridge transport between source and target distributions in a learned latent space, enabling efficient training and inference. To enhance tumor-region fidelity, we introduce a Tumor-Biased Attention Mechanism (TuBAM) that amplifies tumor-relevant latent features during bridge evolution, along with a boundary-aware loss that constrains tumor interfaces to improve margin sharpness. While bridge matching has been explored for medical image translation in pixel space, our latent formulation substantially reduces computational cost and inference time. Experiments on BraTS2023-GLI (BraSyn) and Cleveland Clinic (in-house) liver MRI dataset show that TuLaBM consistently outperforms state-of-the-art baselines on both whole-image and tumor-region metrics, generalizes effectively to unseen liver MRI data in zero-shot and fine-tuned settings, and achieves inference times under 0.097 seconds per image.

We present SuCor, a method for correcting susceptibility induced geometric distortions in echo planar imaging (EPI) using optimal transport (OT) along the phase encoding direction. Given a pair of reversed phase encoding EPI volumes, we model each column of the distortion field as a Wasserstein-2 barycentric displacement between the opposing-polarity intensity profiles. Regularization is performed in the spectral domain using a bending-energy penalty whose strength is selected automatically via the Morozov discrepancy principle, requiring no manual tuning. On a human connectome project (HCP) dataset with left-right/right-left b0 EPI pairs and a co-registered T1 structural reference, SuCor achieves a mean volumetric mutual information of 0.341 with the T1 image, compared to 0.317 for FSL TOPUP, while running in approximately 12 seconds on a single CPU core.

Dynamic functional connectivity (dFC) derived from resting-state functional magnetic resonance imaging (fMRI) has been extensively utilized in brain science research. The sliding window correlation (SWC) method is a widely used approach for constructing dFC by computing correlation coefficients between amplitude time series of signals from pairs of brain regions. In this study, we propose an integrated approach that incorporates both amplitude and phase information of fMRI signals to improve the detection of brain disorders. Specifically, we introduce a multi-scale fusion learning framework, namely MSFL, which leverages two complementary dFC features derived from SWC and phase synchronization (PS). Here, SWC captures amplitude correlations, while PS measures phase coherence within dFC. We evaluated the efficacy of MSFL in classifying autism spectrum disorder and major depressive disorder using two publicly available datasets: ABIDE I and REST-meta-MDD, respectively. The results indicate that MSFL significantly outperforms existing comparative models. Moreover, we performed model explanation analysis using the SHAP framework, which showed that both types of dFC features from SWC and PS contribute to detecting brain disorders.

Purpose: To develop a data-efficient strategy for accelerated MRI reconstruction with Diffusion Probabilistic Generative Models (DPMs) that enables faster scan times in clinical stroke MRI when only limited fully-sampled data samples are available. Methods: Our simple training strategy, inspired by the foundation model paradigm, first trains a DPM on a large, diverse collection of publicly available brain MRI data in fastMRI and then fine-tunes on a small dataset from the target application using carefully selected learning rates and fine-tuning durations. The approach is evaluated on controlled fastMRI experiments and on clinical stroke MRI data with a blinded clinical reader study. Results: DPMs pre-trained on approximately 4000 subjects with non-FLAIR contrasts and fine-tuned on FLAIR data from only 20 target subjects achieve reconstruction performance comparable to models trained with substantially more target-domain FLAIR data across multiple acceleration factors. Experiments reveal that moderate fine-tuning with a reduced learning rate yields improved performance, while insufficient or excessive fine-tuning degrades reconstruction quality. When applied to clinical stroke MRI, a blinded reader study involving two neuroradiologists indicates that images reconstructed using the proposed approach from $2 \times$ accelerated data are non-inferior to standard-of-care in terms of image quality and structural delineation. Conclusion: Large-scale pre-training combined with targeted fine-tuning enables DPM-based MRI reconstruction in data-constrained, accelerated clinical stroke MRI. The proposed approach substantially reduces the need for large application-specific datasets while maintaining clinically acceptable image quality, supporting the use of foundation-inspired diffusion models for accelerated MRI in targeted applications.

Percentage Brain Volume Change (PBVC) derived from Magnetic Resonance Imaging (MRI) is a widely used biomarker of brain atrophy, with SIENA among the most established methods for its estimation. However, SIENA relies on classical image processing steps, particularly skull stripping and tissue segmentation, whose failures can propagate through the pipeline and bias atrophy estimates. In this work, we examine whether targeted deep learning substitutions can improve SIENA while preserving its established and interpretable framework. To this end, we integrate SynthStrip and SynthSeg into SIENA and evaluate three pipeline variants on the ADNI and PPMI longitudinal cohorts. Performance is assessed using three complementary criteria: correlation with longitudinal clinical and structural decline, scan-order consistency, and end-to-end runtime. Replacing the skull-stripping module yields the most consistent gains: in ADNI, it substantially strengthens associations between PBVC and multiple measures of disease progression relative to the standard SIENA pipeline, while across both datasets it markedly improves robustness under scan reversal. The fully integrated pipeline achieves the strongest scan-order consistency, reducing the error by up to 99.1%. In addition, GPU-enabled variants reduce execution time by up to 46% while maintaining CPU runtimes comparable to standard SIENA. Overall, these findings show that deep learning can meaningfully strengthen established longitudinal atrophy pipelines when used to reinforce their weakest image processing steps. More broadly, this study highlights the value of modularly modernizing clinically trusted neuroimaging tools without sacrificing their interpretability. Code is publicly available at https://github.com/Raciti/Enhanced-SIENA.git.

Longitudinal brain MRI is essential for characterizing the progression of neurological diseases such as Alzheimer's disease assessment. However, current deep-learning tools fragment this process: classifiers reduce a scan to a label, volumetric pipelines produce uninterpreted measurements, and vision-language models (VLMs) may generate fluent but potentially hallucinated conclusions. We present LoV3D, a pipeline for training 3D vision-language models, which reads longitudinal T1-weighted brain MRI, produces a region-level anatomical assessment, conducts longitudinal comparison with the prior scan, and finally outputs a three-class diagnosis (Cognitively Normal, Mild Cognitive Impairment, or Dementia) along with a synthesized diagnostic summary. The stepped pipeline grounds the final diagnosis by enforcing label consistency, longitudinal coherence, and biological plausibility, thereby reducing the risks of hallucinations. The training process introduces a clinically-weighted Verifier that scores candidate outputs automatically against normative references derived from standardized volume metrics, driving Direct Preference Optimization without a single human annotation. On a subject-level held-out ADNI test set (479 scans, 258 subjects), LoV3D achieves 93.7% three-class diagnostic accuracy (+34.8% over the no-grounding baseline), 97.2% on two-class diagnosis accuracy (+4% over the SOTA) and 82.6% region-level anatomical classification accuracy (+33.1% over VLM baselines). Zero-shot transfer yields 95.4% on MIRIAD (100% Dementia recall) and 82.9% three-class accuracy on AIBL, confirming high generalizability across sites, scanners, and populations. Code is available at https://github.com/Anonymous-TEVC/LoV-3D.

Brain imaging classification is commonly approached from two perspectives: modeling the full image volume to capture global anatomical context, or constructing ROI-based graphs to encode localized and topological interactions. Although both representations have demonstrated independent efficacy, their relative contributions and potential complementarity remain insufficiently understood. Existing fusion approaches are typically task-specific and do not enable controlled evaluation of each representation under consistent training settings. To address this gap, we propose a unified cross-view contrastive framework for joint imaging-ROI representation learning. Our method learns subject-level global (imaging) and local (ROI-graph) embeddings and aligns them in a shared latent space using a bidirectional contrastive objective, encouraging representations from the same subject to converge while separating those from different subjects. This alignment produces comparable embeddings suitable for downstream fusion and enables systematic evaluation of imaging-only, ROI-only, and joint configurations within a unified training protocol. Extensive experiments on the ADHD-200 and ABIDE datasets demonstrate that joint learning consistently improves classification performance over either branch alone across multiple backbone choices. Moreover, interpretability analyses reveal that imaging-based and ROI-based branches emphasize distinct yet complementary discriminative patterns, explaining the observed performance gains. These findings provide principled evidence that explicitly integrating global volumetric and ROI-level representations is a promising direction for neuroimaging-based brain disorder classification. The source code is available at https://anonymous.4open.science/r/imaging-roi-contrastive-152C/.

Multimodal neuroimaging provides complementary insights for Alzheimer's disease diagnosis, yet clinical datasets frequently suffer from missing modalities. We propose ACADiff, a framework that synthesizes missing brain imaging modalities through adaptive clinical-aware diffusion. ACADiff learns mappings between incomplete multimodal observations and target modalities by progressively denoising latent representations while attending to available imaging data and clinical metadata. The framework employs adaptive fusion that dynamically reconfigures based on input availability, coupled with semantic clinical guidance via GPT-4o-encoded prompts. Three specialized generators enable bidirectional synthesis among sMRI, FDG-PET, and AV45-PET. Evaluated on ADNI subjects, ACADiff achieves superior generation quality and maintains robust diagnostic performance even under extreme 80% missing scenarios, outperforming all existing baselines. To promote reproducibility, code is available at https://github.com/rongzhou7/ACADiff