Time-Resolved Volumetric Metamorphic Relation Imaging

Trochlear dysplasia (TD) is an abnormality of the femoral trochlea associated with anterior knee pain and patellar instability. The sulcus angle (SA) is used to assess trochlear morphology, but it is typically measured on a single axial MR slice with no clear guidance on which to select, making it sensitive to slice selection and landmark placement. We propose an automatic framework for continuous SA profiling from super-resolved MR volumes. Clinically acquired axial, coronal, and sagittal MR scans are combined using implicit neural representations to reconstruct a high-resolution volume. SA measurements are computed across the trochlear region using two landmark detection U-Net models. The approach was evaluated on the public fastMRI dataset and a small in-house cohort of patients with TD. Compared with conventional manual single-slice SA measurements, the proposed automated method yielded a mean absolute error of 11.6$^\circ$ while providing continuous characterization of trochlear morphology. Population-level analysis demonstrated distinct mean SA profiles between the public cohort and the in-house TD cohort, highlighting the potential of profile-based assessment to characterize TD. By reducing reliance on a single manually selected axial slice, the proposed framework extends conventional SA assessment to a continuous profile-based description of trochlear morphology without additional imaging, while remaining conceptually linked to current clinical assessment. Further validation is required. The code is available: https://github.com/wehrlimi/SA_Profile.

Multi-contrast MR scans contain redundant structural information that can be leveraged during reconstruction and potentially accelerate acquisition times. This idea has inspired end-to-end guided reconstruction models, leveraging one or more contrasts to guide the reconstruction of a different contrast. However, these models require large paired multi-contrast raw datasets for training, limiting their application in low-data regimes. In this work, we propose a modular framework, namely CoSMo-RecNet, for learning guided reconstruction models in the low-data regime. At its core is a reusable multi-contrast representation based on a content/style model, which can be learned from large-scale, publicly accessible, unpaired multi-contrast image datasets, without available k-space data. Using this frozen model as a multi-contrast prior and using a set of reference contrasts, the reconstruction problem reduces to a much simpler refinement problem that can be solved by a lightweight unrolled network and thus learned from small, task-specific reconstruction datasets. We demonstrate the efficacy of CoSMo-RecNet by evaluating it on the low-field 0.3 T M4Raw dataset, showing stable reconstruction quality on decreasing the raw training data budget. CoSMo-RecNet achieved higher reconstruction quality with 5 training subjects or lower compared to a parameter-count-matched MoDL trained on 100 subjects. On a data-limited and severely out-of-distribution ultra-low-field 47 mT Halbach scanner dataset, CoSMo-RecNet was superior to other viable strategies, including classical reconstruction, transfer learning, and zero-shot reconstruction.

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

Background: Patient details and acquisition metadata are important for clinical decisions, image quality control, and automated research pipelines, but may be missing or unreliable in imaging archives. Purpose: To develop and evaluate a fast open-source model that predicts patient and acquisition characteristics directly from CT and MR images. Materials and Methods: Separate 3D ResNet-10 ensembles for CT and MR were trained on 57,291 and 43,200 clinical examinations acquired from 2011 to 2025. Both predicted weight, height, age, sex, contrast presence, vertebral coverage, and image noise. The CT model additionally predicted scanner manufacturer, tube voltage, tube current, convolution kernel, and post-injection time; the MR model predicted sequence class. Performance was evaluated on internal CT (n=501) and MR (n=636) test sets and an external CT dataset (n=54). Results: Internal CT MAEs were 3.90 kg, 3.68 cm, and 4.42 years for weight, height, and age, with sex F1=0.990; corresponding MR results were 4.34 kg, 4.62 cm, 7.13 years, and F1=0.970. The CNN outperformed a segmentation-derived XGBoost baseline for all four core targets in both modalities (adjusted P<=.042). F1 scores were 0.963 for CT contrast, 0.953 for MR sequence, and 0.823 for MR contrast. External CT MAEs were 4.45 kg, 4.05 cm, and 5.17 years, with sex F1=0.971. CPU inference required 20 seconds for CT and 12 seconds for MR. Conclusion: One 3D multitask model per modality can rapidly recover patient and acquisition characteristics from heterogeneous CT and MR examinations. Models are available in TotalSegmentator: https://github.com/wasserth/TotalSegmentator

Quantifying myocardial perfusion from cardiac magnetic resonance (CMR) can be achieved by fitting tracer-kinetic models to the dynamic contrast-enhanced MR data. However, fitting the observed data with multi-compartment exchange models, which describe the evolution of the contrast agent in the tissue, to estimate perfusion parameters is a challenging inverse problem that is sensitive to noise and acquisition variability. Previously, physics-informed neural networks (PINNs) have been proposed as an alternative to conventional non-linear least squares fitting methods with promising results for quantitative perfusion CMR. In this work, we extend the previously proposed PINN framework with spatiotemporal implicit neural representations (INRs) to represent the MR signal as a continuous spatiotemporal function and to improve the accuracy, smoothness, and physical consistency of the PINN model. In realistic simulated CMR datasets, our proposed PINN with INRs demonstrates improved robustness and parameter estimation accuracy over the previously established methods. The code is available at https://github.com/q-cardIA/pinn-inr.

Virtual contrast enhancement (VCE) synthesizes enhanced breast MR images from pre-contrast acquisitions. Modern latent generators offer strong image priors, but their bounded natural-image autoencoders conflict with the non-canonical intensity scale of MRI. We show that the upper bound can alter radiomic fidelity before generation, while scaling source and target independently creates a coordinate inconsistency. We propose Predictive Enhancement Calibration (PEC), which represents each pair in a shared, case-adaptive coordinate during training and predicts its unavailable upper endpoint from the pre-contrast image at inference. We integrate PEC with a pretrained FLUX latent flow transformer via parameter-efficient reference conditioning. Target round trips first isolate representation loss before generation; near-matched conditional models then compare PEC with fixed-wide and separate coordinates under comparable training budgets and backbone settings. On the fixed internal MAMA100 development cohort, PEC improves all eight point estimates in this source-only VCE setting, with paired evidence strongest for MSE and LPIPS.\noindent\textbf{Code:} https://github.com/tanlei0/pec-breast-mri-vce

Clinical acquisition in cardiac magnetic resonance (CMR) imaging involves obtaining cross-sectional planes of the heart along the radial and longitudinal directions. Despite these planes being 2D cross-sectional images of the heart, radiologists understand the 3D spatial and continuous temporal nature of the organ being imaged. The same can not be said about the conventional deep learning architectures used to process CMR images, which rely on in-plane and grid-based operations, and are hence unable to organically integrate information from all imaging planes. This paper builds upon previous work on neural implicit segmentation functions (NISF) to overcome unaddressed challenges in cardiac function modeling in the CMR domain. For a given subject, our architecture builds a shared 3D+time representations from all available acquisition planes regardless of orientation. By design, predictions along any imaging plane orientation are cross-sections of the same 3D representation, leading to spatio-temporal consistency across all slices. Moreover, our architecture makes the rotation and translation parameters of imaging planes learnable, allowing us to correct for the commonplace respiratory and patient motion between slice acquisitions under a rigid assumption. Furthermore, interpolation of intensities and segmentation can be performed in 4D at any desired resolution. We perform our study on a 120 subject sub-cohort of CMR imaging data from the UK-Biobank. Our in-plane segmentation performance is on-par with existing CMR segmentation methods and explore how the majority of failure cases arise from limitations in the ground-truth segmentation, for which our representations make predictions with better anatomical accuracy than its original training data. We also evaluate our motion-correction capabilities, displaying quantitative and qualitative improvements in slice alignment.

Female pelvic diseases remain an under researched area characterized by often delayed diagnosis. While pelvic MRI offers superior soft-tissue contrast for diagnosis and image-guided procedures, real-time anomaly detection remains challenging due to physiological motion, tissue deformation, and instrument artifacts. Existing supervised approaches are impractical, as adverse events are rare, heterogeneous, and difficult to annotate. We present a Dinomaly-based unsupervised anomaly detection framework adapted for pelvic MRI that learns normative representations from healthy cases and flags deviations without requiring labels. Our approach leverages a frozen DINOv3 Vision Transformer encoder combined with a noisy MLP bottleneck and Linear Attention decoder to prevent identity mapping while maintaining computational efficiency. Anomalies are localized via per-token cosine distance between encoder and decoder representations, yielding spatial anomaly maps that provide immediate feedback at the scanner to support radiologist decision-making and adaptive protocol adjustment. Evaluated on a curated subset of the Uterine Myoma Dataset, the framework achieves a pixel-level AUROC of 88.06% and high specificity (95.45%) at frame level at 40.5 slices/s, meeting real-time clinical deployment requirements. The spatial anomaly maps and frame-level scores provide immediate, localized feedback at the scanner to support radiologist decision-making and adaptive protocol adjustment during active procedures.

Background and Purpose: Automated detection of focal cortical dysplasia (FCD) requires large volumes of voxelwise lesion-delineated MRI data, which are difficult to acquire. This study aims to generate synthetic MRI data exhibiting FCD, assess their realism, and evaluate their impact on automated FCD detection, particularly in reducing the need for manual annotations. Methods: T1-weighted (T1w) and T2-weighted Fluid-Attenuated Inversion Recovery (FLAIR) MRI scans from 131 FCD patients and 90 healthy controls from multiple (3) sites were retrospectively studied. Synthetic MRIs were generated by conditioning a generative network on binary FCD masks. Two neuroradiologists identified real images from a random set of 14 real and 14 synthetic scans. Three nnU-Net models were trained to detect FCD using: (i) real-only (35 FCD / 35 controls), (ii) real (35 FCD / 35 controls) plus synthetic augmentation, and (iii) expanded real data (70 FCD / 70 controls). Results: Experts showed limited ability to distinguish real from synthetic images, with classification accuracy of 60% for T1w and 70% for FLAIR (inter-rater agreement kappa = 0.86). Augmenting automated FCD detection with synthetic data increased sensitivity by 8.14% (p = 0.12) and improved model confidence at true lesion sites (0.83 +/- 0.11 to 0.89 +/- 0.12; p = 0.02). The expanded real-data model further improved sensitivity to 73.8% (p < 0.001) and confidence to 0.90 +/- 0.14 (p = 0.01). Conclusion: Conditional generative networks can generate realistic synthetic FCD-MRIs, reducing labeled data needs by approximately 20% while maintaining equivalent sensitivity. Equivalent amounts of real data, when available, remain more effective than synthetic augmentation.

Generative models are increasingly used as priors for inverse problems, but their ability to produce realistic images creates a basic trust problem: a plausible reconstruction may be supported by the measurements, or it may be filled in by the prior along unobserved directions. This distinction is especially important in medical imaging, where acquisition operators are designed under scan-time, dose, and calibration constraints. We study generative inverse problems from a measurement-geometry perspective. The central question is whether a fixed measurement operator can distinguish nearby images that are plausible under the generative prior, and whether this relationship can guide better measurements. We introduce a local measurement-manifold compatibility measure that quantifies how well the operator observes prior-relevant tangent directions. Under local regularity assumptions, we prove that this quantity controls the stable part of the reconstruction error, while the generative prior controls off-manifold drift. This worst-direction certificate motivates practical fixed and sequential acquisition rules based on overall local volume preservation, including a posterior-cloud design that adapts measurements at test time without training a sampling policy. Across row-sampling, tomographic, and MR acquisition settings, the proposed scores predict failure modes, explain measurement-induced hallucinations, and guide better sampling. In fastMRI Cartesian sampling, posterior-cloud measurement design improves over strong non-learned ACS-preserving baselines, including variable-density and Poisson-like masks.

As REST APIs become an increasingly significant part of software systems, their validation is becoming more critical. Hence, testing and uncovering underlying issues are of utmost importance for improving software quality. However, testing REST APIs is challenging mainly due to the difficulty of assessing whether the output of an API call is correct, i.e., the test oracle problem. Metamorphic testing is a specification-based testing approach for situations where correct outputs are unknown or not specified explicitly. To check the correctness of a system, relations between the different outputs are specified. We present ARMeta, a tool-supported approach that uses an LLM-based multi-agent workflow to support metamorphic testing of REST APIs documented with OpenAPI. The agentic workflow is used to identify metamorphic test scenarios and specify them in the Given-When-Then format. These scenarios are automatically implemented as executable tests and executed against the system under test. We evaluate ARMeta on two publicly available web applications that expose REST interfaces and compare its performance with a scenario-based testing baseline. The results show that ARMeta explores behaviors that serve as a complement to existing scenario-based testing approaches.

Visual Question Answering (VQA), as the representative multimodal task, serves as a key benchmark for evaluating the reasoning capabilities of Multimodal Large Language Models (MLLMs). However, existing evaluations largely rely on static datasets and accuracy-based metrics, which fail to capture robustness, consistency, and generalization. Inspired by Metamorphic Testing (MT), we propose Metamorphic Robustness Assessment (MetaRA), a testing framework that employs Metamorphic Relations (MRs) to systematically probe vulnerabilities in MLLM-based VQA systems. MetaRA generates controlled variations of image-question inputs based on specific MRs and evaluates models across diverse conditions. Applying MetaRA to multiple MLLM-based VQA models across different tasks reveals nuanced failure patterns, including sensitivity to linguistic perturbations, over-reliance on superficial visual cues, and deeper weaknesses in multimodal reasoning. Experimental results demonstrate that MetaRA provides richer diagnostic insights than conventional accuracy metrics, exposing failure modes that remain hidden under standard benchmarks. Overall, this work highlights the need for systematic robustness evaluation in VQA and positions metamorphic assessment as a scalable, model-agnostic approach toward trustworthy multimodal AI.

Context. Metamorphic Testing addresses the test-oracle problem in scientific computing, but classical Mutation Score operates on syntactic AST mutations and misses domain semantics. Objective. We propose the Semantic Mutation Score (SMS), built on five domain-semantic operators (Conservation Erosion, Operator Substitution, Hyperparameter, Trajectory Flip, Structural Injection). SMS degenerates almost everywhere to MS in a characterised limit, so any SMS-based conclusion remains consistent with prior mutation-testing literature in the classical regime. Method. A 12-PUT x 5-MP design over four single-output float-to-float classes (numeric, probabilistic, surrogate, machine-learning) is paired with a three-layer attribution classifier separating true semantic faults from tolerance, OOD, statistical, and artefact categories. A same-source / cross-source ablation under an identical prompt isolates the LLM-source-diversity contribution. LLM-generated mutants are compared against a default-configuration cosmic-ray syntactic pool at the AST-normalised level. Results. The pre-registered large-effect threshold for Cliff's delta is not met under the point-estimate criterion; the observed effect lies in the medium-effect range. Cross-source pooling under an identical prompt does not appreciably shift delta, indicating that LLM identity is not the lever within this design. AST-level overlap between LLM-generated and default cosmic-ray syntactic mutants is small; the Hyperparameter, Structural Injection, and Trajectory Flip classes are unreachable under default first-order syntactic configurations. Conclusion. SMS is a backward-compatible adequacy metric for domain-semantic metamorphic-relation sets in scientific computing. The first-order unreachability evidence is independent of the effect-size question.

Context. Metamorphic Testing is recognised in IEEE/ISO software-testing standards and increasingly recommended for AI systems, but its progress is bottlenecked by metamorphic relation (MR) identification: existing approaches (structured frameworks, mining and evolutionary pipelines, LLM-assisted methods, MetaPattern catalogues) share an inductive grounding that leaves three foundational questions open: origin, closure, and transferability. Objective. We propose a framework whose downstream step from program-induced operator algebra to MetaPattern set is mechanical and provable, while the upstream curation of the algebra is a stated empirical hypothesis with explicit scope precondition. Method. NOETHER is a two-layer framework. The upstream layer is an eight-block decomposition over recurrent mathematical structures (symmetry, order, self-adjoint, time-reversal, limit, qualitative-dynamics, method-comparison, relational equivalence). The downstream CONSTRUCT-MP algorithm produces a MetaPattern set with algebraic-closure (Theorem 1) and polynomial-time decidability (Theorem 2) guarantees. We test the framework on three operator-algebraic domains. Results. On Boltzmann reactor physics NOETHER systematises a prior inductive catalogue; on equivariant ML it derives executable MRs for rotation invariance, adjoint duality, and training-trajectory reversibility; on relational query optimisers it exercises the relational-equivalence block. The central falsifiable prediction (L*-blindness on homogeneity-preserving mutators) holds on the in-scope substrate. The absolute-completeness conjecture (Theorem 1') is falsified on PWR core diffusion via two pairwise-independent counterexamples that identify five Translate-extension dimensions. Conclusion. Induction is relocated from per-program MR sampling to a per-domain algebraic layer; the downstream step is deductive and mechanical.

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 segmentation of gastrointestinal (GI) organs in magnetic resonance enterography (MRE) is critical for diagnosing inflammatory bowel disease (IBD). However, anatomical variability, class imbalance, and low tissue contrast hinder reliable automation. This study proposes a dual-stage deep learning framework for organ-specific segmentation of GI structures from coronal MRE images to address these challenges. A publicly available MRE dataset of 3,195 coronal T2-weighted HASTE slices from 114 IBD patients was used. Initially, a DenseNet201-UNet++ model generated coarse masks for ROI extraction. A DenseNet121-SelfONN-UNet model was then trained on organ-specific patches. Extensive data augmentation, normalization, five-fold cross-validation, and class-specific weighting were applied to mitigate severe class imbalance, particularly for the appendix. The initial stage achieved strong organ localization but underperformed for the appendix; class weighting improved its DSC from 6.76% to 85.76%. The second-stage DenseNet121-SelfONN-UNet significantly enhanced segmentation across all GI structures, with notable DSC gains (cecum +23.62%, sigmoid +18.57%, rectum +17.99%, small intestine +16.06%). Overall, the framework achieved mDSC of 88.99%, mIoU of 84.76%, and mHD95 of 6.94 mm, outperforming all baselines. This framework demonstrates the effectiveness of a coarse-to-fine, organ-aware segmentation strategy for intestinal MRE. Despite higher computational cost, it shows strong potential for clinical translation and enables anatomically informed diagnostic tools in gastroenterology.

Time-resolved volumetric MR imaging that reconstructs a 3D MRI within sub-seconds to resolve deformable motion is essential for motion-adaptive radiotherapy. Representing patient anatomy and associated motion fields as 3D Gaussians, we developed a spatiotemporal Gaussian representation-based framework (DREME-GSMR), which enables time-resolved dynamic MRI reconstruction from a pre-treatment 3D MR scan without any prior anatomical/motion model. DREME-GSMR represents a reference MRI volume and a corresponding low-rank motion model (as motion-basis components) using 3D Gaussians, and incorporates a dual-path MLP/CNN motion encoder to estimate temporal motion coefficients of the motion model from raw k-space-derived signals. Furthermore, using the solved motion model, DREME-GSMR can infer motion coefficients directly from new online k-space data, allowing subsequent intra-treatment volumetric MR imaging and motion tracking (real-time imaging). A motion-augmentation strategy is further introduced to improve robustness to unseen motion patterns during real-time imaging. DREME-GSMR was evaluated on the XCAT digital phantom, a physical motion phantom, and MR-LINAC datasets acquired from 6 healthy volunteers and 20 patients (with independent sequential scans for cross-evaluation). DREME-GSMR reconstructs MRIs of a ~400ms temporal resolution, with an inference time of ~10ms/volume. In XCAT experiments, DREME-GSMR achieved mean(s.d.) SSIM, tumor center-of-mass-error(COME), and DSC of 0.92(0.01)/0.91(0.02), 0.50(0.15)/0.65(0.19) mm, and 0.92(0.02)/0.92(0.03) for dynamic reconstruction/real-time imaging. For the physical phantom, the mean target COME was 1.19(0.94)/1.40(1.15) mm for dynamic/real-time imaging, while for volunteers and patients, the mean liver COME for real-time imaging was 1.31(0.82) and 0.96(0.64) mm, respectively.

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.