Across this collection, medical imaging research clusters around three interconnected methodological trends: multimodal fusion strategies that combine image data with clinical metadata or auxiliary modalities to improve classification and risk stratification; spatiotemporal modeling that enforces temporal or anatomical consistency in video and volumetric data through architectural constraints like recurrent bottlenecks, hypergraph attention, or physics-informed priors; and domain-transfer approaches that leverage pretraining on high-resource modalities or tasks to enable learning from scarce labels in target domains. The first cluster appears in TB screening via ultrasound with clinical variables, mammography foundation models predicting cardiovascular events, and multi-view echocardiography for ejection fraction prediction, each showing that late fusion or simple averaging often matches or exceeds early fusion while remaining computationally tractable. The second emerges in myocardial strain tracking with persistent memory tokens, aortic segmentation via spatiotemporal distillation, and brain disorder classification through hypergraph networks, where explicit modeling of cyclic or higher-order dependencies recovers physiological constraints that frame-by-frame or voxel-wise methods miss. The third spans echocardiography pretraining for lung ultrasound (finding no advantage over generic video), mammography models transferred to cardiovascular risk without explicit cardiovascular labels, and foundation-model-based segmentation with sparse gaze prompts, revealing that architectural compatibility and representation quality matter more than semantic alignment between source and target domains. Across all three patterns, evaluation prioritizes controlled comparison, held-out test sets, ablation studies, and explicit measurement of what each component contributes, over parameter count or benchmark position alone.
Cole Brennan
Showing of papers
We consider the fusion of lung ultrasound images with routinely-collected clinical and demographic data for the purpose of automated tuberculosis (TB) screening using deep-learning. Such deep-learning based screening tools for TB could meaningfully support the health care system in Africa, where the burden of disease is severe and resources are constrained. Beginning with an established ResNet baseline for classification of lung ultrasound images, which achieves an area under the receiver operating characteristic (AUROC) curve of 0.91 [0.86,0.96] (95% CI), we consider the incorporation of the clinical and demographic data using three fusion approaches. We find that a simple average-based fusion of the output scores of separately-trained image and clinical data classifiers consistently matches or outperforms a more complex approach where the data is fused earlier and a combined classifier is trained. Fusing the image and the clinical classifiers in this way leads to a classifier with an overall AUROC of 0.95 [0.91,0.99] (specificity of 0.76 at sensitivity 0.93) which is an improvement of 4% absolute over the image-only baseline. We also find that greedy feature selection can be used to reduce the number of clinical and demographic inputs without sacrificing classification performance. Finally, when we differentiate between clinical and demographic data that are self-reported, that require some basic measurement or calculation, and that require a point-of-care (POC) test, we find the inclusion of the POC tests included in this study to be of minimal benefit to classification performance. We conclude that the incorporation of routinely-collected clinical and demographic data is a promising way to improve the performance of lung ultrasound based automatic classification.
Lung ultrasound (LUS) is attractive for tuberculosis (TB) screening at primary-care level, but labelled cohorts are small. Echocardiography carries no such constraint, while sharing the same underlying ultrasound imaging physics, signal processing and B-mode appearance as LUS. We ask whether an encoder pretrained on that high-resource ultrasound domain carries representations that remain usable in the low-resource one. Only the encoder varies, across seventeen encoders spanning three architecture families. Among them, a latent-predictive video encoder pretrained on generic video (V-JEPA2-L) and its echocardiography counterpart (EchoJEPA-L) differ in pretraining corpus alone. The choice among these encoders does not resolve the classification, the whole family spanning 2.50 percentage points against a measurement resolution of 2.71. What moves the task instead is feature conditioning. Standardising the features between the encoder and the classifier improves all seventeen encoders by a mean of +1.23 percentage points at $p=1.5\times10^{-5}$. On the held-out test set every encoder selected on the development folds stands above the baseline system by up to +2.57 percentage points of area under the receiver operating characteristic curve (AUROC), and specificity at 90% sensitivity reaches 79.3% against 60.3%. The contrast specified in advance, EchoJEPA-L against V-JEPA2-L, measures -0.16 percentage points at $p=0.926$. We therefore find no evidence that shared ultrasonic physics alone makes echocardiography a more productive pretraining corpus than generic video, and any advantage, if present, is smaller than this cohort can resolve. The video encoders receive replicated still images, however, so whether this absence of an effect reflects the pretraining domain or a video encoder applied to static frames cannot be separated. The limiting factor is the labelled cohort rather than the encoder.
Quantum Machine Learning is a novel field of research aimed at devising machine learning approaches exploiting principles of quantum mechanics, such as superposition, entanglement and interference. In this context, we present a scalable hybrid Quantum Diffusion Model, and evaluate its use for medical image analysis. Specifically, our method is based on a Discrete-Time Quantum Walk algorithm, executed on a real quantum device, to model the forward dynamics of the diffusion model. For the backward step of the diffusion model, we devise and evaluate a classical learning model, which is used to reversely denoise the data. In contrast with other existing attempts at applying quantum machine learning for image analysis tasks, severely limited by the size of existing quantum devices, our method allows to process real-world large size medical data. In particular, we present results on grayscale and RGB images, as well as 3D volumes of moderate sizes. We benchmark our results by reproducing an alternative classical counterpart model, based on diffusion models on discrete state spaces. By doing so, we compare the generation capabilities of both models in terms of three distinct state-of-the-art metrics in the field of image generation, showing the competitive, promising results of our approach.
Ultrasound imaging increasingly targets portable, point-of-care, and wearable settings where constraints on power, bandwidth, and hardware complexity often necessitate sparse data acquisition in spatiotemporal scanning. However, image reconstruction using the sparse data can introduce insufficient phase information in coherent beamforming process, resulting in grating-lobe artifacts that degrade imaging contrast resolution. We present a physics-guided, data-driven framework for sparse-to-dense radio-frequency (RF) reconstruction that aligns training with downstream image formation. Our approach trains an end-to-end interpolation network using a hybrid supervision scheme that combines an RF-domain and a beamforming-domain loss with exponential moving average (EMA) to stabilize the multi-objective training. To improve generalization under variable acquisition layouts, we also introduce a random-skip masking strategy that varies sparsity patterns during training so a single model can handle diverse decimation factors and irregular channel configurations. We evaluate the framework on a held-out test set using the mean structural similarity index measure (SSIM) between reconstructed and ground-truth beamformed images. Across decimation factors $\times 2$ to $\times 13$, the best-performing configuration maintains mean SSIM around 0.95. Overall, the results show consistent gains in RF reconstruction and post-beamforming image quality across diverse acquisition conditions. This approach enables robust, high-quality ultrasound imaging at resource-constrained settings by allowing more sparse scanning in spatiotemporal domain.
This paper presents an end-to-end framework for reconstructing overhead power utility network topology and extracting span-level physical metadata from large-scale aerial LiDAR. The pipeline begins with semantic segmentation of the input point cloud using an improved KPConv-based model, in which data sampling and loss functions are adapted to emphasize pole and conductor (wire) classes. Network topology inference then proceeds in two stages: (i) pole instances are obtained by clustering pole-class points and validating candidates using geometric criteria, including height and verticality estimated via PCA, and (ii) candidate pole pairs are evaluated using a heuristic method and a lightweight ResNet-based classifier on 2D top-view projections of pole and wire point distributions to determine whether a physical conductor span exists. By explicitly classifying candidate spans, the approach mitigates common failure modes of heuristic connectivity rules in dense or cluttered scenes and under partial wire observation. For each validated wire, attributes regarding utility infrastructure geometry are computed, including endpoint conductor heights, ground elevation, sag-related lowest-point features, conductor arrangement, and wire width. Evaluation on multiple real-world aerial LiDAR datasets demonstrates decimeter-level endpoint height accuracy and approximately 9% relative improvement in recall for topology reconstruction compared to heuristic nearest-neighbor baselines, with larger gains in complex layouts.
Cardiovascular magnetic resonance (CMR) provides comprehensive cardiac assessment but remains underutilized because of the complexity of acquisition, post-processing, and interpretation. Existing artificial intelligence (AI) methods address isolated tasks, limiting clinical integration. We present ORION-CMR (On-scanner Reporting with Integrated fOunda-tioN Model), the first clinically evaluated scanner-native end-to-end CMR foundation model. Pretrained on 12,896,733 CMR images from 9,258 studies, ORION-CMR performs sequence classification, ventricular function assessment, late gadolinium enhancement (LGE) detection, binary and multiclass disease classification, and local large language model-based report generation in approximately 90 seconds. The framework. was evaluated on public benchmarks and clinically validated in a multi-vendor cohort of 68 subjects with normal examinations, congenital heart disease, dilated cardiomyopathy, and myocardial infarction. ORION-CMR outperformed supervised baselines and the previously published CMR foundation model (CMR-FM), achieving state-of-the-art performance for LGE classification and scar segmentation. Clinical evaluation achieved an AUC of 0.96 for normal-versus abnormal classification and 0.88 for multiclass disease classification, while generated reports demonstrated 81.4% agreement with expert interpretation. These results demonstrate the feasibility of real-time scanner-native AI-assisted CMR analysis and automated report generation.
Traditional codecs treat every region of a frame alike; a generative layer can instead degrade the regions a viewer attends to least and reconstruct them at the client. We present PRESLEY, which extends the prior conference work ELVIS by replacing destructive block removal with adaptive in-place degradation under a removability mask, signaling per-block strength in a bit-packed side channel, and restoring via generative backbones conditioned on transmitted visual priors rather than unconditioned in-painting. We separate the problem into three goals: choosing which blocks to degrade, degrading them so the encoder spends fewer bits, and restoring them. Against its predecessor at matched rate, PRESLEY achieves a decisive mean -56.4% BD-rate reduction on delivered background quality across 13 rate ladders spanning multiple codecs and dataset families. Against pristine baselines, PRESLEY defines the operating regime of generative transport: delivering substantial bitrate savings (up to -29.4% BD-rate) and superior background quality (17/23 sequences) in the target bit-starved regime, while maintaining foreground fidelity bit-exact. We further map where the theoretical headroom in this class of architecture lies. Using an exact leave-one-superblock-out combinatorial oracle as an additive empirical bound, we show that existing complexity heuristics already capture 83.3% of bit-cost savings, bounding remaining cost-axis headroom at about 5% of total bitrate. We then identify and model the primary unaddressed axis -- post-restoration damage -- which disperses widely (4.9-8.4 dB). We prove that this damage is predictable before transmission (held-out rho = +0.400), establishing the feasibility of transmit-time restorability modeling and defining the roadmap for joint rate-distortion-restoration selection rules.
Clinical decision-making for coronary intervention relies mainly on angiography and fractional flow reserve (FFR). However, angiography is two-dimensional and lacks depth information for 3D lesion characterization, while FFR provides only a single functional index, offering limited hemodynamic insight. Among existing methods, numerical analysis is computationally expensive, whereas learning-based approaches require extensive supervision and often lack physical consistency. To address these limitations, we propose physics-informed hemodynamic modeling, an integrated deep learning framework for 3D coronary blood flow analysis from dual-view angiography. First, an attention-enhanced CNN reconstructs coronary geometry from angiography. The resulting point clouds are then mapped to a reference domain and Fourier-encoded for joint representation. A decoupled network separately predicts velocity and pressure fields, with embedded physical priors enabling efficient transfer across physiological conditions. Across 32 clinical patients evaluated under four flow conditions, the trans-stenotic pressure-drop mean absolute percentage error was 2.02%, while the velocity and pressure relative-L2 errors were 0.054 and 0.023, respectively. Validation against hospital-measured FFR further achieved 93.8% diagnostic accuracy (30/32; exact 95% CI, 79.2%-99.2%). The framework also supports illustrative revascularization comparisons and sparse-data assimilation, with the full angiography-to-hemodynamics pipeline completed within 20 minutes per patient.
Cardiovascular disease (CVD) remains the leading cause of death among women, yet cardiovascular risk assessment often relies on clinical variables that may be missing, outdated, or unavailable in routine care. Screening mammography offers an opportunity for opportunistic cardiovascular risk stratification because it is routinely acquired and contains vascular features, including breast arterial calcifications (BAC), that are associated with cardiovascular risk and events. We evaluate whether mammography specific foundation models, originally pretrained for breast cancer-related tasks, can transfer to cardiovascular risk prediction without cardiovascular specific supervision or explicit BAC annotation. We constructed a 5-year major adverse cardiovascular event (MACE) cohort of 22,497 women linked to electronic health record outcomes, including 500 events (2.22% prevalence). The foundation models achieved AUROCs of 0.823 and 0.822 substantially exceeding an age-only model (AUROC 0.765), despite using only the screening mammogram as input, with no clinical variables. Both foundation models evaluated assigned substantially higher predicted risk to patients with radiologist-documented BAC, despite BAC never being used as a training label, and showed activation patterns consistent with vascular findings. Together, these findings suggest that mammography foundation models can recover clinically relevant cardiovascular risk information directly from mammographic pixels and suggest that screening mammography may provide an opportunistic source of cardiovascular risk information to complement conventional clinical assessment without additional imaging. Code is available in https://github.com/PauFeld/MammoCVD
Accurate classification of brain disorders from neuroimaging data remains challenging because of substantial inter-subject heterogeneity and the complex multi-scale patterns present in functional connectivity and morphological representations. To address these challenges, we propose HyperAMS-Net, a deep learning framework for brain disorder classification using neuroimaging representations derived from resting-state functional MRI or structural MRI. HyperAMS-Net integrates adaptive multi-scale convolution, hypergraph attention, spatial-channel attention, and adaptive feature fusion. Specifically, adaptive multi-scale convolution learns data-driven weights over multiple receptive fields to capture complementary patterns at different scales. Hypergraph attention models higher-order dependencies among learned feature representations through node--hyperedge--node message passing, while spatial-channel attention enhances discriminative feature learning. Adaptive feature fusion further aggregates complementary information across parallel network branches. HyperAMS-Net is evaluated on three benchmark datasets spanning distinct brain disorders: ABIDE for autism spectrum disorder, REST-meta-MDD for major depressive disorder, and ADNI for Alzheimer's disease, using 5-fold stratified cross-validation. HyperAMS-Net achieves state-of-the-art performance across all evaluated datasets, attaining the highest accuracy and AUC among the compared methods. Ablation studies further demonstrate the contribution of each proposed component, with the largest performance degradation observed when hypergraph attention is removed.
This article describes an open image dataset for developing and evaluating active-fire segmentation methods in satellite imagery. The dataset contains 2,148 image-mask pairs from 25 California wildfires, with acquisitions spanning July 2020 to August 2026. Each image is a 512x512-pixel, three-channel composite derived from Sentinel-2 Level-2A bands B12, B11 and B8A at 20 m spatial sampling. A fixed linear rendering is applied throughout the dataset. Corresponding masks distinguish background, SWIR-rule active fire and invalid observations. The masks were generated from shortwave-infrared brightness and near-infrared contrast, followed by constrained neighborhood growth. The release includes chip-level metadata and an incident-disjoint partition containing 18 training, three validation and four test fires. Among the image pairs, 841 contain active-fire labels; these labels occupy 0.0766% of all grid cells. A mask-blind analyst review covers 233 test chips and provides a separate assessment of the rule-generated labels at chip and connected-component levels. Reference training and evaluation code accompanies the data, including a ResNet-34 U-Net implementation with validation-based checkpoint and threshold selection. The archived images, masks, metadata and review annotations support research on rare-class segmentation, learning from algorithmic labels and transfer across fire incidents. The versioned dataset is deposited on Zenodo, with preparation and reuse software maintained in a public GitHub repository.
Emerging physical AI systems require low-latency, task-oriented video communication over unreliable channels. We propose a semantic-aware multi-level neural video coding method for robust low-latency video transmission over unreliable channels that are abstracted as multi-level packet erasure channels. Built upon the real-time DCVC-RT neural video codec, the proposed framework introduces a semantic- and feature-aware coding strategy that partitions encoded representations into packets carrying different levels of semantic and latent-feature importance and assigns these packets to different streams, each associated with a priority level when transmitted over unreliable communication channels. We also developed an error-resilient entropy model that removes inter-packet dependencies, allowing each packet to be decoded independently under packet losses. The complete system is trained end-to-end over the abstracted multi-level packet erasure channels, enabling learning of channel-aware representations together with importance-aware packet assignment while facilitating the network for differentiated packet prioritization. Experiments show that the proposed framework significantly improves robustness over baseline DCVC-RT under packet erasures, achieving graceful degradation in less important regions while better preserving task-relevant visual content.
This work introduces quantum-inspired tensor-network circuits as trainable transforms for image inpainting. Among the proposed architectures, the diagonal quantum Fourier transform (QFT) relaxation is invertible with $O(N^2 \log N)$ computational cost for $N\times N$ images, inherently preserving minimum coherence throughout training via its circuit structure and eliminating the need for explicit coherence penalties. Unconstrained gradient-based phase optimization (Riemannian-optimization free) enables efficient learning from randomly sampled training data, allowing the learned transform to generalize to test images observed through fixed sampling masks. Numerical tests show that the learned models outperform fixed transforms and per-image optimization while matching the performance of much larger unitary architectures, yet with far fewer parameters.
Detecting brain metastases in magnetic resonance imaging (MRI) remains challenging because lesions vary widely in size and appearance, with very small metastases occupying only a minute fraction of a three-dimensional input. We investigate whether combining different spatial fields of view (FOVs) improves lesion detection in multimodal MRI and present a scale-aware 3D deep-learning framework. The method uses independently trained $96^3$ and $64^3$ 3D U-Nets whose whole-volume probability maps are combined by weighted late fusion. This design allows us to study the effect of spatial context separately from image resolution and modality choice. On a 97-patient development cohort, cross-FOV fusion improved lesion-level precision and F1 while substantially reducing false positives relative to the individual models. A same-FOV ensemble control showed that these gains were not explained solely by averaging independently trained networks, supporting a contribution from complementary spatial context. An exploratory cross-FOV agreement filter reduced false positives but did not improve overall F1. These results support cross-FOV probability fusion as a simple and computationally practical strategy for improving the precision-false-positive trade-off in 3D brain-metastasis detection.
Myocardial strain from echocardiography is a key biomarker for cardiac function. Recent deep learning methods show strong performance for myocardial motion tracking but often lack physiological constraints, leading to temporal drift across the cardiac cycle. Consequently, tracked points may not return to their relative initial positions at the end of each cardiac cycle, producing inaccurate strain estimates and even divergence in some cases. We propose a deep learning framework that compensates for drift during myocardial tracking. We extend a state-of-the-art echocardiographic tracking method (TAS-Net) with persistent memory tokens that share information across sliding windows over full cardiac cycles. A teacher-student fine-tuning strategy on real echocardiographic data then enforces physiologically consistent cyclic motion while preserving tracking accuracy. Experiments show reduced global and regional strain drift, improved agreement with clinical references, and better test-retest reproducibility, supporting more reliable myocardial strain estimation in clinical practice.
Most automated brain parcellation tools are developed and validated on T1-weighted (T1w) MRI. Yet, some clinical workflows for which parcellation is relevant only use contrast-enhanced T1w (T1ce) MRI, on which T1w-trained models are less accurate. We present a unified network that parcellates both pre- and post-contrast agent T1w MRI reliably, trained on a combination of the two with conditioning that spatially modulates its response differently for each. Feature-wise Linear Modulation (FiLM) is a known approach for input-based modulation in networks. It applies a per-channel scale and shift uniformly across the input. However, the appearance change between pre- and post-contrast varies locally across the brain, making FiLM suboptimal for our use case. In this work, we introduce Spatial FiLM (SpFiLM), a conditioning layer whose modulation varies spatially, assembling a voxel-wise scale and shift from image-derived spatial patterns. Using a cohort of 134 patients with paired T1w and T1ce MRI parcellated into 106 classes, the addition of SpFiLM layers in a UNet increased the mean Dice on the test set of 25 patients from 80.2% to 84.1%, a 4.9% relative improvement. Adding SpFiLM layers led to the best performance on both pre- and post-contrast MRI, even when controlling for network parameter counts.
We present, to the best of our knowledge, the first publicly available resource for predicting left ventricular ejection fraction (EF) from parasternal long-axis (PLAX) echocardiography. Because no PLAX-EF datasets previously existed, our work focuses on an innovative data generation strategy to overcome this scarcity. By leveraging a time-based correlation between clinical notes and echocardiographic videos, combined with fine-tuning view classifiers and proxy labeling, we created a labeled dataset of over 25,000 PLAX videos. This enables us to train the first reproducible PLAX EF model, achieving a mean absolute error (MAE) of 6.86%. Given that apical four-chamber (A4C) methods, the clinical standard, report MAE values of 6%-7%, our results demonstrate that EF estimation from PLAX views is both feasible and clinically relevant. This surpasses the performance of existing methods and provides a clinically relevant solution for situations where apical views may not be feasible. Going further, we demonstrate that combining PLAX and A4C predictions via simple unweighted late fusion improves both single-view baselines to a 6.37% MAE, underscoring the value of multi-view integration. To promote continued research, we release the dataset labels, trained models, and runnable demos on GitHub, Hugging Face, and Google Colab: https://github.com/Jeffrey4899/PLAX_EF_Labels_202509
Smartphone skin photographs are indispensable to teledermatology, yet assessing the diagnostic suitability of submitted cases (gradability) remains a critical bottleneck in mobile care workflows. Dermatologists routinely review multiple photographic views (regional, angled, and close-up) to identify consistent textural detail rather than relying on a single image. We present the Semantic Tri-view Pipeline, an interpretable architecture for automated teledermatology gradability screening that formalizes epidermal micro-relief as a computable biomarker of image quality. Using an expert-annotated subset of the public SCIN dataset, we train a lightweight DeepLabV3+ model to segment micro-relief fidelity. These spatial masks are then aggregated across up to three case views with a logistic regression classifier, leveraging viewpoint redundancy to support robustness under uncontrolled smartphone acquisition. This approach learns context-aware, clinically intelligible heuristics, such as penalizing high-fidelity texture in regional distance views. Evaluated at a predefined 90% sensitivity operating point, the system's apparent errors largely reflect subjective clinical variance on borderline cases where clinicians rely on non-visual metadata. On SCIN, performance improves from an AUC of 0.81 (80.6% PPV) on variance-heavy majority-consensus cases to 0.96 (97.7% PPV) on optically unambiguous unanimous cases. Overall, this work delivers an interpretable, privacy-by-design, edge-ready system that can provide real-time feedback during case submission to filter ungradable photo sets before review.
Image super-resolution, which aims to reconstruct high-resolution images from their low-resolution observations, is fundamental to medical imaging, remote sensing, surveillance, microscopy, and scientific visualization. Traditional model-based methods formulate super-resolution as an inverse problem with hand-crafted regularization priors. While interpretable and theoretically grounded, they rely on fixed assumptions and require computationally intensive iterative solvers. Deep learning methods offer data-driven flexibility by learning nonlinear mappings from low- to high-resolution images, among which diffusion models have achieved particularly impressive perceptual quality. However, the standard diffusion training objective is a pixel-domain noise-prediction loss that does not explicitly enforce perceptual fidelity, which can lead to oversmoothing and loss of fine image structure. To address these limitations, we propose a perceptually regularized diffusion framework that incorporates prior knowledge through perceptual-loss-based regularization, improving training convergence and encouraging the recovery of meaningful image features. Experiments on benchmark datasets demonstrate improved perceptual quality and competitive distortion metrics, highlighting the effectiveness of regularization for diffusion-based super resolution.
Medical image segmentation remains difficult to scale because high-performing methods typically rely on dense expert annotations and task-specific training. We introduce GazeRefine, a training-free framework that uses gaze as an inference-time prompt for zero-shot medical image segmentation. Sparse, duration-weighted fixations are converted into foreground and background priors that initialize semantic prototypes in frozen DINOv3 feature space. These prototypes are iteratively refined through foreground-background discrimination, feature-space affinity propagation, and anchoring to the initial gaze guidance, allowing segmentation to extend beyond directly fixated regions while limiting semantic drift. GazeRefine requires no segmentation masks, fine-tuning, adapters, prompt encoders, or gradient updates. We evaluate the method on gaze-annotated polyp segmentation and prostate MRI segmentation. The results show strong performance on colonoscopy images and competitive performance on prostate MRI, supporting gaze-guided prototype refinement as a promising approach for segmentation-label-efficient, human-in-the-loop medical image segmentation. Our tools and code can be found in the following repository: https://github.com/MohammedOussamaBEN/GazeRefine.git
We present CheXtriev, a graph-based, anatomy-aware framework for chest radiograph retrieval. Unlike prior methods focussed on global features, our method leverages graph transformers to extract informative features from specific anatomical regions. Furthermore, it captures spatial context and the interplay between anatomical location and findings. This contextualization, grounded in evidence-based anatomy, results in a richer anatomy-aware representation and leads to more accurate, effective and efficient retrieval, particularly for less prevalent findings. CheXtriv outperforms state-of-the-art global and local approaches by 18% to 26% in retrieval accuracy and 11% to 23% in ranking quality. The code is available at https://github.com/cvit-mip/chextriev.
Cardiac cine-MRI serves as a direct visual indicator of cardiovascular hemodynamics by capturing the continuous wall motion of the aorta. Quantifying these dynamic structural changes across the cardiac cycle is essential for measuring aortic distensibility, a primary marker of arterial stiffness. However, standard 2D segmentation networks focus on each frame independently. Consequently, when rapid systolic flow temporarily obscures the aorta's boundaries, this lack of continuous context results in frame-to-frame tracking dropouts and boundary inconsistencies. Spatiotemporal ($2\text{D}+t$) networks can enforce temporal consistency across the sequence but suffer from a scarcity of expert annotations. To address this, we present a semi-supervised spatiotemporal ($2\text{D}$ to $2\text{D}+t$) knowledge distillation framework exploiting the cardiac cycle. The framework distills a spatial teacher's expertise into a spatiotemporal student network by executing a dynamic latent interception, pairing a recurrent spatiotemporal bottleneck with a residual spatial bypass. Our model selection strategy applies a baseline validation threshold ($\text{DSC} \ge 0.50$) prior to selecting the epoch that maximizes anatomical consistency. This strategy enables the spatiotemporal student model to achieve superior surface tracking accuracy ($\text{NSD@1mm} = 92.3\% \pm 0.2\%$) and high structural reliability ($\text{Frac}_{2\text{CC}} = 99.2\% \pm 0.6\%$), reducing population-wide structural anomalies by over 56\% compared to a 2D nnU-Net baseline.
The Bayesian Ideal Observer (IO) establishes the theoretical upper bound on task performance for binary detection tasks. However, analytical computation of the IO test statistic is generally intractable. Numerical approaches based on Markov-chain Monte Carlo (MCMC) methods, including their recent deep generative model-based extensions, typically require extensive posterior sampling for each test image. Supervised learning has also been investigated to approximate the IO performance. However, such methods are typically trained for a specific detection task and signal and may require retraining when the task or signal changes. The score function, defined as the gradient of the log probability density, encodes the local geometry of the data distribution and is a fundamental quantity in modern score-based generative modeling. This work reformulates the IO test statistic in terms of the score function and introduces a score-based ideal observer (SIO). The proposed SIO uses a denoising convolutional neural network trained exclusively on signal-absent images to estimate the signal-absent score function. Once trained, the resulting score model can be used to approximate the IO test statistic for detection tasks involving arbitrary additive signals, without per-image posterior sampling or signal-specific retraining. Numerical studies consider a signal-known-exactly (SKE) detection task with a stochastic lumpy-background model. The results demonstrate that the proposed SIO can closely approximate the IO performance.
Pretrained image encoders are central to medical image classification, where expert annotation is costly and task-specific cohorts are often limited. As the model space expands from general-purpose to broad-medical and specialty-specific encoders, selecting the representation becomes a substantive modeling decision. Clean-test discrimination alone is insufficient for this purpose: encoders with similar AUROC can differ in calibration, label efficiency, and stability under acquisition perturbations or distribution shift. We introduce CRS-Bench, a controlled benchmark for multi-objective medical encoder selection. CRS-Bench evaluates 15 pretrained encoder families across dermatology, ophthalmology, and radiology using ISIC 2019, APTOS 2019, and CheXpert, with CheXpert-to-MIMIC-CXR as an observed institutional shift, yielding 17,575 controlled run records and 3,515 seed-aggregated metric rows. Each encoder is characterized along four operational reliability dimensions: discrimination, calibration, label efficiency, and robustness. We summarize these dimensions using the Clinical Reliability Score (CRS), a Pareto-aware, reference-relative score combining dominance, profile balance, and worst-axis performance. AUROC and CRS are positively associated but not decision-equivalent: 21 of 105 pairwise orderings reverse, with a mean absolute rank displacement of 1.87. Paired-seed bootstrap analysis identifies PanDerm, MedSigLIP, and MedGemma as a stable leading reliability tier rather than a statistically resolved single leader. CRS-Bench provides a controlled framework for selecting medical image encoders from multi-axis reliability profiles rather than clean-test AUROC alone.
Pathologic complete response (pCR) is a strong neoadjuvant endpoint, yet 5-15% of complete responders recur and clinical/genomic variables do not reliably identify them. We tested whether pretreatment dynamic contrast-enhanced MRI entropy - intratumoral enhancement heterogeneity - resolves response quality hidden within pCR and residual cancer burden (RCB). Across four cohorts (1,200 patients), a prespecified entropy threshold defined favorable and adverse structural states. Crossing structure with pathology yielded a four-tier framework spanning 4.1-fold recurrence in I-SPY1 and 7.7-fold at response extremes. In I-SPY2, 55 of 219 complete responders (25.1%) were structurally adverse, pretreatment. In an external HER2-positive responder synthesis (I-SPY1 pathology-confirmed pCR plus UCSF best-response proxy; n = 33, 10 events), adverse structure was associated with higher recurrence risk (HR = 2.87, 95% CI 1.38-5.96) capturing 7 of 10 recurrences, enriching rather than determining risk. In a HER2-positive RCB-0 subset, recurrence was 12.5% with favorable and 80.0% with adverse structure; Firth Cox regression preserved the association (HR = 8.13, 95% CI 1.71-49.21; n = 21, 6 events). In Duke (n = 908; 76 events), favorable structure remained independently associated with lower distant-recurrence risk (adjusted HR = 0.61, 95% CI 0.41-0.91). RNA linked favorable structure to a directionally reproduced immune-architecture program among non-overlapping patients within ISPY2; EMT-pathway enrichment was favorable-side, while the adverse tier contained a broadly immune-depleted substate. Yet full-cohort RNA models weakly discriminated structural state and did not recover continuous entropy. Pretreatment MRI therefore does not replace pCR or RCB; it reveals response-quality differences that these endpoints compress and identifies a recurrence-enriched group for prospective validation.
Generative segmentation provides an alternative to direct pixel-wise prediction by operating on learned latent representations, but effective image-to-mask translation must preserve target structure while remaining computationally efficient. We propose Generative Embedding Translation (GET), a structured embedding-translation framework that progressively transforms image embeddings into mask embeddings within the frozen latent space of a Stable Diffusion VAE. GET uses a U-Net-style Embedding Translation Network with 1.07M trainable parameters, combining Mobile Bottleneck Convolutions, Subsampled Self-Attention, and Multi-scale Feature Enrichment for local modeling, global context, and multi-scale refinement. Across five medical segmentation datasets, GET outperforms generative, CNN, and Transformer baselines. Compared with the strongest generative baseline, GMS, GET improves average Dice and IoU by 0.93% and 1.26%, reduces HD95 by 0.81 pixels, and uses 31.41% fewer trainable parameters. Under bidirectional BUS-BUSI domain shift, GET further improves Dice and IoU by 3.51% and 3.39%, while reducing HD95 by 27.37 pixels. Our code is available at: https://github.com/maklachur/GET.
Reliable quantitative analysis of dynamic contrast-enhanced MRI requires high-quality spatiotemporal reconstructions at high undersampling rates. Scan-specific reconstructions using Gaussian and Gabor primitives have shown promising results without the need for large training datasets, but have not addressed the additional dimension of dynamic contrast. We propose a multi-dimensional, primitive based framework for dynamic contrast-enhanced MRI reconstruction that disentangles the underlying anatomy, the dynamic contrast enhancement, and residual motion into separate temporal basis functions, thereby enabling a geometrical interpretation of the representation. We show that this architecture achieves performance competitive with conventional reconstruction methods, both in reconstruction quality and in the accuracy of extracted aorta and kidney enhancement curves. The modular tier design extends naturally to additional dynamic factors and higher acceleration rates. Code available at https://github.com/compai-lab/2026-GaborDCE-spieker.
MRI reconstruction methods for undersampled k-space data naturally utilize complex-valued measurements. Parallel developments in sparse phase retrieval have shown that magnitude-only measurements may provide complementary information for signal recovery. However, their use in MRI reconstruction remains largely unexplored, due to lack of practical settings where informative magnitude measurements can be obtained without additional scan time. In this work, we investigate the use of auxiliary k-space magnitude information for accelerated steady-state dynamic MRI reconstruction, and demonstrate strong consistency of k-space magnitudes across time-frames. Building on this observation, we propose $\mathbb{C}+\text{Mag}$, a magnitude-informed physics-driven deep learning reconstruction method. The proposed method employs an ADMM-based unrolling framework with a novel magnitude-aware data-fidelity formulation, where quadratically smoothed optimization and momentum-based updates are introduced to address the non-differentiability and non-convexity of the magnitude constraints. Experiments on retrospectively undersampled cine MRI and phase-contrast flow MRI datasets, as well as prospectively undersampled real-time cine MRI acquisitions, demonstrate improved artifact suppression, sharper anatomical recovery, and better preservation of phase information compared to conventional PD-DL methods, which is further supported through blinded expert reader evaluations.
Reliable quantitative analysis of dynamic contrast-enhanced MRI requires high-quality spatiotemporal reconstructions at high undersampling rates. Scan-specific reconstructions using Gaussian and Gabor primitives have shown promising results without the need for large training datasets, but have not addressed the additional dimension of dynamic contrast. We propose a multi-dimensional, primitive based framework for dynamic contrast-enhanced MRI reconstruction that disentangles the underlying anatomy, the dynamic contrast enhancement, and residual motion into separate temporal basis functions, thereby enabling a geometrical interpretation of the representation. We show that this architecture achieves performance competitive with conventional reconstruction methods, both in reconstruction quality and in the accuracy of extracted aorta and kidney enhancement curves. The modular tier design extends naturally to additional dynamic factors and higher acceleration rates. Code available at https://github.com/compai-lab/ 2026-GaborDCE-spieker.
Background: Accurate body composition analysis using Computed Tomography (CT) scans is essential for assessing skeletal muscle area (SMA) and skeletal muscle density (SMD), key markers of nutritional status in cancer patients. Conventional manual methods are labour-intensive and require specialist expertise, limiting their routine clinical use. Therefore, this study serves as a feasibility and pilot investigation to explore the potential of deep learning-based automated regression for body composition analysis within a clinical workflow. Methods: Four deep learning architectures (AlexNet, UNet, GoogLeNet, and ResNet34) were trained to predict SMA, SMD, subcutaneous fat area (SFA), and visceral fat area (VFA) from CT scans of colorectal cancer patients. Systematic hyperparameter optimization identified the most accurate models, which were subsequently implemented in a web application for clinical use. Results: GoogLeNet achieved the best performance, with a mean percentage error (PE) of 4.96% for SMA prediction, while AlexNet reached 8.12% for SMD. Independent testing demonstrated robust accuracy, correctly classifying body composition metrics in 80% of cases. The web application delivered rapid and consistent outputs, supporting integration into clinical workflows. Conclusion: Optimized deep learning models, particularly GoogLeNet and AlexNet, can automate CT-derived body composition analysis with a Mean Percentage Error (PE) of 4.96% for SMA and 8.12% for SMD. These tools have the potential to streamline clinical practice by reducing the time and expertise required for manual segmentation. Further validation in larger, more diverse datasets is warranted.