Daily Papers

Longitudinal medical imaging captures temporal evolution of lesions, yet extracting the underlying dynamical parameters governing this evolution remains challenging. We propose an inverse Bayesian framework for inferring lesion dynamics from longitudinal spectral CT. We decompose spectral feature (x) evolution into three components: equation* dx_i{dt} = A_i x_i + B \cdot n + C \cdot Δx_{sat} equation* where A_i captures intrinsic dynamics (lesion-autonomous evolution), B captures local environment tumour burden (organ tumour burden through satellite count coupling), and C captures environment/satellite state change (i.e., whether surrounding lesions move similarly or not). We demonstrate the framework on photon-counting NSCLC CT data from metastases, recovering distinct dynamical regimes: lung lesions exhibit significant satellite count coupling (B=-0.34, p<0.05) suggesting competitive dynamics, while liver lesions show synergistic satellite behaviour coupling (Capprox+1.0, p<0.05). Synthetic validation confirms parameter recovery, and cross-coupling analysis validates that our method detects non-zero coupling when present. This work establishes inverse dynamical inference as a principled methodology for extracting interpretable parameters from longitudinal imaging, moving beyond static feature extraction toward mechanistic characterisation of lesion behaviour. The code and data are available at: https://github.com/lukasf98/inverse-bayesian-inference

Longitudinal analysis has great potential to reveal developmental trajectories and monitor disease progression in medical imaging. This process relies on consistent and robust joint 4D segmentation. Traditional techniques are dependent on the similarity of images over time and the use of subject-specific priors to reduce random variation and improve the robustness and sensitivity of the overall longitudinal analysis. This is however slow and computationally intensive as subject-specific templates need to be rebuilt every time. The focus of this work to accelerate this analysis with the use of deep learning. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The state of art using 3D patches as inputs to modified Unet provides results around {0.91 pm 0.5} Dice and using multi-view atlas in CNNs provide around the same results. In this work, different models are explored, each offers better accuracy and fast results while increasing the segmentation quality. These methods are evaluated on 135 scans from the EADC-ADNI Harmonized Hippocampus Protocol. Proposed CNN based segmentation approaches demonstrate how 2D segmentation using prior slices can provide similar results to 3D segmentation while maintaining good continuity in the 3D dimension and improved speed. Just using 2D modified sagittal slices provide us a better Dice and longitudinal analysis for a given subject. For the ADNI dataset, using the simple UNet CNN technique gives us {0.84 pm 0.5} and while using modified CNN techniques on the same input yields {0.89 pm 0.5}. Rate of atrophy and RMS error are calculated for several test cases using various methods and analyzed.

In medical imaging, the clinical value of Computed Tomography (CT) lies not only in depicting current disease status, but crucially in enabling longitudinal comparison of serial scans to determine disease evolution, a process that underpins response assessment, recurrence detection, and ongoing patient management. Yet, despite this central role of temporal comparison in clinical decision-making, existing medical foundation models remain largely confined to single-study understanding, leaving temporally grounded cross-examination insufficiently addressed. To address this gap, we study longitudinal imaging difference reporting, a task in which a model takes two temporally separated scans from the same patient and generates a clinically meaningful report describing interval changes between them. We introduce CT-ΔBench, a dedicated benchmark for this task with patient-level splitting to prevent information leakage. To better evaluate this task beyond surface-level text similarity, we further develop change-aware metrics specifically designed to capture clinically meaningful longitudinal changes, and conduct an independent physician validation to assess the reliability of the synthesized references and event extraction pipeline. We also compare direct paired-CT reasoning with an indirect two-stage pipeline that first generates single-timepoint reports and then performs textual differencing. Finally, we propose DeltaMed, a baseline model for direct paired-CT difference reporting, and train it on the benchmark training set. Together, these contributions lay the groundwork for temporally aware medical foundation models that better reflect real-world longitudinal clinical reasoning.

Longitudinal multimodal data, including electronic health records (EHR) and sequential chest X-rays (CXRs), is critical for modeling disease progression, yet remains underutilized due to two key challenges: (1) redundancy in consecutive CXR sequences, where static anatomical regions dominate over clinically-meaningful dynamics, and (2) temporal misalignment between sparse, irregular imaging and continuous EHR data. We introduce DiPro, a novel framework that addresses these challenges through region-aware disentanglement and multi-timescale alignment. First, we disentangle static (anatomy) and dynamic (pathology progression) features in sequential CXRs, prioritizing disease-relevant changes. Second, we hierarchically align these static and dynamic CXR features with asynchronous EHR data via local (pairwise interval-level) and global (full-sequence) synchronization to model coherent progression pathways. Extensive experiments on the MIMIC dataset demonstrate that DiPro could effectively extract temporal clinical dynamics and achieve state-of-the-art performance on both disease progression identification and general ICU prediction tasks.

Chest Xray imaging is a widely used diagnostic tool in modern medicine, and its high utilization creates substantial workloads for radiologists. To alleviate this burden, vision language models are increasingly applied to automate Chest Xray radiology report generation (CXRRRG), aiming for clinically accurate descriptions while reducing manual effort. Conventional approaches, however, typically rely on single images, failing to capture the longitudinal context necessary for producing clinically faithful comparison statements. Recently, growing attention has been directed toward incorporating longitudinal data into CXR RRG, enabling models to leverage historical studies in ways that mirror radiologists diagnostic workflows. Nevertheless, existing surveys primarily address single image CXRRRG and offer limited guidance for longitudinal settings, leaving researchers without a systematic framework for model design. To address this gap, this survey provides the first comprehensive review of longitudinal radiology report generation (LRRG). Specifically, we examine dataset construction strategies, report generation architectures alongside longitudinally tailored designs, and evaluation protocols encompassing both longitudinal specific measures and widely used benchmarks. We further summarize LRRG methods performance, alongside analyses of different ablation studies, which collectively highlight the critical role of longitudinal information and architectural design choices in improving model performance. Finally, we summarize five major limitations of current research and outline promising directions for future development, aiming to lay a foundation for advancing this emerging field.

Off-resonance artifacts in magnetic resonance imaging (MRI) are visual distortions that occur when the actual resonant frequencies of spins within the imaging volume differ from the expected frequencies used to encode spatial information. These discrepancies can be caused by a variety of factors, including magnetic field inhomogeneities, chemical shifts, or susceptibility differences within the tissues. Such artifacts can manifest as blurring, ghosting, or misregistration of the reconstructed image, and they often compromise its diagnostic quality. We propose to resolve these artifacts by lifting the 2D MRI reconstruction problem to 3D, introducing an additional "spectral" dimension to model this off-resonance. Our approach is inspired by recent progress in modeling radiance fields, and is capable of reconstructing both static and dynamic MR images as well as separating fat and water, which is of independent clinical interest. We demonstrate our approach in the context of PROPELLER (Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction) MRI acquisitions, which are popular for their robustness to motion artifacts. Our method operates in a few minutes on a single GPU, and to our knowledge is the first to correct for chemical shift in gradient echo PROPELLER MRI reconstruction without additional measurements or pretraining data.

With the growing volume of CT examinations, there is an increasing demand for automated tools such as organ segmentation, abnormality detection, and report generation to support radiologists in managing their clinical workload. Multi-label classification of 3D Chest CT scans remains a critical yet challenging problem due to the complex spatial relationships inherent in volumetric data and the wide variability of abnormalities. Existing methods based on 3D convolutional neural networks struggle to capture long-range dependencies, while Vision Transformers often require extensive pre-training on large-scale, domain-specific datasets to perform competitively. In this work of academic research, we propose a 2.5D alternative by introducing a new graph-based framework that represents 3D CT volumes as structured graphs, where axial slice triplets serve as nodes processed through spectral graph convolution, enabling the model to reason over inter-slice dependencies while maintaining complexity compatible with clinical deployment. Our method, trained and evaluated on 3 datasets from independent institutions, achieves strong cross-dataset generalization, and shows competitive performance compared to state-of-the-art visual encoders. We further conduct comprehensive ablation studies to evaluate the impact of various aggregation strategies, edge-weighting schemes, and graph connectivity patterns. Additionally, we demonstrate the broader applicability of our approach through transfer experiments on automated radiology report generation and abdominal CT data.

Brain tissue segmentation is essential for neuroscience and clinical studies. However, segmentation on longitudinal data is challenging due to dynamic brain changes across the lifespan. Previous researches mainly focus on self-supervision with regularizations and will lose longitudinal generalization when fine-tuning on a specific age group. In this paper, we propose a dual meta-learning paradigm to learn longitudinally consistent representations and persist when fine-tuning. Specifically, we learn a plug-and-play feature extractor to extract longitudinal-consistent anatomical representations by meta-feature learning and a well-initialized task head for fine-tuning by meta-initialization learning. Besides, two class-aware regularizations are proposed to encourage longitudinal consistency. Experimental results on the iSeg2019 and ADNI datasets demonstrate the effectiveness of our method. Our code is available at https://github.com/ladderlab-xjtu/DuMeta.

Accurate segmentation of Multiple Sclerosis (MS) lesions in longitudinal MRI scans is crucial for monitoring disease progression and treatment efficacy. Although changes across time are taken into account when assessing images in clinical practice, most existing deep learning methods treat scans from different timepoints separately. Among studies utilizing longitudinal images, a simple channel-wise concatenation is the primary albeit suboptimal method employed to integrate timepoints. We introduce a novel approach that explicitly incorporates temporal differences between baseline and follow-up scans through a unique architectural inductive bias called Difference Weighting Block. It merges features from two timepoints, emphasizing changes between scans. We achieve superior scores in lesion segmentation (Dice Score, Hausdorff distance) as well as lesion detection (lesion-level F_1 score) as compared to state-of-the-art longitudinal and single timepoint models across two datasets. Our code is made publicly available at www.github.com/MIC-DKFZ/Longitudinal-Difference-Weighting.

Automated radiology report generation offers an effective solution to alleviate radiologists' workload. However, most existing methods focus primarily on single or fixed-view images to model current disease conditions, which limits diagnostic accuracy and overlooks disease progression. Although some approaches utilize longitudinal data to track disease progression, they still rely on single images to analyze current visits. To address these issues, we propose enhanced contrastive learning with Multi-view Longitudinal data to facilitate chest X-ray Report Generation, named MLRG. Specifically, we introduce a multi-view longitudinal contrastive learning method that integrates spatial information from current multi-view images and temporal information from longitudinal data. This method also utilizes the inherent spatiotemporal information of radiology reports to supervise the pre-training of visual and textual representations. Subsequently, we present a tokenized absence encoding technique to flexibly handle missing patient-specific prior knowledge, allowing the model to produce more accurate radiology reports based on available prior knowledge. Extensive experiments on MIMIC-CXR, MIMIC-ABN, and Two-view CXR datasets demonstrate that our MLRG outperforms recent state-of-the-art methods, achieving a 2.3% BLEU-4 improvement on MIMIC-CXR, a 5.5% F1 score improvement on MIMIC-ABN, and a 2.7% F1 RadGraph improvement on Two-view CXR.

The growing availability of longitudinal Magnetic Resonance Imaging (MRI) datasets has facilitated Artificial Intelligence (AI)-driven modeling of disease progression, making it possible to predict future medical scans for individual patients. However, despite significant advancements in AI, current methods continue to face challenges including achieving patient-specific individualization, ensuring spatiotemporal consistency, efficiently utilizing longitudinal data, and managing the substantial memory demands of 3D scans. To address these challenges, we propose Brain Latent Progression (BrLP), a novel spatiotemporal model designed to predict individual-level disease progression in 3D brain MRIs. The key contributions in BrLP are fourfold: (i) it operates in a small latent space, mitigating the computational challenges posed by high-dimensional imaging data; (ii) it explicitly integrates subject metadata to enhance the individualization of predictions; (iii) it incorporates prior knowledge of disease dynamics through an auxiliary model, facilitating the integration of longitudinal data; and (iv) it introduces the Latent Average Stabilization (LAS) algorithm, which (a) enforces spatiotemporal consistency in the predicted progression at inference time and (b) allows us to derive a measure of the uncertainty for the prediction at the global and voxel level. We train and evaluate BrLP on 11,730 T1-weighted (T1w) brain MRIs from 2,805 subjects and validate its generalizability on an external test set comprising 2,257 MRIs from 962 subjects. Our experiments compare BrLP-generated MRI scans with real follow-up MRIs, demonstrating state-of-the-art accuracy compared to existing methods. The code is publicly available at: https://github.com/LemuelPuglisi/BrLP.

Recently, Spectral Compressive Imaging (SCI) has achieved remarkable success, unlocking significant potential for dynamic spectral vision. However, existing reconstruction methods, primarily image-based, suffer from two limitations: (i) Encoding process masks spatial-spectral features, leading to uncertainty in reconstructing missing information from single compressed measurements, and (ii) The frame-by-frame reconstruction paradigm fails to ensure temporal consistency, which is crucial in the video perception. To address these challenges, this paper seeks to advance spectral reconstruction from the image level to the video level, leveraging the complementary features and temporal continuity across adjacent frames in dynamic scenes. Initially, we construct the first high-quality dynamic hyperspectral image dataset (DynaSpec), comprising 30 sequences obtained through frame-scanning acquisition. Subsequently, we propose the Propagation-Guided Spectral Video Reconstruction Transformer (PG-SVRT), which employs a spatial-then-temporal attention to effectively reconstruct spectral features from abundant video information, while using a bridged token to reduce computational complexity. Finally, we conduct simulation experiments to assess the performance of four SCI systems, and construct a DD-CASSI prototype for real-world data collection and benchmarking. Extensive experiments demonstrate that PG-SVRT achieves superior performance in reconstruction quality, spectral fidelity, and temporal consistency, while maintaining minimal FLOPs. Project page: https://github.com/nju-cite/DynaSpec

Human organs constantly undergo anatomical changes due to a complex mix of short-term (e.g., heartbeat) and long-term (e.g., aging) factors. Evidently, prior knowledge of these factors will be beneficial when modeling their future state, i.e., via image generation. However, most of the medical image generation tasks only rely on the input from a single image, thus ignoring the sequential dependency even when longitudinal data is available. Sequence-aware deep generative models, where model input is a sequence of ordered and timestamped images, are still underexplored in the medical imaging domain that is featured by several unique challenges: 1) Sequences with various lengths; 2) Missing data or frame, and 3) High dimensionality. To this end, we propose a sequence-aware diffusion model (SADM) for the generation of longitudinal medical images. Recently, diffusion models have shown promising results in high-fidelity image generation. Our method extends this new technique by introducing a sequence-aware transformer as the conditional module in a diffusion model. The novel design enables learning longitudinal dependency even with missing data during training and allows autoregressive generation of a sequence of images during inference. Our extensive experiments on 3D longitudinal medical images demonstrate the effectiveness of SADM compared with baselines and alternative methods. The code is available at https://github.com/ubc-tea/SADM-Longitudinal-Medical-Image-Generation.

Four-dimensional computed tomography (4D CT) reconstruction is crucial for capturing dynamic anatomical changes but faces inherent limitations from conventional phase-binning workflows. Current methods discretize temporal resolution into fixed phases with respiratory gating devices, introducing motion misalignment and restricting clinical practicality. In this paper, We propose X^2-Gaussian, a novel framework that enables continuous-time 4D-CT reconstruction by integrating dynamic radiative Gaussian splatting with self-supervised respiratory motion learning. Our approach models anatomical dynamics through a spatiotemporal encoder-decoder architecture that predicts time-varying Gaussian deformations, eliminating phase discretization. To remove dependency on external gating devices, we introduce a physiology-driven periodic consistency loss that learns patient-specific breathing cycles directly from projections via differentiable optimization. Extensive experiments demonstrate state-of-the-art performance, achieving a 9.93 dB PSNR gain over traditional methods and 2.25 dB improvement against prior Gaussian splatting techniques. By unifying continuous motion modeling with hardware-free period learning, X^2-Gaussian advances high-fidelity 4D CT reconstruction for dynamic clinical imaging. Code is publicly available at: https://x2-gaussian.github.io/.

Clinical routine and retrospective cohorts commonly include multi-parametric Magnetic Resonance Imaging; however, they are mostly acquired in different anisotropic 2D views due to signal-to-noise-ratio and scan-time constraints. Thus acquired views suffer from poor out-of-plane resolution and affect downstream volumetric image analysis that typically requires isotropic 3D scans. Combining different views of multi-contrast scans into high-resolution isotropic 3D scans is challenging due to the lack of a large training cohort, which calls for a subject-specific framework. This work proposes a novel solution to this problem leveraging Implicit Neural Representations (INR). Our proposed INR jointly learns two different contrasts of complementary views in a continuous spatial function and benefits from exchanging anatomical information between them. Trained within minutes on a single commodity GPU, our model provides realistic super-resolution across different pairs of contrasts in our experiments with three datasets. Using Mutual Information (MI) as a metric, we find that our model converges to an optimum MI amongst sequences, achieving anatomically faithful reconstruction. Code is available at: https://github.com/jqmcginnis/multi_contrast_inr/

Diffusion models typically suffer from error accumulation during iterative sampling, commonly referred to as exposure bias. We reveal systematic frequency-dependent discrepancies between training and inference, which can be interpreted as frequency-dependent SNR error. Crucially, the direction of this mismatch varies across models and timesteps, indicating that fixed correction rules do not generalize. We propose Spectral Alignment (SPA), a lightweight, guidance-based method that calibrates the power spectrum of intermediate predictions to a pre-computed prior. Our approach consists of two stages: (1) offline fitting of a parametric spectrum model from training data, and (2) inference-time guidance via efficient FFT-based gradient computation. SPA introduces minimal computational overhead (3-4\%) and is complementary to Classifier-Free Guidance (CFG). We demonstrate consistent improvements across diverse architectures, from pixel-space models (DDPM, ADM) to latent diffusion models (SD2.0, SDXL) and flow-matching models (SD3.5, FLUX). Our implementation is available at https://github.com/SonyResearch/SPA.

In clinical practice, patients often undergo multiple imaging examinations over successive visits, yielding longitudinal data. Modeling such temporal information is crucial for reliable assessment of disease progression and treatment response. However, despite the rapid advancement of multimodal large language models (MLLMs), longitudinal medical visual reasoning remains largely underexplored. To fill this gap, we propose LoMeVQA, a comprehensive benchmark consisting of 206K longitudinal visual question answering (VQA) pairs for temporal medical image analysis. LoMeVQA covers five tasks: progress classification, progress description, progress report generation, differential region grounding, and differential region description. To construct the dataset, we develop an automated pipeline that (1) organizes patient records chronologically, (2) extracts clinically meaningful entities via a medical knowledge graph, and (3) models their temporal evolution to guide large language models in generating high-quality longitudinal VQA pairs. Extensive evaluations demonstrate that both general-purpose and medical-domain MLLMs perform poorly on LoMeVQA, revealing substantial limitations in temporal reasoning. To address these limitations, we introduce MedLong-8B, which achieves state-of-the-art performance across all tasks. Beyond benchmarking, we conduct detailed analyses that uncover key failure modes and shed light on how to improve longitudinal medical visual reasoning. Our data is available at: https://github.com/pepperbubble/LoMeVQA

Sparse-view computed tomography (CT) -- using a small number of projections for tomographic reconstruction -- enables much lower radiation dose to patients and accelerated data acquisition. The reconstructed images, however, suffer from strong artifacts, greatly limiting their diagnostic value. Current trends for sparse-view CT turn to the raw data for better information recovery. The resultant dual-domain methods, nonetheless, suffer from secondary artifacts, especially in ultra-sparse view scenarios, and their generalization to other scanners/protocols is greatly limited. A crucial question arises: have the image post-processing methods reached the limit? Our answer is not yet. In this paper, we stick to image post-processing methods due to great flexibility and propose global representation (GloRe) distillation framework for sparse-view CT, termed GloReDi. First, we propose to learn GloRe with Fourier convolution, so each element in GloRe has an image-wide receptive field. Second, unlike methods that only use the full-view images for supervision, we propose to distill GloRe from intermediate-view reconstructed images that are readily available but not explored in previous literature. The success of GloRe distillation is attributed to two key components: representation directional distillation to align the GloRe directions, and band-pass-specific contrastive distillation to gain clinically important details. Extensive experiments demonstrate the superiority of the proposed GloReDi over the state-of-the-art methods, including dual-domain ones. The source code is available at https://github.com/longzilicart/GloReDi.

Spectral imaging offers promising applications across diverse domains, including medicine and urban scene understanding, and is already established as a critical modality in remote sensing. However, variability in channel dimensionality and captured wavelengths among spectral cameras impede the development of AI-driven methodologies, leading to camera-specific models with limited generalizability and inadequate cross-camera applicability. To address this bottleneck, we introduce CARL, a model for Camera-Agnostic Representation Learning across RGB, multispectral, and hyperspectral imaging modalities. To enable the conversion of a spectral image with any channel dimensionality to a camera-agnostic representation, we introduce a novel spectral encoder, featuring a self-attention-cross-attention mechanism, to distill salient spectral information into learned spectral representations. Spatio-spectral pre-training is achieved with a novel feature-based self-supervision strategy tailored to CARL. Large-scale experiments across the domains of medical imaging, autonomous driving, and satellite imaging demonstrate our model's unique robustness to spectral heterogeneity, outperforming on datasets with simulated and real-world cross-camera spectral variations. The scalability and versatility of the proposed approach position our model as a backbone for future spectral foundation models. Code and model weights are publicly available at https://github.com/IMSY-DKFZ/CARL.

Longitudinal chest X-ray (CXR) interpretation requires reasoning over disease evolution across multiple patient visits, yet most existing medical VQA benchmarks focus on single images or short-horizon image pairs. We introduce MI-CXR, a benchmark for standardized evaluation of Multi-Interval longitudinal reasoning over multi-visit CXR sequences, without requiring free-form report generation or additional clinical context. MI-CXR comprises five-way multiple-choice questions over five-visit patient timelines and instantiates three complementary task families: Temporal Event Localization, Interval-wise Change Reasoning, and Global Trajectory Summarization, which assess clinically grounded visual reasoning over time. Evaluating 14 state-of-the-art vision-language models (VLMs) shows low overall performance, with an average accuracy of 29.3%, only modestly above random guessing. Using stage-wise diagnostic probing, we find that models often produce locally plausible interval descriptions but fail to enforce temporal constraints or compose evidence into globally consistent decisions over the full timeline. These findings reveal key limitations of current VLMs and establish MI-CXR as a principled benchmark for longitudinal medical reasoning. The benchmark is available at https://github.com/AIDASLab/MI-CXR

In this work, we present LesionLocator, a framework for zero-shot longitudinal lesion tracking and segmentation in 3D medical imaging, establishing the first end-to-end model capable of 4D tracking with dense spatial prompts. Our model leverages an extensive dataset of 23,262 annotated medical scans, as well as synthesized longitudinal data across diverse lesion types. The diversity and scale of our dataset significantly enhances model generalizability to real-world medical imaging challenges and addresses key limitations in longitudinal data availability. LesionLocator outperforms all existing promptable models in lesion segmentation by nearly 10 dice points, reaching human-level performance, and achieves state-of-the-art results in lesion tracking, with superior lesion retrieval and segmentation accuracy. LesionLocator not only sets a new benchmark in universal promptable lesion segmentation and automated longitudinal lesion tracking but also provides the first open-access solution of its kind, releasing our synthetic 4D dataset and model to the community, empowering future advancements in medical imaging. Code is available at: www.github.com/MIC-DKFZ/LesionLocator

Diffusion models have been shown to implicitly generate visual content autoregressively in the frequency domain, where low-frequency components are generated earlier in the denoising process while high-frequency details emerge only in later timesteps. This structure offers a natural opportunity for efficient generation, as high-resolution computation on noise-dominated frequencies is largely redundant. We propose Spectral Progressive Diffusion, a general framework that progressively grows resolution along the denoising trajectory of pretrained diffusion models. To this end, we develop a spectral noise expansion mechanism and derive an optimal resolution schedule from the model's power spectrum. Our framework supports training-free acceleration and a novel fine-tuning recipe that further improves efficiency and quality. We demonstrate significant speedups on state-of-the-art pretrained image and video generation models while preserving visual quality.

Advances in medical imaging technologies have enabled the collection of longitudinal images, which involve repeated scanning of the same patients over time, to monitor disease progression. However, predictive modeling of such data remains challenging due to high dimensionality, irregular sampling, and data sparsity. To address these issues, we propose ImageFlowNet, a novel model designed to forecast disease trajectories from initial images while preserving spatial details. ImageFlowNet first learns multiscale joint representation spaces across patients and time points, then optimizes deterministic or stochastic flow fields within these spaces using a position-parameterized neural ODE/SDE framework. The model leverages a UNet architecture to create robust multiscale representations and mitigates data scarcity by combining knowledge from all patients. We provide theoretical insights that support our formulation of ODEs, and motivate our regularizations involving high-level visual features, latent space organization, and trajectory smoothness. We validate ImageFlowNet on three longitudinal medical image datasets depicting progression in geographic atrophy, multiple sclerosis, and glioblastoma, demonstrating its ability to effectively forecast disease progression and outperform existing methods. Our contributions include the development of ImageFlowNet, its theoretical underpinnings, and empirical validation on real-world datasets. The official implementation is available at https://github.com/KrishnaswamyLab/ImageFlowNet.

Radiotherapy often involves a prolonged treatment period. During this time, patients may experience organ motion due to breathing and other physiological factors. Predicting and modeling this motion before treatment is crucial for ensuring precise radiation delivery. However, existing pre-treatment organ motion prediction methods primarily rely on deformation analysis using principal component analysis (PCA), which is highly dependent on registration quality and struggles to capture periodic temporal dynamics for motion modeling.In this paper, we observe that organ motion prediction closely resembles an autoregressive process, a technique widely used in natural language processing (NLP). Autoregressive models predict the next token based on previous inputs, naturally aligning with our objective of predicting future organ motion phases. Building on this insight, we reformulate organ motion prediction as an autoregressive process to better capture patient-specific motion patterns. Specifically, we acquire 4D CT scans for each patient before treatment, with each sequence comprising multiple 3D CT phases. These phases are fed into the autoregressive model to predict future phases based on prior phase motion patterns. We evaluate our method on a real-world test set of 4D CT scans from 50 patients who underwent radiotherapy at our institution and a public dataset containing 4D CT scans from 20 patients (some with multiple scans), totaling over 1,300 3D CT phases. The performance in predicting the motion of the lung and heart surpasses existing benchmarks, demonstrating its effectiveness in capturing motion dynamics from CT images. These results highlight the potential of our method to improve pre-treatment planning in radiotherapy, enabling more precise and adaptive radiation delivery.

Photon-counting CT (PCCT) provides superior image quality with higher spatial resolution and lower noise compared to conventional energy-integrating CT (EICT), but its limited clinical availability restricts large-scale research and clinical deployment. To bridge this gap, we propose SUMI, a simulated degradation-to-enhancement method that learns to reverse realistic acquisition artifacts in low-quality EICT by leveraging high-quality PCCT as reference. Our central insight is to explicitly model realistic acquisition degradations, transforming PCCT into clinically plausible lower-quality counterparts and learning to invert this process. The simulated degradations were validated for clinical realism by board-certified radiologists, enabling faithful supervision without requiring paired acquisitions at scale. As outcomes of this technical contribution, we: (1) train a latent diffusion model on 1,046 PCCTs, using an autoencoder first pre-trained on both these PCCTs and 405,379 EICTs from 145 hospitals to extract general CT latent features that we release for reuse in other generative medical imaging tasks; (2) construct a large-scale dataset of over 17,316 publicly available EICTs enhanced to PCCT-like quality, with radiologist-validated voxel-wise annotations of airway trees, arteries, veins, lungs, and lobes; and (3) demonstrate substantial improvements: across external data, SUMI outperforms state-of-the-art image translation methods by 15% in SSIM and 20% in PSNR, improves radiologist-rated clinical utility in reader studies, and enhances downstream top-ranking lesion detection performance, increasing sensitivity by up to 15% and F1 score by up to 10%. Our results suggest that emerging imaging advances can be systematically distilled into routine EICT using limited high-quality scans as reference.

Forecasting the future anatomy of slow-evolving neurodegenerative diseases could enable earlier, more targeted intervention and improve clinical trial design, but it remains challenging because true progression signals are subtle in longitudinal MRI. In this low-signal regime, transferring modern generative sequence models directly is unreliable: training is dominated by stable baseline anatomy and confounded by dense, sample-specific nuisance variation. We first provide a theoretical analysis that explains these failures through two modes. Identity collapse occurs when optimization is driven toward reproducing the current anatomy, which prevents the model from learning faint temporal change. The continuous interpolation trap arises when standard smooth networks cannot separate localized biological drift from pervasive noise, which leads to spurious changes that diffuse across the volume. To address both issues, we propose Latent Drift, a progressive generative framework that learns change in a compressed semantic representation rather than synthesizing full-resolution anatomy. This design removes pixel-level identity from the prediction target and concentrates model capacity on progression-relevant dynamics. We further apply Finite Scalar Quantization to the learned change representation, which suppresses small, high-frequency nuisance fluctuations while preserving consistent structural drift. Experiments on longitudinal 3D brain MRI show that Latent Drift improves patient-specific neuro-forecasting over diffusion and autoregressive transformer baselines across generative fidelity and clinically relevant evaluation metrics. Project page: https://cutepkq.github.io/latent-drift{https://cutepkq.github.io/latent-drift}.

Tracking tumor lesions across serial CT scans is essential for oncological response assessment. Existing automated methods face a fundamental trade-off: end-to-end trackers achieve high automation but offer no opportunity to correct silent tracking failures, while decoupled registration-segmentation pipelines permit user verification yet discard the lesion's prior appearance, limiting accuracy in ambiguous cases. In this work, we propose a Verified Tracking paradigm: a clinician verifies a registration-proposed prompt, which the model leverages alongside the baseline lesion appearance to resolve segmentation ambiguities. We present a unified framework combining early spatial prompt fusion with latent temporal difference weighting for longitudinally-informed segmentation. To address data scarcity, we leverage large-scale synthetic pretraining, proving essential for exploiting longitudinal context, improving performance by up to 4.5 Dice points over training from scratch. Our approach secured first place in the MICCAI autoPET IV challenge. We further curate and release PanTrack, a new longitudinal pancreatic cancer benchmark, to assess out-of-distribution generalization. Experiments show that our model outperforms prior work in both fully automatic and the proposed verified tracking setting offering a clinically safe middle ground between automation and control. Code, model and dataset will be released at https://github.com/MIC-DKFZ/LongiSeg

In longitudinal clinical practice, every chest X-ray is read in the context of the patients prior exam, and much of what the radiologist communicates is the change from one visit to the next. To the best of our knowledge, we present the first training-free best-of-N sampling scheme for pre-trained chest X-ray report generators that is explicitly aware of this longitudinal prior to current transition. We call it transition-aware best-of-N sampling, each report is split into sentences and embedded into an unordered set in Rd; each (prior, current) pair is reduced to a fixed-dim directional vector via a set-to-set distance designed to encode the change between the two sets; and candidates are scored by cosine distance from their candidate transition vector to a cached bank of ground-truth training transition vectors, aggregated as min or kNN. We instantiate the framework with four directional set distances (mean-shift, novelty residual, directed-Hausdorff anchor, and cost-weighted optimal transport) and evaluate on a multi-visit AP-PA cohort, running inference under three prompts on three vision-language generators. Transition-aware best-of-N outperforms random selection across the board, with the largest relative gains on the Impression section.

In this work, we introduce Brain Latent Progression (BrLP), a novel spatiotemporal disease progression model based on latent diffusion. BrLP is designed to predict the evolution of diseases at the individual level on 3D brain MRIs. Existing deep generative models developed for this task are primarily data-driven and face challenges in learning disease progressions. BrLP addresses these challenges by incorporating prior knowledge from disease models to enhance the accuracy of predictions. To implement this, we propose to integrate an auxiliary model that infers volumetric changes in various brain regions. Additionally, we introduce Latent Average Stabilization (LAS), a novel technique to improve spatiotemporal consistency of the predicted progression. BrLP is trained and evaluated on a large dataset comprising 11,730 T1-weighted brain MRIs from 2,805 subjects, collected from three publicly available, longitudinal Alzheimer's Disease (AD) studies. In our experiments, we compare the MRI scans generated by BrLP with the actual follow-up MRIs available from the subjects, in both cross-sectional and longitudinal settings. BrLP demonstrates significant improvements over existing methods, with an increase of 22% in volumetric accuracy across AD-related brain regions and 43% in image similarity to the ground-truth scans. The ability of BrLP to generate conditioned 3D scans at the subject level, along with the novelty of integrating prior knowledge to enhance accuracy, represents a significant advancement in disease progression modeling, opening new avenues for precision medicine. The code of BrLP is available at the following link: https://github.com/LemuelPuglisi/BrLP.

We introduce SPECTRE, a fully transformer-based foundation model for volumetric computed tomography (CT). Our Self-Supervised & Cross-Modal Pretraining for CT Representation Extraction (SPECTRE) approach utilizes scalable 3D Vision Transformer architectures and modern self-supervised and vision-language pretraining strategies to learn general-purpose CT representations. Volumetric CT poses unique challenges, such as extreme token scaling, geometric anisotropy, and weak or noisy clinical supervision, that make standard transformer and contrastive learning recipes ineffective out of the box. The framework jointly optimizes a local transformer for high-resolution volumetric feature extraction and a global transformer for whole-scan context modeling, making large-scale 3D attention computationally tractable. Notably, SPECTRE is trained exclusively on openly available CT datasets, demonstrating that high-performing, generalizable representations can be achieved without relying on private data. Pretraining combines DINO-style self-distillation with SigLIP-based vision-language alignment using paired radiology reports, yielding features that are both geometrically consistent and clinically meaningful. Across multiple CT benchmarks, SPECTRE consistently outperforms prior CT foundation models in both zero-shot and fine-tuned settings, establishing SPECTRE as a scalable, open, and fully transformer-based foundation model for 3D medical imaging.

Radiation therapy (RT) requires precise dose delivery over multiple fractions, with CT fundamental for treatment planning due to its electron density information. Repeated CT acquisitions impose radiation exposure and logistical burdens, MRI lacks electron density, and cone-beam CT (CBCT) requires correction for dose calculation. Synthetic CT (sCT) generation addresses these by converting MRI or CBCT into CT-equivalent images with accurate Hounsfield Unit (HU) values, enabling MRI-only RT and CBCT-based adaptive workflows. Building on SynthRAD2023, SynthRAD2025 benchmarked sCT methods on 2,362 patients from five European centers across head and neck, thorax, and abdomen. Two tasks: MRI-to-CT (890 cases) and CBCT-to-CT (1,472 cases), evaluated via image similarity (MAE, PSNR, MS-SSIM), segmentation (Dice, HD95), and dosimetric metrics from photon and proton plans. With 803 participants and 12/13 valid submissions, Task 1 top performance reached MAE 64.8pm21.3 HU, PSNR sim30 dB, MS-SSIM sim0.936, Dice 0.79, photon γ_{2%/2mm}>98%, proton γapprox85%. Task 2 improved: MAE 48.3pm13.4 HU, PSNR 32.6 dB, MS-SSIM 0.968, Dice 0.86, photon γ>99%, proton γapprox89%. Strong image--segmentation correlations (ρ=0.78--0.79) but moderate dose correlations confirmed image quality is insufficient as a dosimetric surrogate. Head-and-neck cases were most consistent; thoracic and abdominal cases showed greater variability. Residual errors at tissue interfaces propagate along beam paths, affecting proton dose more than photon. SynthRAD2025 demonstrates that deep learning yields clinically relevant sCTs, especially for CBCT-to-CT, while identifying persistent MRI-to-CT challenges and underscoring dose-based evaluation as essential for clinical validation.

Over 85 million computed tomography (CT) scans are performed annually in the US, of which approximately one quarter focus on the abdomen. Given the current radiologist shortage, there is a large impetus to use artificial intelligence to alleviate the burden of interpreting these complex imaging studies. Prior state-of-the-art approaches for automated medical image interpretation leverage vision language models (VLMs). However, current medical VLMs are generally limited to 2D images and short reports, and do not leverage electronic health record (EHR) data for supervision. We introduce Merlin - a 3D VLM that we train using paired CT scans (6+ million images from 15,331 CTs), EHR diagnosis codes (1.8+ million codes), and radiology reports (6+ million tokens). We evaluate Merlin on 6 task types and 752 individual tasks. The non-adapted (off-the-shelf) tasks include zero-shot findings classification (31 findings), phenotype classification (692 phenotypes), and zero-shot cross-modal retrieval (image to findings and image to impressions), while model adapted tasks include 5-year disease prediction (6 diseases), radiology report generation, and 3D semantic segmentation (20 organs). We perform internal validation on a test set of 5,137 CTs, and external validation on 7,000 clinical CTs and on two public CT datasets (VerSe, TotalSegmentator). Beyond these clinically-relevant evaluations, we assess the efficacy of various network architectures and training strategies to depict that Merlin has favorable performance to existing task-specific baselines. We derive data scaling laws to empirically assess training data needs for requisite downstream task performance. Furthermore, unlike conventional VLMs that require hundreds of GPUs for training, we perform all training on a single GPU.

Iterative self-training (self-distillation) repeatedly refits a model on pseudo-labels generated by its own predictions. We study this procedure in overparameterized linear regression: an initial estimator is trained on noisy labels, and each subsequent iterate is trained on fresh covariates with noiseless pseudo-labels from the previous model. In the high-dimensional regime, we derive deterministic-equivalent recursions for the prediction risk and effective noise across iterations, and prove that the empirical quantities concentrate sharply around these limits. The recursion separates two competing forces: a systematic component that grows with iteration due to progressive signal forgetting, and a stochastic component that decays due to denoising via repeated data-dependent projections. Their interaction yields a U-shaped test-risk curve and an optimal early-stopping time. In spiked covariance models, iteration further acts as an iteration-dependent spectral filter that preserves strong eigendirections while suppressing weaker ones, inducing an implicit form of soft feature selection distinct from ridge regression. Finally, we propose an iterated generalized cross-validation criterion and prove its uniform consistency for estimating the risk along the self-training trajectory, enabling fully data-driven selection of the stopping time and regularization. Experiments on synthetic covariances validate the theory and illustrate the predicted denoising-forgetting trade-off.

We present GB-LSR (Global-Bandwidth Local Spectral Representation), a fixed-grid local spectral representation for continuous image reconstruction. The image domain is partitioned into non-overlapping square patches, each carrying coefficients for a truncated Fourier basis predicted from shared convolutional-encoder features. A single trainable scalar bandwidth is shared globally across all patches and images, and reconstruction at any continuous coordinate is a fixed-size basis contraction whose cost is independent of image size. We study three bandwidth-handling variants: a trainable global scalar (main), a fixed global scalar, and a per-patch bandwidth field. On a standardized native-reconstruction benchmark across Kodak, Set14, and Urban100, the main variant outperforms matched-budget amortized LIIF / LTE / WIRE re-implementations by 2.8-3.6 dB PSNR and 0.11-0.15 LPIPS, while running at roughly one-quarter of the slowest baseline's inference cost. The single global scalar suffices empirically: per-patch adaptive-bandwidth alternatives do not improve over it on either a closed-form locality diagnostic or an end-to-end ablation. In a separate arbitrary-scale super-resolution (ASR) extension, GB-LSR achieves competitive PSNR-Y under a canonical-style SR protocol and runs 1.44x faster than LIIF-RDN and 3.25x faster than LTE-SwinIR at x4; within the same extension, a variant trained and evaluated without 4-corner local-ensemble averaging gives a 1.77x speedup with 35% lower peak memory and negligible PSNR change, while additionally widening the RDN encoder from 64 to 96 channels gives a small positive PSNR shift with a 1.58x speedup and 31% lower peak memory. Native-reconstruction claims are scoped to the matched-budget amortized protocol, and ASR claims are scoped to a separate canonical-style SR protocol.

Spectra are a prevalent yet highly information-dense form of scientific imagery, presenting substantial challenges to multimodal large language models (MLLMs) due to their unstructured and domain-specific characteristics. Here we introduce SpecVQA, a professional scientific-image benchmark for evaluating multimodal models on scientific spectral understanding, covering 7 representative spectrum types with expert-annotated question-answer pairs. The aim comprises two aspects: spectra scientific QA evaluation and corresponding underlying task evaluation. SpecVQA contains 620 figures and 3100 QA pairs curated from peer-reviewed literature, targeting both direct information extraction and domain-specific reasoning. To effectively reduce token length while preserving essential curve characteristics, we propose a spectral data sampling and interpolation reconstruction approach. Ablation studies further confirm that the approach achieves substantial performance improvements on the proposed benchmark. We test the capability of prominent MLLMs in scientific spectral understanding on our benchmark and present a leaderboard. This work represents an essential step toward enhancing spectral understanding in multimodal large models and suggests promising directions for extending visual-language models to broader scientific research and data analysis.

Due to the three-dimensional nature of CT- or MR-scans, generative modeling of medical images is a particularly challenging task. Existing approaches mostly apply patch-wise, slice-wise, or cascaded generation techniques to fit the high-dimensional data into the limited GPU memory. However, these approaches may introduce artifacts and potentially restrict the model's applicability for certain downstream tasks. This work presents WDM, a wavelet-based medical image synthesis framework that applies a diffusion model on wavelet decomposed images. The presented approach is a simple yet effective way of scaling diffusion models to high resolutions and can be trained on a single 40 GB GPU. Experimental results on BraTS and LIDC-IDRI unconditional image generation at a resolution of 128 times 128 times 128 show state-of-the-art image fidelity (FID) and sample diversity (MS-SSIM) scores compared to GANs, Diffusion Models, and Latent Diffusion Models. Our proposed method is the only one capable of generating high-quality images at a resolution of 256 times 256 times 256.

Dimensionality reduction is critical for deploying dense retrieval systems at scale, yet mainstream post-hoc methods face a fundamental trade-off: principal component analysis (PCA) preserves dominant variance but underutilizes representational capacity, while whitening enforces isotropy at the cost of amplifying noise in the heavy-tailed eigenspectrum of retrieval embeddings. Intermediate spectral scaling methods unify these extremes by reweighting dimensions with a power coefficient γ, but treat γ as a fixed hyperparameter that requires task-specific tuning. We show that the optimal scaling strength γ is not a global constant: it varies systematically with target dimensionality k and is governed by the signal-to-noise ratio (SNR) of the retained subspace. Based on this insight, we propose Spectral Tempering (SpecTemp), a learning-free method that derives an adaptive γ(k) directly from the corpus eigenspectrum using local SNR analysis and knee-point normalization, requiring no labeled data or validation-based search. Extensive experiments demonstrate that Spectral Tempering consistently achieves near-oracle performance relative to grid-searched γ^*(k) while remaining fully learning-free and model-agnostic. Our code is publicly available at https://anonymous.4open.science/r/SpecTemp-0D37.

We present MInDI-3D (Medical Inversion by Direct Iteration in 3D), the first 3D conditional diffusion-based model for real-world sparse-view Cone Beam Computed Tomography (CBCT) artefact removal, aiming to reduce imaging radiation exposure. A key contribution is extending the "InDI" concept from 2D to a full 3D volumetric approach for medical images, implementing an iterative denoising process that refines the CBCT volume directly from sparse-view input. A further contribution is the generation of a large pseudo-CBCT dataset (16,182) from chest CT volumes of the CT-RATE public dataset to robustly train MInDI-3D. We performed a comprehensive evaluation, including quantitative metrics, scalability analysis, generalisation tests, and a clinical assessment by 11 clinicians. Our results show MInDI-3D's effectiveness, achieving a 12.96 (6.10) dB PSNR gain over uncorrected scans with only 50 projections on the CT-RATE pseudo-CBCT (independent real-world) test set and enabling an 8x reduction in imaging radiation exposure. We demonstrate its scalability by showing that performance improves with more training data. Importantly, MInDI-3D matches the performance of a 3D U-Net on real-world scans from 16 cancer patients across distortion and task-based metrics. It also generalises to new CBCT scanner geometries. Clinicians rated our model as sufficient for patient positioning across all anatomical sites and found it preserved lung tumour boundaries well.

Medical tabular data are ubiquitous in clinical research, but deep learning for tables remains underexplored because reliable labels often require costly expert adjudication, even though structured clinical variables are routinely available in tabular form. Self-supervised learning can leverage these unlabeled tables, and recent binning-based pretexts offer a promising inductive bias, but existing objectives fix a single global quantile discretization and apply feature-agnostic supervision. We propose Adaptive Binning, a training-adaptive discretization pretext for tabular SSL that couples discretization to learning through a feature-wise coarse-to-fine curriculum. Motivated by the spectral bias of neural networks and the principles of curriculum learning, our method progressively refines discretization per feature upon plateau detection and selects representation-aware splits to jointly improve value-space concentration and representation-space coherence. A heterogeneity-aware objective unifies categorical reconstruction with ordinal supervision for numerical features, and experiments on public medical tabular datasets under unified evaluation protocols show consistent gains for linear probing and fine-tuning without dataset-specific discretization tuning. We further introduce a medical tabular SSL benchmark with standardized protocols to support reproducible progress in this underexplored domain. Our code is available at https://github.com/labhai/Adaptive-Binning.

Recent works have established that AI models introduce spectral artifacts into generated images and propose approaches for learning to capture them using labeled data. However, the significant differences in such artifacts among different generative models hinder these approaches from generalizing to generators not seen during training. In this work, we build upon the key idea that the spectral distribution of real images constitutes both an invariant and highly discriminative pattern for AI-generated image detection. To model this under a self-supervised setup, we employ masked spectral learning using the pretext task of frequency reconstruction. Since generated images constitute out-of-distribution samples for this model, we propose spectral reconstruction similarity to capture this divergence. Moreover, we introduce spectral context attention, which enables our approach to efficiently capture subtle spectral inconsistencies in images of any resolution. Our spectral AI-generated image detection approach (SPAI) achieves a 5.5% absolute improvement in AUC over the previous state-of-the-art across 13 recent generative approaches, while exhibiting robustness against common online perturbations. Code is available on https://mever-team.github.io/spai.

Hyperspectral Image (HSI) reconstruction has made gratifying progress with the deep unfolding framework by formulating the problem into a data module and a prior module. Nevertheless, existing methods still face the problem of insufficient matching with HSI data. The issues lie in three aspects: 1) fixed gradient descent step in the data module while the degradation of HSI is agnostic in the pixel-level. 2) inadequate prior module for 3D HSI cube. 3) stage interaction ignoring the differences in features at different stages. To address these issues, in this work, we propose a Pixel Adaptive Deep Unfolding Transformer (PADUT) for HSI reconstruction. In the data module, a pixel adaptive descent step is employed to focus on pixel-level agnostic degradation. In the prior module, we introduce the Non-local Spectral Transformer (NST) to emphasize the 3D characteristics of HSI for recovering. Moreover, inspired by the diverse expression of features in different stages and depths, the stage interaction is improved by the Fast Fourier Transform (FFT). Experimental results on both simulated and real scenes exhibit the superior performance of our method compared to state-of-the-art HSI reconstruction methods. The code is released at: https://github.com/MyuLi/PADUT.

Accurate medical image segmentation is crucial for precise anatomical delineation. Deep learning models like U-Net have shown great success but depend heavily on large datasets and struggle with domain shifts, complex structures, and limited training samples. Recent studies have explored diffusion models for segmentation by iteratively refining masks. However, these methods still retain the conventional image-to-mask mapping, making them highly sensitive to input data, which hampers stability and generalization. In contrast, we introduce DiffAtlas, a novel generative framework that models both images and masks through diffusion during training, effectively ``GenAI-fying'' atlas-based segmentation. During testing, the model is guided to generate a specific target image-mask pair, from which the corresponding mask is obtained. DiffAtlas retains the robustness of the atlas paradigm while overcoming its scalability and domain-specific limitations. Extensive experiments on CT and MRI across same-domain, cross-modality, varying-domain, and different data-scale settings using the MMWHS and TotalSegmentator datasets demonstrate that our approach outperforms existing methods, particularly in limited-data and zero-shot modality segmentation. Code is available at https://github.com/M3DV/DiffAtlas.

We investigate a variational method for ill-posed problems, named graphLa+Psi, which embeds a graph Laplacian operator in the regularization term. The novelty of this method lies in constructing the graph Laplacian based on a preliminary approximation of the solution, which is obtained using any existing reconstruction method Psi from the literature. As a result, the regularization term is both dependent on and adaptive to the observed data and noise. We demonstrate that graphLa+Psi is a regularization method and rigorously establish both its convergence and stability properties. We present selected numerical experiments in 2D computerized tomography, wherein we integrate the graphLa+Psi method with various reconstruction techniques Psi, including Filter Back Projection (graphLa+FBP), standard Tikhonov (graphLa+Tik), Total Variation (graphLa+TV), and a trained deep neural network (graphLa+Net). The graphLa+Psi approach significantly enhances the quality of the approximated solutions for each method Psi. Notably, graphLa+Net is outperforming, offering a robust and stable application of deep neural networks in solving inverse problems.

Widely adopted evaluation metrics for sparse-view CT reconstruction--such as Structural Similarity Index Measure and Peak Signal-to-Noise Ratio--prioritize pixel-wise fidelity but often fail to capture the completeness of critical anatomical structures, particularly small or thin regions that are easily missed. To address this limitation, we propose a suite of novel anatomy-aware evaluation metrics designed to assess structural completeness across anatomical structures, including large organs, small organs, intestines, and vessels. Building on these metrics, we introduce CARE, a Completeness-Aware Reconstruction Enhancement framework that incorporates structural penalties during training to encourage anatomical preservation of significant structures. CARE is model-agnostic and can be seamlessly integrated into analytical, implicit, and generative methods. When applied to these methods, CARE substantially improves structural completeness in CT reconstructions, achieving up to +32% improvement for large organs, +22% for small organs, +40% for intestines, and +36% for vessels.

Integrating multi-modal clinical data, such as electronic health records (EHR) and chest X-ray images (CXR), is particularly beneficial for clinical prediction tasks. However, in a temporal setting, multi-modal data are often inherently asynchronous. EHR can be continuously collected but CXR is generally taken with a much longer interval due to its high cost and radiation dose. When clinical prediction is needed, the last available CXR image might have been outdated, leading to suboptimal predictions. To address this challenge, we propose DDL-CXR, a method that dynamically generates an up-to-date latent representation of the individualized CXR images. Our approach leverages latent diffusion models for patient-specific generation strategically conditioned on a previous CXR image and EHR time series, providing information regarding anatomical structures and disease progressions, respectively. In this way, the interaction across modalities could be better captured by the latent CXR generation process, ultimately improving the prediction performance. Experiments using MIMIC datasets show that the proposed model could effectively address asynchronicity in multimodal fusion and consistently outperform existing methods.

Diffusion models have recently emerged as powerful priors for solving inverse problems. While computed tomography (CT) is theoretically a linear inverse problem, it poses many practical challenges. These include correlated noise, artifact structures, reliance on system geometry, and misaligned value ranges, which make the direct application of diffusion models more difficult than in domains like natural image generation. To systematically evaluate how diffusion models perform in this context and compare them with established reconstruction methods, we introduce DM4CT, a comprehensive benchmark for CT reconstruction. DM4CT includes datasets from both medical and industrial domains with sparse-view and noisy configurations. To explore the challenges of deploying diffusion models in practice, we additionally acquire a high-resolution CT dataset at a high-energy synchrotron facility and evaluate all methods under real experimental conditions. We benchmark ten recent diffusion-based methods alongside seven strong baselines, including model-based, unsupervised, and supervised approaches. Our analysis provides detailed insights into the behavior, strengths, and limitations of diffusion models for CT reconstruction. The real-world dataset is publicly available at zenodo.org/records/15420527, and the codebase is open-sourced at github.com/DM4CT/DM4CT.

MRI is an indispensable clinical tool, offering a rich variety of tissue contrasts to support broad diagnostic and research applications. Clinical exams routinely acquire multiple structural sequences that provide complementary information for differential diagnosis, while research protocols often incorporate advanced functional, diffusion, spectroscopic, and relaxometry sequences to capture multidimensional insights into tissue structure and composition. However, these capabilities come at the cost of prolonged scan times, which reduce patient throughput, increase susceptibility to motion artifacts, and may require trade-offs in image quality or diagnostic scope. Over the last two decades, advances in image reconstruction algorithms--alongside improvements in hardware and pulse sequence design--have made it possible to accelerate acquisitions while preserving diagnostic quality. Central to this progress is the ability to incorporate prior information to regularize the solutions to the reconstruction problem. In this tutorial, we overview the basics of MRI reconstruction and highlight state-of-the-art approaches, beginning with classical methods that rely on explicit hand-crafted priors, and then turning to deep learning methods that leverage a combination of learned and crafted priors to further push the performance envelope. We also explore the translational aspects and eventual clinical implications of these methods. We conclude by discussing future directions to address remaining challenges in MRI reconstruction. The tutorial is accompanied by a Python toolbox (https://github.com/tutorial-MRI-recon/tutorial) to demonstrate select methods discussed in the article.

Despite the recent visually-pleasing results achieved, the massive computational cost has been a long-standing flaw for diffusion probabilistic models (DPMs), which, in turn, greatly limits their applications on resource-limited platforms. Prior methods towards efficient DPM, however, have largely focused on accelerating the testing yet overlooked their huge complexity and sizes. In this paper, we make a dedicated attempt to lighten DPM while striving to preserve its favourable performance. We start by training a small-sized latent diffusion model (LDM) from scratch, but observe a significant fidelity drop in the synthetic images. Through a thorough assessment, we find that DPM is intrinsically biased against high-frequency generation, and learns to recover different frequency components at different time-steps. These properties make compact networks unable to represent frequency dynamics with accurate high-frequency estimation. Towards this end, we introduce a customized design for slim DPM, which we term as Spectral Diffusion (SD), for light-weight image synthesis. SD incorporates wavelet gating in its architecture to enable frequency dynamic feature extraction at every reverse steps, and conducts spectrum-aware distillation to promote high-frequency recovery by inverse weighting the objective based on spectrum magni tudes. Experimental results demonstrate that, SD achieves 8-18x computational complexity reduction as compared to the latent diffusion models on a series of conditional and unconditional image generation tasks while retaining competitive image fidelity.

Conditional diffusion inversion provides a powerful framework for unpaired image-to-image translation. However, we demonstrate through an extensive analysis that standard deterministic inversion (e.g. DDIM) fails when the source domain is spectrally sparse compared to the target domain (e.g., super-resolution, sketch-to-image). In these contexts, the recovered latent from the input does not follow the expected isotropic Gaussian distribution. Instead it exhibits a signal with lower frequencies, locking target sampling to oversmoothed and texture-poor generations. We term this phenomenon spectral collapse. We observe that stochastic alternatives attempting to restore the noise variance tend to break the semantic link to the input, leading to structural drift. To resolve this structure-texture trade-off, we propose Orthogonal Variance Guidance (OVG), an inference-time method that corrects the ODE dynamics to enforce the theoretical Gaussian noise magnitude within the null-space of the structural gradient. Extensive experiments on microscopy super-resolution (BBBC021) and sketch-to-image (Edges2Shoes) demonstrate that OVG effectively restores photorealistic textures while preserving structural fidelity.

Conventional Computed Tomography (CT) methods require large numbers of noise-free projections for accurate density reconstructions, limiting their applicability to the more complex class of Cone Beam Geometry CT (CBCT) reconstruction. Recently, deep learning methods have been proposed to overcome these limitations, with methods based on neural fields (NF) showing strong performance, by approximating the reconstructed density through a continuous-in-space coordinate based neural network. Our focus is on improving such methods, however, unlike previous work, which requires training an NF from scratch for each new set of projections, we instead propose to leverage anatomical consistencies over different scans by training a single conditional NF on a dataset of projections. We propose a novel conditioning method where local modulations are modeled per patient as a field over the input domain through a Neural Modulation Field (NMF). The resulting Conditional Cone Beam Neural Tomography (CondCBNT) shows improved performance for both high and low numbers of available projections on noise-free and noisy data.

Longitudinal brain analysis is essential for understanding healthy aging and identifying pathological deviations. Longitudinal registration of sequential brain MRI underpins such analyses. However, existing methods are limited by reliance on densely sampled time series, a trade-off between accuracy and temporal smoothness, and an inability to prospectively forecast future brain states. To overcome these challenges, we introduce TimeFlow, a learning-based framework for longitudinal brain MRI registration. TimeFlow uses a U-Net backbone with temporal conditioning to model neuroanatomy as a continuous function of age. Given only two scans from an individual, TimeFlow estimates accurate and temporally coherent deformation fields, enabling non-linear extrapolation to predict future brain states. This is achieved by our proposed inter-/extra-polation consistency constraints applied to both the deformation fields and deformed images. Remarkably, these constraints preserve temporal consistency and continuity without requiring explicit smoothness regularizers or densely sampled sequential data. Extensive experiments demonstrate that TimeFlow outperforms state-of-the-art methods in terms of both future timepoint forecasting and registration accuracy. Moreover, TimeFlow supports novel biological brain aging analyses by differentiating neurodegenerative trajectories from normal aging without requiring segmentation, thereby eliminating the need for labor-intensive annotations and mitigating segmentation inconsistency. TimeFlow offers an accurate, data-efficient, and annotation-free framework for longitudinal analysis of brain aging and chronic diseases, capable of forecasting brain changes beyond the observed study period.

Multi-site neuroimaging analysis is fundamentally confounded by scanner-induced covariate shifts, where the marginal distribution of voxel intensities P(x) varies non-linearly across acquisition protocols while the conditional anatomy P(y|x) remains constant. This is particularly detrimental to radiomic reproducibility, where acquisition variance often exceeds biological pathology variance. Existing statistical harmonization methods (e.g., ComBat) operate in feature space, precluding spatial downstream tasks, while standard deep learning approaches are theoretically bounded by local effective receptive fields (ERF), failing to model the global intensity correlations characteristic of field-strength bias. We propose SA-CycleGAN-2.5D, a domain adaptation framework motivated by the HΔH-divergence bound of Ben-David et al., integrating three architectural innovations: (1) A 2.5D tri-planar manifold injection preserving through-plane gradients nabla_z at O(HW) complexity; (2) A U-ResNet generator with dense voxel-to-voxel self-attention, surpassing the O(L) receptive field limit of CNNs to model global scanner field biases; and (3) A spectrally-normalized discriminator constraining the Lipschitz constant (K_D le 1) for stable adversarial optimization. Evaluated on 654 glioma patients across two institutional domains (BraTS and UPenn-GBM), our method reduces Maximum Mean Discrepancy (MMD) by 99.1% (1.729 to 0.015) and degrades domain classifier accuracy to near-chance (59.7%). Ablation confirms that global attention is statistically essential (Cohen's d = 1.32, p < 0.001) for the harder heterogeneous-to-homogeneous translation direction. By bridging 2D efficiency and 3D consistency, our framework yields voxel-level harmonized images that preserve tumor pathophysiology, enabling reproducible multi-center radiomic analysis.

We demonstrate a compact, cost-effective snapshot spectral imaging system named Aperture Diffraction Imaging Spectrometer (ADIS), which consists only of an imaging lens with an ultra-thin orthogonal aperture mask and a mosaic filter sensor, requiring no additional physical footprint compared to common RGB cameras. Then we introduce a new optical design that each point in the object space is multiplexed to discrete encoding locations on the mosaic filter sensor by diffraction-based spatial-spectral projection engineering generated from the orthogonal mask. The orthogonal projection is uniformly accepted to obtain a weakly calibration-dependent data form to enhance modulation robustness. Meanwhile, the Cascade Shift-Shuffle Spectral Transformer (CSST) with strong perception of the diffraction degeneration is designed to solve a sparsity-constrained inverse problem, realizing the volume reconstruction from 2D measurements with Large amount of aliasing. Our system is evaluated by elaborating the imaging optical theory and reconstruction algorithm with demonstrating the experimental imaging under a single exposure. Ultimately, we achieve the sub-super-pixel spatial resolution and high spectral resolution imaging. The code will be available at: https://github.com/Krito-ex/CSST.

Model-based reconstruction employing the time separation technique (TST) was found to improve dynamic perfusion imaging of the liver using C-arm cone-beam computed tomography (CBCT). To apply TST using prior knowledge extracted from CT perfusion data, the liver should be accurately segmented from the CT scans. Reconstructions of primary and model-based CBCT data need to be segmented for proper visualisation and interpretation of perfusion maps. This research proposes Turbolift learning, which trains a modified version of the multi-scale Attention UNet on different liver segmentation tasks serially, following the order of the trainings CT, CBCT, CBCT TST - making the previous trainings act as pre-training stages for the subsequent ones - addressing the problem of limited number of datasets for training. For the final task of liver segmentation from CBCT TST, the proposed method achieved an overall Dice scores of 0.874pm0.031 and 0.905pm0.007 in 6-fold and 4-fold cross-validation experiments, respectively - securing statistically significant improvements over the model, which was trained only for that task. Experiments revealed that Turbolift not only improves the overall performance of the model but also makes it robust against artefacts originating from the embolisation materials and truncation artefacts. Additionally, in-depth analyses confirmed the order of the segmentation tasks. This paper shows the potential of segmenting the liver from CT, CBCT, and CBCT TST, learning from the available limited training data, which can possibly be used in the future for the visualisation and evaluation of the perfusion maps for the treatment evaluation of liver diseases.

Effectively discerning spatial-spectral dependencies in HSI denoising is crucial, but prevailing methods using convolution or transformers still face computational efficiency limitations. Recently, the emerging Selective State Space Model(Mamba) has risen with its nearly linear computational complexity in processing natural language sequences, which inspired us to explore its potential in handling long spectral sequences. In this paper, we propose HSIDMamba(HSDM), tailored to exploit the linear complexity for effectively capturing spatial-spectral dependencies in HSI denoising. In particular, HSDM comprises multiple Hyperspectral Continuous Scan Blocks, incorporating BCSM(Bidirectional Continuous Scanning Mechanism), scale residual, and spectral attention mechanisms to enhance the capture of long-range and local spatial-spectral information. BCSM strengthens spatial-spectral interactions by linking forward and backward scans and enhancing information from eight directions through SSM, significantly enhancing the perceptual capability of HSDM and improving denoising performance more effectively. Extensive evaluations against HSI denoising benchmarks validate the superior performance of HSDM, achieving state-of-the-art results in performance and surpassing the efficiency of the latest transformer architectures by 30%.

Positron emission tomography/computed tomography (PET/CT) is essential in oncology, yet the rapid expansion of scanners has outpaced the availability of trained specialists, making automated PET/CT report generation (PETRG) increasingly important for reducing clinical workload. Compared with structural imaging (e.g., X-ray, CT, and MRI), functional PET poses distinct challenges: metabolic patterns vary with tracer physiology, and whole-body 3D contextual information is required rather than local-region interpretation. To advance PETRG, we propose PETRG-3D, an end-to-end 3D dual-branch framework that separately encodes PET and CT volumes and incorporates style-adaptive prompts to mitigate inter-hospital variability in reporting practices. We construct PETRG-Lym, a multi-center lymphoma dataset collected from four hospitals (824 reports w/ 245,509 paired PET/CT slices), and construct AutoPET-RG-Lym, a publicly accessible PETRG benchmark derived from open imaging data but equipped with new expert-written, clinically validated reports (135 cases). To assess clinical utility, we introduce PETRG-Score, a lymphoma-specific evaluation protocol that jointly measures metabolic and structural findings across curated anatomical regions. Experiments show that PETRG-3D substantially outperforms existing methods on both natural language metrics (e.g., +31.49\% ROUGE-L) and clinical efficacy metrics (e.g., +8.18\% PET-All), highlighting the benefits of volumetric dual-modality modeling and style-aware prompting. Overall, this work establishes a foundation for future PET/CT-specific models emphasizing disease-aware reasoning and clinically reliable evaluation. Codes, models, and AutoPET-RG-Lym will be released.

This paper contributes to the "BraTS 2024 Brain MR Image Synthesis Challenge" and presents a conditional Wavelet Diffusion Model (cWDM) for directly solving a paired image-to-image translation task on high-resolution volumes. While deep learning-based brain tumor segmentation models have demonstrated clear clinical utility, they typically require MR scans from various modalities (T1, T1ce, T2, FLAIR) as input. However, due to time constraints or imaging artifacts, some of these modalities may be missing, hindering the application of well-performing segmentation algorithms in clinical routine. To address this issue, we propose a method that synthesizes one missing modality image conditioned on three available images, enabling the application of downstream segmentation models. We treat this paired image-to-image translation task as a conditional generation problem and solve it by combining a Wavelet Diffusion Model for high-resolution 3D image synthesis with a simple conditioning strategy. This approach allows us to directly apply our model to full-resolution volumes, avoiding artifacts caused by slice- or patch-wise data processing. While this work focuses on a specific application, the presented method can be applied to all kinds of paired image-to-image translation problems, such as CT leftrightarrow MR and MR leftrightarrow PET translation, or mask-conditioned anatomically guided image generation.

Quantitative susceptibility maps from magnetic resonance images can provide both prognostic and diagnostic information in multiple sclerosis, a neurodegenerative disease characterized by the formation of lesions in white matter brain tissue. In particular, susceptibility maps provide adequate contrast to distinguish between "rim" lesions, surrounded by deposited paramagnetic iron, and "non-rim" lesion types. These paramagnetic rim lesions (PRLs) are an emerging biomarker in multiple sclerosis. Much effort has been devoted to both detection and segmentation of such lesions to monitor longitudinal change. As paramagnetic rim lesions are rare, addressing this problem requires confronting the class imbalance between rim and non-rim lesions. We produce synthetic quantitative susceptibility maps of paramagnetic rim lesions and show that inclusion of such synthetic data improves classifier performance and provide a multi-channel extension to generate accompanying contrasts and probabilistic segmentation maps. We exploit the projection capability of our trained generative network to demonstrate a novel denoising approach that allows us to train on ambiguous rim cases and substantially increase the minority class. We show that both synthetic lesion synthesis and our proposed rim lesion label denoising method best approximate the unseen rim lesion distribution and improve detection in a clinically interpretable manner. We release our code and generated data at https://github.com/agr78/PRLx-GAN upon publication.

Many low-dose CT imaging methods rely on supervised learning, which requires a large number of paired noisy and clean images. However, obtaining paired images in clinical practice is challenging. To address this issue, zero-shot self-supervised methods train denoising networks using only the information within a single image, such as ZS-N2N. However, these methods often employ downsampling operations that degrade image resolution. Additionally, the training dataset is inherently constrained to the image itself. In this paper, we propose a zero-shot low-dose CT imaging method based on sinogram flicking, which operates within a single image but generates many copies via random conjugate ray matching. Specifically, two conjugate X-ray pencil beams measure the same path; their expected values should be identical, while their noise levels vary during measurements. By randomly swapping portions of the conjugate X-rays in the sinogram domain, we generate a large set of sinograms with consistent content but varying noise patterns. When displayed dynamically, these sinograms exhibit a flickering effect due to their identical structural content but differing noise patterns-hence the term sinogram flicking. We train the network on pairs of sinograms with the same content but different noise distributions using a lightweight model adapted from ZS-NSN. This process is repeated to obtain the final results. A simulation study demonstrates that our method outperforms state-of-the-art approaches such as ZS-N2N.

Vision-Language Pre-training (VLP) has shown the merits of analysing medical images, by leveraging the semantic congruence between medical images and their corresponding reports. It efficiently learns visual representations, which in turn facilitates enhanced analysis and interpretation of intricate imaging data. However, such observation is predominantly justified on single-modality data (mostly 2D images like X-rays), adapting VLP to learning unified representations for medical images in real scenario remains an open challenge. This arises from medical images often encompass a variety of modalities, especially modalities with different various number of dimensions (e.g., 3D images like Computed Tomography). To overcome the aforementioned challenges, we propose an Unified Medical Image Pre-training framework, namely UniMedI, which utilizes diagnostic reports as common semantic space to create unified representations for diverse modalities of medical images (especially for 2D and 3D images). Under the text's guidance, we effectively uncover visual modality information, identifying the affected areas in 2D X-rays and slices containing lesion in sophisticated 3D CT scans, ultimately enhancing the consistency across various medical imaging modalities. To demonstrate the effectiveness and versatility of UniMedI, we evaluate its performance on both 2D and 3D images across 10 different datasets, covering a wide range of medical image tasks such as classification, segmentation, and retrieval. UniMedI has demonstrated superior performance in downstream tasks, showcasing its effectiveness in establishing a universal medical visual representation.

Diffusion models are a strong backbone for visual generation, but their inherently sequential denoising process leads to slow inference. Previous methods accelerate sampling by caching and reusing intermediate outputs based on feature distances between adjacent timesteps. However, existing caching strategies typically rely on raw feature differences that entangle content and noise. This design overlooks spectral evolution, where low-frequency structure appears early and high-frequency detail is refined later. We introduce Spectral-Evolution-Aware Cache (SeaCache), a training-free cache schedule that bases reuse decisions on a spectrally aligned representation. Through theoretical and empirical analysis, we derive a Spectral-Evolution-Aware (SEA) filter that preserves content-relevant components while suppressing noise. Employing SEA-filtered input features to estimate redundancy leads to dynamic schedules that adapt to content while respecting the spectral priors underlying the diffusion model. Extensive experiments on diverse visual generative models and the baselines show that SeaCache achieves state-of-the-art latency-quality trade-offs.

Longitudinal treatment decisions require predicting potential outcomes under future treatment sequences in the presence of time-varying confounding, heterogeneous patient dynamics, and limited domain-specific data. Existing longitudinal causal estimators typically train a new model for each cohort or simulator. We introduce Causal Longitudinal Prior-Fitted Networks (CausalLongPFN), a prior-fitted in-context predictor for longitudinal causal prediction. The model is pretrained entirely on synthetic episodes sampled from a broad prior over temporal structural causal models, exposing it to treatment-confounder feedback, latent heterogeneity, nonlinear state evolution, delayed effects, and cumulative treatment responses. At test time, CausalLongPFN is frozen: it conditions on support trajectories, a query history, and a proposed future treatment sequence, and returns a predictive distribution over future outcomes without gradient updates or propensity-model fitting. Multi-step predictions are obtained by recursively applying the one-step predictor under the specified treatment sequence. We evaluate on branchable cancer, HIV, and warfarin benchmarks with ground-truth counterfactual labels, and on factual-only rolling-origin prediction in MIMIC-III ICU trajectories. CausalLongPFN is competitive with domain-trained longitudinal baselines on counterfactual benchmarks and performs strongly on factual MIMIC-III prediction, suggesting that broad synthetic causal pretraining can provide a useful frozen alternative when repeated domain-specific training is costly or impractical.

We introduce a Three-Dimensional Convolutional Variational Autoencoder (3D-CVAE) for automated anomaly detection in Electron Energy Loss Spectroscopy Spectrum Imaging (EELS-SI) data. Our approach leverages the full three-dimensional structure of EELS-SI data to detect subtle spectral anomalies while preserving both spatial and spectral correlations across the datacube. By employing negative log-likelihood loss and training on bulk spectra, the model learns to reconstruct bulk features characteristic of the defect-free material. In exploring methods for anomaly detection, we evaluated both our 3D-CVAE approach and Principal Component Analysis (PCA), testing their performance using Fe L-edge peak shifts designed to simulate material defects. Our results show that 3D-CVAE achieves superior anomaly detection and maintains consistent performance across various shift magnitudes. The method demonstrates clear bimodal separation between normal and anomalous spectra, enabling reliable classification. Further analysis verifies that lower dimensional representations are robust to anomalies in the data. While performance advantages over PCA diminish with decreasing anomaly concentration, our method maintains high reconstruction quality even in challenging, noise-dominated spectral regions. This approach provides a robust framework for unsupervised automated detection of spectral anomalies in EELS-SI data, particularly valuable for analyzing complex material systems.

Gradient signals in LLM training are highly anisotropic: recurrent linguistic structure concentrates energy into a small set of dominant spectral directions, while context specific information resides in a long tail. We show that this spike tail separation persists throughout training, with the spike occupying only about 1.5% of directions yet dominating optimizer statistics. This dominance suppresses tail learning by contracting tail updates through second moment normalization and tightening the globally stable learning rate bound. Motivated by this analysis, we propose Spectra, a spike aware optimizer that suppresses the dominant low rank spike subspace without amplifying the noise sensitive spectral tail. Spectra tracks the spike subspace via cached, warm started power iteration and applies low rank spectral shaping with negligible overhead and substantially reduced optimizer state memory. On LLaMA3 8B trained on 50B tokens, Spectra reaches the same target loss 30% faster than AdamW, reduces per step end to end overhead by 0.7%, cuts optimizer state memory by 49.25%, and improves average downstream accuracy by 1.62%. Compared to Muon, Spectra is 5.1x faster in optimizer processing time, achieves a lower final loss, and improves average accuracy by 0.66%.

Magnetic Resonance Imaging (MRI) is often acquired with anisotropic resolution to reduce scan time, producing stair-step artifacts along the through-plane direction. In through-plane MRI super-resolution, an efficiency-fidelity trade-off arises: feed-forward regressors are fast but oversmooth at large slice-thicknesses, while sampling-based methods improve fidelity at high inference cost. We propose DRIFT, a two-stage thickness-conditioned rectified flow framework for through-plane MRI super-resolution with continuous input slice-thickness. Stage 1 employs an Anatomical Projection Network (APN) to map low-resolution patches to a coarse high-resolution manifold, providing a deterministic anatomical initialization that shortens the residual transport of Stage 2 and stabilizes slice-wise refinement. Stage 2 refines details via rectified flow and introduces a Physics-Aware Difficulty (PAD) metric derived from slice-thickness induced through-plane bandwidth deficit to guide an Adaptive Integration Scheduler (AIS), allocating ODE steps by thickness. A Consistent Endpoint Trajectory Alignment (CETA) loss enforces thickness-consistent reconstructions. Experiments show that DRIFT outperforms super-resolution baselines while reducing inference cost. Code, models, and interactive demos are available at https://yoonseokchoi-ai.github.io/drift-eccv2026/.

We study sinusoidal recurrence as an iterative mechanism for harmonic spectral enrichment in implicit neural representations (INRs). Our analysis reveals that sinusoidal activations induce a harmonic line spectrum, providing a spectral account of how recurrent unrolling enriches the effective spectral support. We realize this principle with a shared sinusoidal block that iteratively refines the latent representation. We empirically validate the resulting spectral behavior against feed-forward INRs, non-sinusoidal recurrent variants, and equilibrium-style sinusoidal models. Complementing this analysis, we evaluate the proposed architecture across image and 3D representation tasks. On RGB image benchmarks, our method achieves higher fidelity than feed-forward baselines with fewer parameters and fewer optimization steps, and it further transfers favorably to super-resolution, NeRF, and SDF tasks.

Chest X-Ray (CXR) report generation is a promising approach to improving the efficiency of CXR interpretation. However, a significant increase in diagnostic accuracy is required before that can be realised. Motivated by this, we propose a framework that is more inline with a radiologist's workflow by considering longitudinal data. Here, the decoder is additionally conditioned on the report from the subject's previous imaging study via a prompt. We also propose a new reward for reinforcement learning based on CXR-BERT, which computes the similarity between reports. We conduct experiments on the MIMIC-CXR dataset. The results indicate that longitudinal data improves CXR report generation. CXR-BERT is also shown to be a promising alternative to the current state-of-the-art reward based on RadGraph. This investigation indicates that longitudinal CXR report generation can offer a substantial increase in diagnostic accuracy. Our Hugging Face model is available at: https://huggingface.co/aehrc/cxrmate and code is available at: https://github.com/aehrc/cxrmate.

Medical imaging plays a crucial role in diagnosis, with radiology reports serving as vital documentation. Automating report generation has emerged as a critical need to alleviate the workload of radiologists. While machine learning has facilitated report generation for 2D medical imaging, extending this to 3D has been unexplored due to computational complexity and data scarcity. We introduce the first method to generate radiology reports for 3D medical imaging, specifically targeting chest CT volumes. Given the absence of comparable methods, we establish a baseline using an advanced 3D vision encoder in medical imaging to demonstrate our method's effectiveness, which leverages a novel auto-regressive causal transformer. Furthermore, recognizing the benefits of leveraging information from previous visits, we augment CT2Rep with a cross-attention-based multi-modal fusion module and hierarchical memory, enabling the incorporation of longitudinal multimodal data. Access our code at https://github.com/ibrahimethemhamamci/CT2Rep

Large and demographically balanced datasets are essential for reliable neuroimaging biomarkers. Full-resolution 3D brain MRI synthesis can support data augmentation in this setting, but existing approaches either incur prohibitive computational cost at volumetric scale or rely on lossy latent compression that may compromise anatomical detail. As a result, practical 3D generative augmentation often requires specialized compute infrastructure. We propose WaveDiT, a conditional flow matching framework operating in the coefficient space of a 3D Haar Discrete Wavelet Transform. The model combines factorized spatio-depth attention with band-wise heteroscedastic uncertainty modeling derived from higher-order wavelet statistics. Predicted log-variance is integrated directly into both the flow objective and conditioning pathway, enabling adaptive precision consistent with the heavy-tailed and input-dependent variance structure of anatomical detail. This formulation supports full-resolution 3D synthesis under practical memory and time constraints on a single modern GPU. Evaluation on a multi-site cohort demonstrates improved alignment between generated and real MRI distributions, together with enhanced downstream brain age prediction and region-level anatomical agreement relative to diffusion, latent, and wavelet-based baselines. Code is available at https://github.com/sisinflab/WaveDiT

Automated structured radiology report generation (SRRG) from chest X-ray images offers significant potential to reduce workload of radiologists by generating reports in structured formats that ensure clarity, consistency, and adherence to clinical reporting standards. While radiologists effectively utilize available clinical contexts in their diagnostic reasoning, existing SRRG systems overlook these essential elements. This fundamental gap leads to critical problems including temporal hallucinations when referencing non-existent clinical contexts. To address these limitations, we propose contextualized SRRG (C-SRRG) that comprehensively incorporates rich clinical context for SRRG. We curate C-SRRG dataset by integrating comprehensive clinical context encompassing 1) multi-view X-ray images, 2) clinical indication, 3) imaging techniques, and 4) prior studies with corresponding comparisons based on patient histories. Through extensive benchmarking with state-of-the-art multimodal large language models, we demonstrate that incorporating clinical context with the proposed C-SRRG significantly improves report generation quality. We publicly release dataset, code, and checkpoints to facilitate future research for clinically-aligned automated RRG at https://github.com/vuno/contextualized-srrg.

This work studies Hyperspectral image (HSI) super-resolution (SR). HSI SR is characterized by high-dimensional data and a limited amount of training examples. This exacerbates the undesirable behaviors of neural networks such as memorization and sensitivity to out-of-distribution samples. This work addresses these issues with three contributions. First, we observe that HSI SR and RGB image SR are correlated and develop a novel multi-tasking network to train them jointly so that the auxiliary task RGB image SR can provide additional supervision. Second, we propose a simple, yet effective data augmentation routine, termed Spectral Mixup, to construct effective virtual training samples to enlarge the training set. Finally, we extend the network to a semi-supervised setting so that it can learn from datasets containing only low-resolution HSIs. With these contributions, our method is able to learn from heterogeneous datasets and lift the requirement for having a large amount of HD HSI training samples. Extensive experiments on four standard datasets show that our method outperforms existing methods significantly and underpin the relevance of our contributions. Code has been made available at https://github.com/kli8996/HSISR.

Longitudinal modelling of Alzheimer's disease progression is clinically useful only if it can describe not just the most likely next diagnosis, but how a patient may evolve over time and how reliable that forecast is. Most deep learning approaches reduce this problem to single-step classification, treating cognitively normal, mild cognitive impairment, and dementia as flat categories while providing limited insight into how uncertainty accumulates across future visits. We propose a probabilistic framework that combines ordinal diagnosis prediction, multi-horizon trajectory generation, and decomposed uncertainty estimation. A Temporal Fusion Transformer encoder is adapted with a CORAL ordinal output layer, asymmetric loss weighting, and converter oversampling to respect disease-stage ordering and improve sensitivity to MCI-to-dementia transitions. Conditioned on the learned patient-context representation, an autoregressive Mixture Density Network generates five-year probabilistic trajectories for diagnosis state, CDR Sum of Boxes, MMSE orientation, and hippocampal volume. On ADNI, the model outperforms linear, recurrent, and transformer baselines for next-visit diagnosis prediction, with the strongest gains on MCI-versus-dementia discrimination. Generated trajectories achieve near-nominal 90% credible interval coverage, widening uncertainty across the forecast horizon, and biomarker dynamics consistent with expected Alzheimer's disease progression. We further separate aleatoric from epistemic uncertainty using analytic mixture variance and a five-member bootstrap ensemble, which provides the strongest encoder diversity and output-level epistemic signal. Epistemic uncertainty is higher for rare progression archetypes, MCI and dementia patients, and under external evaluation on OASIS-3, where it increases alongside prediction error.

Neural operator surrogates (NO) approximate PDE solutions orders of magnitude faster than numerical solvers, but suffer from spectral bias: high-frequency content is systematically attenuated, limiting reliability where fine-scale structure matters. Sparse sensor measurements of the field are often available too, offering pointwise accuracy without spectral distortion but covering only a small fraction of the domain. We address this by treating NO predictions as auxiliary observations in a diffusion posterior sampling framework. Our method, FreqNO-DPS (https://github.com/niccoloperrone/FreqNO-DPS), combines an unconditional score-based diffusion prior, trained on high-fidelity simulations, with diffusion posterior sampling (DPS) conditioned on sparse observations and guided by a frozen neural operator. Naive integration reintroduces the surrogate's spectral bias; we resolve this with a closed-form, spectrally shaped guidance score that weights the surrogate by its frequency-dependent accuracy and needs no denoiser backpropagation. A distribution-free analysis bounds the approximation error across the frequency-diffusion-time plane and shows the guidance's frequency dependence is preserved regardless of distributional assumptions. On 3D elastic wavefield prediction at 5% and 2% sensor coverage, the method reaches near-zero spectral bias across all bands, where both the surrogate and sensor-only DPS show systematic high-frequency attenuation. Isotropic guidance, the natural baseline, improves pointwise accuracy but carries the bias into the posterior nearly intact, confirming that frequency-dependent calibration is essential, not merely beneficial. The framework needs only paired surrogate/reference data and exploits no problem-specific structure beyond the residual's approximate spectral diagonality, verifiable for new surrogates via the coherence diagnostic we provide.

Several recent studies advocate the use of spectral discriminators, which evaluate the Fourier spectra of images for generative modeling. However, the effectiveness of the spectral discriminators is not well interpreted yet. We tackle this issue by examining the spectral discriminators in the context of perceptual image super-resolution (i.e., GAN-based SR), as SR image quality is susceptible to spectral changes. Our analyses reveal that the spectral discriminator indeed performs better than the ordinary (a.k.a. spatial) discriminator in identifying the differences in the high-frequency range; however, the spatial discriminator holds an advantage in the low-frequency range. Thus, we suggest that the spectral and spatial discriminators shall be used simultaneously. Moreover, we improve the spectral discriminators by first calculating the patch-wise Fourier spectrum and then aggregating the spectra by Transformer. We verify the effectiveness of the proposed method twofold. On the one hand, thanks to the additional spectral discriminator, our obtained SR images have their spectra better aligned to those of the real images, which leads to a better PD tradeoff. On the other hand, our ensembled discriminator predicts the perceptual quality more accurately, as evidenced in the no-reference image quality assessment task.

Hyperspectral images (HSI) provide rich spectral information that contributed to the successful performance improvement of numerous computer vision tasks. However, it can only be achieved at the expense of images' spatial resolution. Hyperspectral image super-resolution (HSI-SR) addresses this problem by fusing low resolution (LR) HSI with multispectral image (MSI) carrying much higher spatial resolution (HR). All existing HSI-SR approaches require the LR HSI and HR MSI to be well registered and the reconstruction accuracy of the HR HSI relies heavily on the registration accuracy of different modalities. This paper exploits the uncharted problem domain of HSI-SR without the requirement of multi-modality registration. Given the unregistered LR HSI and HR MSI with overlapped regions, we design a unique unsupervised learning structure linking the two unregistered modalities by projecting them into the same statistical space through the same encoder. The mutual information (MI) is further adopted to capture the non-linear statistical dependencies between the representations from two modalities (carrying spatial information) and their raw inputs. By maximizing the MI, spatial correlations between different modalities can be well characterized to further reduce the spectral distortion. A collaborative l_{2,1} norm is employed as the reconstruction error instead of the more common l_2 norm, so that individual pixels can be recovered as accurately as possible. With this design, the network allows to extract correlated spectral and spatial information from unregistered images that better preserves the spectral information. The proposed method is referred to as unregistered and unsupervised mutual Dirichlet Net (u^2-MDN). Extensive experimental results using benchmark HSI datasets demonstrate the superior performance of u^2-MDN as compared to the state-of-the-art.

Detecting and delineating tiny targets in 3D brain scans is a central yet under-addressed challenge in medical imaging.In ischemic stroke, for instance, the culprit thrombus is small, low-contrast, and variably expressed across modalities(e.g., susceptibility-weighted T2 blooming, diffusion restriction on DWI/ADC), while real-world multi-center dataintroduce domain shifts, anisotropy, and frequent missing sequences. We introduce a methodology that couples an attention-based recurrent segmentation network (UpAttLLSTM), a training schedule that progressively increases the difficulty of hetero-modal learning, with gradual modality dropout, UpAttLLSTM aggregates context across slices via recurrent units (2.5D) and uses attention gates to fuse complementary cues across available sequences, making it robust to anisotropy and class imbalance. Gradual modality dropout systematically simulates site heterogeneity,noise, and missing modalities during training, acting as both augmentation and regularization to improve multi-center generalization. On a monocentric cohort, our approach detects thrombi in >90% of cases with a Dice score of 0.65. In a multi-center setting with missing modalities, it achieves-80% detection with a Dice score around 0.35. Beyond stroke, the proposed methodology directly transfers to other small-lesion tasks in 3D medical imaging where targets are scarce, subtle, and modality-dependent

Four-dimensional cone-beam computed tomography (4D CBCT) provides respiration-resolved images and can be used for image-guided radiation therapy. However, the ability to reveal respiratory motion comes at the cost of image artifacts. As raw projection data are sorted into multiple respiratory phases, the cone-beam projections become much sparser and the reconstructed 4D CBCT images will be covered by severe streak artifacts. Although several deep learning-based methods have been proposed to address this issue, most algorithms employ 2D network models as backbones, neglecting the intrinsic structural priors within 4D CBCT images. In this paper, we first explore the origin and appearance of streak artifacts in 4D CBCT images. We find that streak artifacts exhibit a unique rotational motion along with the patient's respiration, distinguishable from diaphragm-driven respiratory motion in the spatiotemporal domain. Therefore, we propose a novel 4D neural network model, RSTAR4D-Net, designed to address Rotational STreak Artifact Reduction by integrating the spatial and temporal information within 4D CBCT images. Specifically, we overcome the computational and training difficulties of a 4D neural network. The specially designed model adopts an efficient implementation of 4D convolutions to reduce computational costs and thus can process the whole 4D image in one pass. Additionally, a Tetris training strategy pertinent to the separable 4D convolutions is proposed to effectively train the model using limited 4D training samples. Extensive experiments substantiate the effectiveness of our proposed method, and the RSTAR4D-Net shows superior performance compared to other methods. The source code and dynamic demos are available at https://github.com/ivy9092111111/RSTAR.

Foundation models have triggered a paradigm shift in computer vision and are increasingly being adopted in remote sensing, particularly for multispectral imagery. Yet, their potential in hyperspectral imaging (HSI) remains untapped due to the absence of comprehensive and globally representative hyperspectral datasets. To close this gap, we introduce SpectralEarth, a large-scale multi-temporal dataset designed to pretrain hyperspectral foundation models leveraging data from the Environmental Mapping and Analysis Program (EnMAP). SpectralEarth comprises 538,974 image patches covering 415,153 unique locations from more than 11,636 globally distributed EnMAP scenes spanning two years of archive. Additionally, 17.5% of these locations include multiple timestamps, enabling multi-temporal HSI analysis. Utilizing state-of-the-art self-supervised learning (SSL) algorithms, we pretrain a series of foundation models on SpectralEarth. We integrate a spectral adapter into classical vision backbones to accommodate the unique characteristics of HSI. In tandem, we construct four downstream datasets for land-cover and crop-type mapping, providing benchmarks for model evaluation. Experimental results support the versatility of our models, showcasing their generalizability across different tasks and sensors. We also highlight computational efficiency during model fine-tuning. The dataset, models, and source code will be made publicly available.

We propose a computationally efficient inferential procedure for longitudinal function-on-function regression. The method follows a marginal three-step approach: (1) fit massive pointwise longitudinal scalar-on-function regression models, (2) smooth the resulting estimates along the bivariate functional domain, and (3) compute confidence bands using either an analytic approach for Gaussian data or a cluster bootstrap for Gaussian or non-Gaussian data. Simulation studies demonstrate that the proposed method achieves accurate estimation and valid inference, while substantially reducing computational burden compared to existing approaches. Methods are motivated by a physical activity intervention trial in older adults where high-dimensional wearable data were collected longitudinally across multiple visits. Our applications reveal significant increases in physical activity in the morning using interpersonal intervention strategies, but not intrapersonal strategies. The proposed methods are implemented in an R package.

Medical image segmentation faces critical challenges in semi-supervised learning scenarios due to severe annotation scarcity requiring expert radiological knowledge, significant inter-annotator variability across different viewpoints and expertise levels, and inadequate multi-scale feature integration for precise boundary delineation in complex anatomical structures. Existing semi-supervised methods demonstrate substantial performance degradation compared to fully supervised approaches, particularly in small target segmentation and boundary refinement tasks. To address these fundamental challenges, we propose SASNet (Scale-aware Adaptive Supervised Network), a dual-branch architecture that leverages both low-level and high-level feature representations through novel scale-aware adaptive reweight mechanisms. Our approach introduces three key methodological innovations, including the Scale-aware Adaptive Reweight strategy that dynamically weights pixel-wise predictions using temporal confidence accumulation, the View Variance Enhancement mechanism employing 3D Fourier domain transformations to simulate annotation variability, and segmentation-regression consistency learning through signed distance map algorithms for enhanced boundary precision. These innovations collectively address the core limitations of existing semi-supervised approaches by integrating spatial, temporal, and geometric consistency principles within a unified optimization framework. Comprehensive evaluation across LA, Pancreas-CT, and BraTS datasets demonstrates that SASNet achieves superior performance with limited labeled data, surpassing state-of-the-art semi-supervised methods while approaching fully supervised performance levels. The source code for SASNet is available at https://github.com/HUANGLIZI/SASNet.

This paper studies sequence modeling for prediction tasks with long range dependencies. We propose a new formulation for state space models (SSMs) based on learning linear dynamical systems with the spectral filtering algorithm (Hazan et al. (2017)). This gives rise to a novel sequence prediction architecture we call a spectral state space model. Spectral state space models have two primary advantages. First, they have provable robustness properties as their performance depends on neither the spectrum of the underlying dynamics nor the dimensionality of the problem. Second, these models are constructed with fixed convolutional filters that do not require learning while still outperforming SSMs in both theory and practice. The resulting models are evaluated on synthetic dynamical systems and long-range prediction tasks of various modalities. These evaluations support the theoretical benefits of spectral filtering for tasks requiring very long range memory.

Cycle consistency has long been exploited as a powerful prior for jointly optimizing maps within a collection of shapes. In this paper, we investigate its utility in the approaches of Deep Functional Maps, which are considered state-of-the-art in non-rigid shape matching. We first justify that under certain conditions, the learned maps, when represented in the spectral domain, are already cycle consistent. Furthermore, we identify the discrepancy that spectrally consistent maps are not necessarily spatially, or point-wise, consistent. In light of this, we present a novel design of unsupervised Deep Functional Maps, which effectively enforces the harmony of learned maps under the spectral and the point-wise representation. By taking advantage of cycle consistency, our framework produces state-of-the-art results in mapping shapes even under significant distortions. Beyond that, by independently estimating maps in both spectral and spatial domains, our method naturally alleviates over-fitting in network training, yielding superior generalization performance and accuracy within an array of challenging tests for both near-isometric and non-isometric datasets. Codes are available at https://github.com/rqhuang88/Spatiallyand-Spectrally-Consistent-Deep-Functional-Maps.

While implicit regularization facilitates benign overfitting in low-noise regimes, recent theoretical work predicts a sharp phase transition to harmful overfitting as the noise-to-signal ratio increases. We experimentally isolate the geometric mechanism of this transition: the Malignant Tail, a failure mode where networks functionally segregate signal and noise, reducing coherent semantic features into low-rank subspaces while pushing stochastic label noise into high-frequency orthogonal components, distinct from systematic or corruption-aligned noise. Through a Spectral Linear Probe of training dynamics, we demonstrate that Stochastic Gradient Descent (SGD) fails to suppress this noise, instead implicitly biasing it toward high-frequency orthogonal subspaces, effectively preserving signal-noise separability. We show that this geometric separation is distinct from simple variance reduction in untrained models. In trained networks, SGD actively segregates noise, allowing post-hoc Explicit Spectral Truncation (d << D) to surgically prune the noise-dominated subspace. This approach recovers the optimal generalization capability latent in the converged model. Unlike unstable temporal early stopping, Geometric Truncation provides a stable post-hoc intervention. Our findings suggest that under label noise, excess spectral capacity is not harmless redundancy but a latent structural liability that allows for noise memorization, necessitating explicit rank constraints to filter stochastic corruptions for robust generalization.

Vision-language models can connect the text description of an object to its specific location in an image through visual grounding. This has potential applications in enhanced radiology reporting. However, these models require large annotated image-text datasets, which are lacking for PET/CT. We developed an automated pipeline to generate weak labels linking PET/CT report descriptions to their image locations and used it to train a 3D vision-language visual grounding model. Our pipeline finds positive findings in PET/CT reports by identifying mentions of SUVmax and axial slice numbers. From 25,578 PET/CT exams, we extracted 11,356 sentence-label pairs. Using this data, we trained ConTEXTual Net 3D, which integrates text embeddings from a large language model with a 3D nnU-Net via token-level cross-attention. The model's performance was compared against LLMSeg, a 2.5D version of ConTEXTual Net, and two nuclear medicine physicians. The weak-labeling pipeline accurately identified lesion locations in 98% of cases (246/251), with 7.5% requiring boundary adjustments. ConTEXTual Net 3D achieved an F1 score of 0.80, outperforming LLMSeg (F1=0.22) and the 2.5D model (F1=0.53), though it underperformed both physicians (F1=0.94 and 0.91). The model achieved better performance on FDG (F1=0.78) and DCFPyL (F1=0.75) exams, while performance dropped on DOTATE (F1=0.58) and Fluciclovine (F1=0.66). The model performed consistently across lesion sizes but showed reduced accuracy on lesions with low uptake. Our novel weak labeling pipeline accurately produced an annotated dataset of PET/CT image-text pairs, facilitating the development of 3D visual grounding models. ConTEXTual Net 3D significantly outperformed other models but fell short of the performance of nuclear medicine physicians. Our study suggests that even larger datasets may be needed to close this performance gap.

Computed tomography and magnetic resonance imaging are two widely used clinical imaging modalities for non-invasive diagnosis. However, both of these modalities come with certain problems. CT uses harmful ionising radiation, and MRI suffers from slow acquisition speed. Both problems can be tackled by undersampling, such as sparse sampling. However, such undersampled data leads to lower resolution and introduces artefacts. Several techniques, including deep learning based methods, have been proposed to reconstruct such data. However, the undersampled reconstruction problem for these two modalities was always considered as two different problems and tackled separately by different research works. This paper proposes a unified solution for both sparse CT and undersampled radial MRI reconstruction, achieved by applying Fourier transform-based pre-processing on the radial MRI and then finally reconstructing both modalities using sinogram upsampling combined with filtered back-projection. The Primal-Dual network is a deep learning based method for reconstructing sparsely-sampled CT data. This paper introduces Primal-Dual UNet, which improves the Primal-Dual network in terms of accuracy and reconstruction speed. The proposed method resulted in an average SSIM of 0.932\textpm0.021 while performing sparse CT reconstruction for fan-beam geometry with a sparsity level of 16, achieving a statistically significant improvement over the previous model, which resulted in 0.919\textpm0.016. Furthermore, the proposed model resulted in 0.903\textpm0.019 and 0.957\textpm0.023 average SSIM while reconstructing undersampled brain and abdominal MRI data with an acceleration factor of 16, respectively - statistically significant improvements over the original model, which resulted in 0.867\textpm0.025 and 0.949\textpm0.025.

Segmentation of the main coronary artery from X-ray coronary angiography (XCA) sequences is crucial for the diagnosis of coronary artery diseases. However, this task is challenging due to issues such as blurred boundaries, inconsistent radiation contrast, complex motion patterns, and a lack of annotated images for training. Although Semi-Supervised Learning (SSL) can alleviate the annotation burden, conventional methods struggle with complicated temporal dynamics and unreliable uncertainty quantification. To address these challenges, we propose SAM3-based Teacher-student framework with Motion-Aware consistency and Progressive Confidence Regularization (SMART), a semi-supervised vessel segmentation approach for X-ray angiography videos. First, our method utilizes SAM3's unique promptable concept segmentation design and innovates a SAM3-based teacher-student framework to maximize the performance potential of both the teacher and the student. Second, we enhance segmentation by integrating the vessel mask warping technique and motion consistency loss to model complex vessel dynamics. To address the issue of unreliable teacher predictions caused by blurred boundaries and minimal contrast, we further propose a progressive confidence-aware consistency regularization to mitigate the risk of unreliable outputs. Extensive experiments on three datasets of XCA sequences from different institutions demonstrate that SMART achieves state-of-the-art performance while requiring significantly fewer annotations, making it particularly valuable for real-world clinical applications where labeled data is scarce. Our code is available at: https://github.com/qimingfan10/SMART.

In this paper, we study the diffusability (learnability) of variational autoencoders (VAE) in latent diffusion. First, we show that pixel-space diffusion trained with an MSE objective is inherently biased toward learning low and mid spatial frequencies, and that the power-law power spectral density (PSD) of natural images makes this bias perceptually beneficial. Motivated by this result, we propose the Spectrum Matching Hypothesis: latents with superior diffusability should (i) follow a flattened power-law PSD (Encoding Spectrum Matching, ESM) and (ii) preserve frequency-to-frequency semantic correspondence through the decoder (Decoding Spectrum Matching, DSM). In practice, we apply ESM by matching the PSD between images and latents, and DSM via shared spectral masking with frequency-aligned reconstruction. Importantly, Spectrum Matching provides a unified view that clarifies prior observations of over-noisy or over-smoothed latents, and interprets several recent methods as special cases (e.g., VA-VAE, EQ-VAE). Experiments suggest that Spectrum Matching yields superior diffusion generation on CelebA and ImageNet datasets, and outperforms prior approaches. Finally, we extend the spectral view to representation alignment (REPA): we show that the directional spectral energy of the target representation is crucial for REPA, and propose a DoG-based method to further improve the performance of REPA. Our code is available https://github.com/forever208/SpectrumMatching.

In this paper, we present a Hybrid Spectral Denoising Transformer (HSDT) for hyperspectral image denoising. Challenges in adapting transformer for HSI arise from the capabilities to tackle existing limitations of CNN-based methods in capturing the global and local spatial-spectral correlations while maintaining efficiency and flexibility. To address these issues, we introduce a hybrid approach that combines the advantages of both models with a Spatial-Spectral Separable Convolution (S3Conv), Guided Spectral Self-Attention (GSSA), and Self-Modulated Feed-Forward Network (SM-FFN). Our S3Conv works as a lightweight alternative to 3D convolution, which extracts more spatial-spectral correlated features while keeping the flexibility to tackle HSIs with an arbitrary number of bands. These features are then adaptively processed by GSSA which per-forms 3D self-attention across the spectral bands, guided by a set of learnable queries that encode the spectral signatures. This not only enriches our model with powerful capabilities for identifying global spectral correlations but also maintains linear complexity. Moreover, our SM-FFN proposes the self-modulation that intensifies the activations of more informative regions, which further strengthens the aggregated features. Extensive experiments are conducted on various datasets under both simulated and real-world noise, and it shows that our HSDT significantly outperforms the existing state-of-the-art methods while maintaining low computational overhead. Code is at https: //github.com/Zeqiang-Lai/HSDT.

Gliomas are the most common primary brain malignancies, with different degrees of aggressiveness, variable prognosis and various heterogeneous histologic sub-regions, i.e., peritumoral edematous/invaded tissue, necrotic core, active and non-enhancing core. This intrinsic heterogeneity is also portrayed in their radio-phenotype, as their sub-regions are depicted by varying intensity profiles disseminated across multi-parametric magnetic resonance imaging (mpMRI) scans, reflecting varying biological properties. Their heterogeneous shape, extent, and location are some of the factors that make these tumors difficult to resect, and in some cases inoperable. The amount of resected tumor is a factor also considered in longitudinal scans, when evaluating the apparent tumor for potential diagnosis of progression. Furthermore, there is mounting evidence that accurate segmentation of the various tumor sub-regions can offer the basis for quantitative image analysis towards prediction of patient overall survival. This study assesses the state-of-the-art machine learning (ML) methods used for brain tumor image analysis in mpMRI scans, during the last seven instances of the International Brain Tumor Segmentation (BraTS) challenge, i.e., 2012-2018. Specifically, we focus on i) evaluating segmentations of the various glioma sub-regions in pre-operative mpMRI scans, ii) assessing potential tumor progression by virtue of longitudinal growth of tumor sub-regions, beyond use of the RECIST/RANO criteria, and iii) predicting the overall survival from pre-operative mpMRI scans of patients that underwent gross total resection. Finally, we investigate the challenge of identifying the best ML algorithms for each of these tasks, considering that apart from being diverse on each instance of the challenge, the multi-institutional mpMRI BraTS dataset has also been a continuously evolving/growing dataset.

This thesis addresses two persistent and closely related challenges in modern deep learning, reliability and efficiency, through a unified framework grounded in Spectral Geometry and Random Matrix Theory (RMT). As deep networks and large language models continue to scale, their internal behavior becomes increasingly opaque, leading to hallucinations, fragile generalization under distribution shift, and growing computational and energy demands. By analyzing the eigenvalue dynamics of hidden activations across layers and inputs, this work shows that spectral statistics provide a compact, stable, and interpretable lens on model behavior, capable of separating structured, causal representations from noise-dominated variability. Within this framework, the first contribution, EigenTrack, introduces a real-time method for detecting hallucinations and out-of-distribution behavior in large language and vision-language models. EigenTrack transforms streaming activations into spectral descriptors such as entropy, variance, and deviations from the Marchenko-Pastur baseline, and models their temporal evolution using lightweight recurrent classifiers, enabling early detection of reliability failures before they appear in model outputs while offering interpretable insight into representation dynamics. The second contribution, RMT-KD, presents a principled approach to compressing deep networks via random matrix theoretic knowledge distillation. By interpreting outlier eigenvalues in activation spectra as carriers of task-relevant information, RMT-KD progressively projects networks onto lower-dimensional subspaces through iterative self-distillation, yielding significantly more compact and energy-efficient models while preserving accuracy and dense, hardware-friendly structure.

Self-supervised deep learning has accelerated 2D natural image analysis but remains difficult to translate into 3D MRI, where data are scarce and pre-trained 2D backbones cannot capture volumetric context. We present a sequence-invariant self-supervised framework leveraging quantitative MRI (qMRI). By simulating multiple MRI contrasts from a single 3D qMRI scan and enforcing consistent representations across these contrasts, we learn anatomy-centric rather than sequence-specific features. The result is a single 3D encoder that excels across tasks and protocols. Experiments on healthy brain segmentation (IXI), stroke lesion segmentation (ARC), and MRI denoising show significant gains over baseline SSL approaches, especially in low-data settings (up to +8.3\% Dice, +4.2 dB PSNR). It also generalises to unseen sites, supporting scalable clinical use. Code and trained models are publicly available at https://github.com/liamchalcroft/contrast-squared

Typical quantitative MRI (qMRI) methods estimate parameter maps after image reconstructing, which is prone to biases and error propagation. We propose a Nonlinear Conjugate Gradient (NLCG) optimizer for model-based T2/T1 estimation, which incorporates U-Net regularization trained in a scan-specific manner. This end-to-end method directly estimates qMRI maps from undersampled k-space data using mono-exponential signal modeling with zero-shot scan-specific neural network regularization to enable high fidelity T1 and T2 mapping. T2 and T1 mapping results demonstrate the ability of the proposed NLCG-Net to improve estimation quality compared to subspace reconstruction at high accelerations.

Adapting large-scale pre-trained generative models in a parameter-efficient manner is gaining traction. Traditional methods like low rank adaptation achieve parameter efficiency by imposing constraints but may not be optimal for tasks requiring high representation capacity. We propose a novel spectrum-aware adaptation framework for generative models. Our method adjusts both singular values and their basis vectors of pretrained weights. Using the Kronecker product and efficient Stiefel optimizers, we achieve parameter-efficient adaptation of orthogonal matrices. We introduce Spectral Orthogonal Decomposition Adaptation (SODA), which balances computational efficiency and representation capacity. Extensive evaluations on text-to-image diffusion models demonstrate SODA's effectiveness, offering a spectrum-aware alternative to existing fine-tuning methods.

Magnetic Resonance Imaging with tagging (tMRI) has long been utilized for quantifying tissue motion and strain during deformation. However, a phenomenon known as tag fading, a gradual decrease in tag visibility over time, often complicates post-processing. The first contribution of this study is to model tag fading by considering the interplay between T_1 relaxation and the repeated application of radio frequency (RF) pulses during serial imaging sequences. This is a factor that has been overlooked in prior research on tMRI post-processing. Further, we have observed an emerging trend of utilizing raw tagged MRI within a deep learning-based (DL) registration framework for motion estimation. In this work, we evaluate and analyze the impact of commonly used image similarity objectives in training DL registrations on raw tMRI. This is then compared with the Harmonic Phase-based approach, a traditional approach which is claimed to be robust to tag fading. Our findings, derived from both simulated images and an actual phantom scan, reveal the limitations of various similarity losses in raw tMRI and emphasize caution in registration tasks where image intensity changes over time.

Computed tomography (CT) serves as an effective tool for lung cancer screening, diagnosis, treatment, and prognosis, providing a rich source of features to quantify temporal and spatial tumor changes. Nonetheless, the diversity of CT scanners and customized acquisition protocols can introduce significant inconsistencies in texture features, even when assessing the same patient. This variability poses a fundamental challenge for subsequent research that relies on consistent image features. Existing CT image standardization models predominantly utilize GAN-based supervised or semi-supervised learning, but their performance remains limited. We present DiffusionCT, an innovative score-based DDPM model that operates in the latent space to transform disparate non-standard distributions into a standardized form. The architecture comprises a U-Net-based encoder-decoder, augmented by a DDPM model integrated at the bottleneck position. First, the encoder-decoder is trained independently, without embedding DDPM, to capture the latent representation of the input data. Second, the latent DDPM model is trained while keeping the encoder-decoder parameters fixed. Finally, the decoder uses the transformed latent representation to generate a standardized CT image, providing a more consistent basis for downstream analysis. Empirical tests on patient CT images indicate notable improvements in image standardization using DiffusionCT. Additionally, the model significantly reduces image noise in SPAD images, further validating the effectiveness of DiffusionCT for advanced imaging tasks.

While deep learning-based denoising has become widely adopted in low-dose CT, conventional models use generic architectures designed for natural images, failing to account for non-stationary and spatially correlated CT noise characteristics. To address this, we propose an Efficient Noise COntext-aware REpresentation (ENCORE) framework that explicitly leverages CT noise characteristics and anatomical features. First, we reformulate the noise synthesis procedure based on a realistic noise distribution beyond the conventional Gaussian approximation, establishing a rigorous foundation for training pair generation. Next, we extract local noise power and correlation contexts to guide the denoising process. To fully leverage the potential of noise context, we propose a FlyingConv module, which adaptively changes convolution weights for each local image region. Notably, our approach demonstrates substantial gains in both denoising quality and computational efficiency. Furthermore, manipulating the intensity of the noise context maps at inference time enables zero-shot conditional denoising, allowing for dynamic control over the output image texture. The entire pipeline is available at https://github.com/minwoo-yu/ENCORE.git

Continuous Glucose Monitoring (CGM) can detect early metabolic subphenotypes (insulin resistance, IR; β-cell dysfunction), but population-scale deployment faces two coupled problems. First, the same physiological state appears through multiple views (CGM time series, venous OGTT, Glucodensity summaries), so single-view representations fail to transfer when deployment shifts the modality or setting. Second, baselines perform inconsistently across these shifts. Both problems point to one remedy: representations that abstract away from any single view to capture higher-level temporal and distributional structure. We propose CGM-JEPA, a self-supervised pretraining framework which predicts masked latent representations rather than raw values, yielding abstraction that transfers across modalities. X-CGM-JEPA adds a masked Glucodensity cross-view objective for complementary distributional information. We pretrain on sim389k unlabeled CGM readings from 228 subjects and evaluate on two clinical cohorts (N=27 and N=17 public-release subsets) across three regimes (cohort generalization, venous-to-CGM transfer, home CGM) under 20-iteration times 2-fold cross-validation. X-CGM-JEPA ranks first or second on AUROC for both endpoints across all three regimes while no baseline does, exceeding the strongest baseline by up to +6.5 pp in cohort generalization and +3.6 pp in venous-to-CGM transfer (paired Wilcoxon, p<0.001). Under modality shift, it matches mean AUROC while redistributing toward weaker subgroups (ethnicity AUROC gap shrinks 25-54%); on sparse in-domain venous data, the distributional view lifts label-aware clustering (ARI +39%, NMI +40%). Code and weights: https://github.com/cruiseresearchgroup/CGM-JEPA

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

Satellite remote sensing missions have gained popularity over the past fifteen years due to their ability to cover large swaths of land at regular intervals, making them ideal for monitoring environmental trends. The FINCH mission, a 3U+ CubeSat equipped with a hyperspectral camera, aims to monitor crop residue cover in agricultural fields. Although hyperspectral imaging captures both spectral and spatial information, it is prone to various types of noise, including random noise, stripe noise, and dead pixels. Effective denoising of these images is crucial for downstream scientific tasks. Traditional methods, including hand-crafted techniques encoding strong priors, learned 2D image denoising methods applied across different hyperspectral bands, or diffusion generative models applied independently on bands, often struggle with varying noise strengths across spectral bands, leading to significant spectral distortion. This paper presents a novel approach to hyperspectral image denoising using latent diffusion models that integrate spatial and spectral information. We particularly do so by building a 3D diffusion model and presenting a 3-stage training approach on real and synthetically crafted datasets. The proposed method preserves image structure while reducing noise. Evaluations on both popular hyperspectral denoising datasets and synthetically crafted datasets for the FINCH mission demonstrate the effectiveness of this approach.

Counterfactual medical image generation enables clinicians to explore clinical hypotheses, such as predicting disease progression, facilitating their decision-making. While existing methods can generate visually plausible images from disease progression prompts, they produce silent predictions that lack interpretation to verify how the generation reflects the hypothesized progression -- a critical gap for medical applications that require traceable reasoning. In this paper, we propose Interpretable Counterfactual Generation (ICG), a novel task requiring the joint generation of counterfactual images that reflect the clinical hypothesis and interpretation texts that outline the visual changes induced by the hypothesis. To enable ICG, we present ICG-CXR, the first dataset pairing longitudinal medical images with hypothetical progression prompts and textual interpretations. We further introduce ProgEmu, an autoregressive model that unifies the generation of counterfactual images and textual interpretations. We demonstrate the superiority of ProgEmu in generating progression-aligned counterfactuals and interpretations, showing significant potential in enhancing clinical decision support and medical education. Project page: https://progemu.github.io.

This paper presents a data-driven, task-specific paradigm for experimental design, to shorten acquisition time, reduce costs, and accelerate the deployment of imaging devices. Current approaches in experimental design focus on model-parameter estimation and require specification of a particular model, whereas in imaging, other tasks may drive the design. Furthermore, such approaches often lead to intractable optimization problems in real-world imaging applications. Here we present a new paradigm for experimental design that simultaneously optimizes the design (set of image channels) and trains a machine-learning model to execute a user-specified image-analysis task. The approach obtains data densely-sampled over the measurement space (many image channels) for a small number of acquisitions, then identifies a subset of channels of prespecified size that best supports the task. We propose a method: TADRED for TAsk-DRiven Experimental Design in imaging, to identify the most informative channel-subset whilst simultaneously training a network to execute the task given the subset. Experiments demonstrate the potential of TADRED in diverse imaging applications: several clinically-relevant tasks in magnetic resonance imaging; and remote sensing and physiological applications of hyperspectral imaging. Results show substantial improvement over classical experimental design, two recent application-specific methods within the new paradigm, and state-of-the-art approaches in supervised feature selection. We anticipate further applications of our approach. Code is available: https://github.com/sbb-gh/experimental-design-multichannel

Recently, diffusion models have been used to solve various inverse problems in an unsupervised manner with appropriate modifications to the sampling process. However, the current solvers, which recursively apply a reverse diffusion step followed by a projection-based measurement consistency step, often produce suboptimal results. By studying the generative sampling path, here we show that current solvers throw the sample path off the data manifold, and hence the error accumulates. To address this, we propose an additional correction term inspired by the manifold constraint, which can be used synergistically with the previous solvers to make the iterations close to the manifold. The proposed manifold constraint is straightforward to implement within a few lines of code, yet boosts the performance by a surprisingly large margin. With extensive experiments, we show that our method is superior to the previous methods both theoretically and empirically, producing promising results in many applications such as image inpainting, colorization, and sparse-view computed tomography. Code available https://github.com/HJ-harry/MCG_diffusion

Implicit Neural Representations (INRs) have emerged as a powerful paradigm for representing signals such as images, audio, and 3D scenes. However, existing INR frameworks -- including MLPs with Fourier features, SIREN, and multiresolution hash grids -- implicitly assume a global and stationary spectral basis. This assumption is fundamentally misaligned with real-world signals whose frequency characteristics vary significantly across space, exhibiting local high-frequency textures, smooth regions, and frequency drift phenomena. We propose Neural Spectral Transport Representation (NSTR), the first INR framework that explicitly models a spatially varying local frequency field. NSTR introduces a learnable frequency transport equation, a PDE that governs how local spectral compositions evolve across space. Given a learnable local spectrum field S(x) and a frequency transport network F_θ enforcing nabla S(x) approx F_θ(x, S(x)), NSTR reconstructs signals by spatially modulating a compact set of global sinusoidal bases. This formulation enables strong local adaptivity and offers a new level of interpretability via visualizing frequency flows. Experiments on 2D image regression, audio reconstruction, and implicit 3D geometry show that NSTR achieves significantly better accuracy-parameter trade-offs than SIREN, Fourier-feature MLPs, and Instant-NGP. NSTR requires fewer global frequencies, converges faster, and naturally explains signal structure through spectral transport fields. We believe NSTR opens a new direction in INR research by introducing explicit modeling of space-varying spectrum.

Recent research in medical image analysis with deep learning almost exclusively focuses on grid- or voxel-based data representations. We challenge this common choice by introducing MedFuncta, a modality-agnostic continuous data representation based on neural fields. We demonstrate how to scale neural fields from single instances to large datasets by exploiting redundancy in medical signals and by applying an efficient meta-learning approach with a context reduction scheme. We further address the spectral bias in commonly used SIREN activations, by introducing an omega_0-schedule, improving reconstruction quality and convergence speed. We validate our proposed approach on a large variety of medical signals of different dimensions and modalities (1D: ECG; 2D: Chest X-ray, Retinal OCT, Fundus Camera, Dermatoscope, Colon Histopathology, Cell Microscopy; 3D: Brain MRI, Lung CT) and successfully demonstrate that we can solve relevant downstream tasks on these representations. We additionally release a large-scale dataset of > 550k annotated neural fields to promote research in this direction.

Vision-language models (VLMs) pretrained on large-scale image-text pairs demonstrate strong image-level understanding, but are primarily optimized for global alignment and do not explicitly encode fine-grained anatomical structure, limiting their suitability for spatially precise tasks such as segmentation. We introduce CheXanatomy, a framework that integrates explicit anatomical knowledge into a pretrained VLM through autoregressive token-space supervision. Instead of adding task-specific decoder heads, the model is trained to generate anatomical segmentation masks via next-token prediction. To enable scalable supervision, we synthesize realistic chest radiographs from CT volumes and forward-project CT segmentation labels to obtain anatomically consistent 2D masks. We evaluate the approach on synthetic and real chest radiographs against a U-Net baseline, including ablations on model scale, input resolution, and vision encoder fine-tuning. Autoregressive anatomical supervision achieves performance comparable to specialized convolutional models in-distribution and demonstrates improved geometric robustness under domain shift to real CXR data. In addition, anatomy-pretrained models exhibit improved sample efficiency when adapting to novel localization tasks under limited supervision. Larger models and higher input image resolution improve performance, while vision encoder fine-tuning has limited effect. These results show that embedding anatomical structure directly into the generative objective promotes spatially grounded representations and supports anatomy-aware medical vision-language modeling.

Accurate medical image segmentation is critical for early medical diagnosis. Most existing methods are based on U-shape structure and use element-wise addition or concatenation to fuse different level features progressively in decoder. However, both the two operations easily generate plenty of redundant information, which will weaken the complementarity between different level features, resulting in inaccurate localization and blurred edges of lesions. To address this challenge, we propose a general multi-scale in multi-scale subtraction network (M^{2}SNet) to finish diverse segmentation from medical image. Specifically, we first design a basic subtraction unit (SU) to produce the difference features between adjacent levels in encoder. Next, we expand the single-scale SU to the intra-layer multi-scale SU, which can provide the decoder with both pixel-level and structure-level difference information. Then, we pyramidally equip the multi-scale SUs at different levels with varying receptive fields, thereby achieving the inter-layer multi-scale feature aggregation and obtaining rich multi-scale difference information. In addition, we build a training-free network ``LossNet'' to comprehensively supervise the task-aware features from bottom layer to top layer, which drives our multi-scale subtraction network to capture the detailed and structural cues simultaneously. Without bells and whistles, our method performs favorably against most state-of-the-art methods under different evaluation metrics on eleven datasets of four different medical image segmentation tasks of diverse image modalities, including color colonoscopy imaging, ultrasound imaging, computed tomography (CT), and optical coherence tomography (OCT). The source code can be available at https://github.com/Xiaoqi-Zhao-DLUT/MSNet.

We introduce a novel uncertainty-aware multimodal segmentation framework that leverages both radiological images and associated clinical text for precise medical diagnosis. We propose a Modality Decoding Attention Block (MoDAB) with a lightweight State Space Mixer (SSMix) to enable efficient cross-modal fusion and long-range dependency modelling. To guide learning under ambiguity, we propose the Spectral-Entropic Uncertainty (SEU) Loss, which jointly captures spatial overlap, spectral consistency, and predictive uncertainty in a unified objective. In complex clinical circumstances with poor image quality, this formulation improves model reliability. Extensive experiments on various publicly available medical datasets, QATA-COVID19, MosMed++, and Kvasir-SEG, demonstrate that our method achieves superior segmentation performance while being significantly more computationally efficient than existing State-of-the-Art (SoTA) approaches. Our results highlight the importance of incorporating uncertainty modelling and structured modality alignment in vision-language medical segmentation tasks. Code: https://github.com/arya-domain/UA-VLS

Hyperspectral image denoising is unique for the highly similar and correlated spectral information that should be properly considered. However, existing methods show limitations in exploring the spectral correlations across different bands and feature interactions within each band. Besides, the low- and high-level features usually exhibit different importance for different spatial-spectral regions, which is not fully explored for current algorithms as well. In this paper, we present a Mixed Attention Network (MAN) that simultaneously considers the inter- and intra-spectral correlations as well as the interactions between low- and high-level spatial-spectral meaningful features. Specifically, we introduce a multi-head recurrent spectral attention that efficiently integrates the inter-spectral features across all the spectral bands. These features are further enhanced with a progressive spectral channel attention by exploring the intra-spectral relationships. Moreover, we propose an attentive skip-connection that adaptively controls the proportion of the low- and high-level spatial-spectral features from the encoder and decoder to better enhance the aggregated features. Extensive experiments show that our MAN outperforms existing state-of-the-art methods on simulated and real noise settings while maintaining a low cost of parameters and running time.

Hyperspectral images (HSIs) often suffer from diverse and unknown degradations during imaging, leading to severe spectral and spatial distortions. Existing HSI restoration methods typically rely on specific degradation assumptions, limiting their effectiveness in complex scenarios. In this paper, we propose MP-HSIR, a novel multi-prompt framework that effectively integrates spectral, textual, and visual prompts to achieve universal HSI restoration across diverse degradation types and intensities. Specifically, we develop a prompt-guided spatial-spectral transformer, which incorporates spatial self-attention and a prompt-guided dual-branch spectral self-attention. Since degradations affect spectral features differently, we introduce spectral prompts in the local spectral branch to provide universal low-rank spectral patterns as prior knowledge for enhancing spectral reconstruction. Furthermore, the text-visual synergistic prompt fuses high-level semantic representations with fine-grained visual features to encode degradation information, thereby guiding the restoration process. Extensive experiments on 9 HSI restoration tasks, including all-in-one scenarios, generalization tests, and real-world cases, demonstrate that MP-HSIR not only consistently outperforms existing all-in-one methods but also surpasses state-of-the-art task-specific approaches across multiple tasks. The code and models will be released at https://github.com/ZhehuiWu/MP-HSIR.

Objective: While recent advances in text-conditioned generative models have enabled the synthesis of realistic medical images, progress has been largely confined to 2D modalities such as chest X-rays. Extending text-to-image generation to volumetric Computed Tomography (CT) remains a significant challenge, due to its high dimensionality, anatomical complexity, and the absence of robust frameworks that align vision-language data in 3D medical imaging. Methods: We introduce a novel architecture for Text-to-CT generation that combines a latent diffusion model with a 3D contrastive vision-language pretraining scheme. Our approach leverages a dual-encoder CLIP-style model trained on paired CT volumes and radiology reports to establish a shared embedding space, which serves as the conditioning input for generation. CT volumes are compressed into a low-dimensional latent space via a pretrained volumetric VAE, enabling efficient 3D denoising diffusion without requiring external super-resolution stages. Results: We evaluate our method on the CT-RATE dataset and conduct a comprehensive assessment of image fidelity, clinical relevance, and semantic alignment. Our model achieves competitive performance across all tasks, significantly outperforming prior baselines for text-to-CT generation. Moreover, we demonstrate that CT scans synthesized by our framework can effectively augment real data, improving downstream diagnostic performance. Conclusion: Our results show that modality-specific vision-language alignment is a key component for high-quality 3D medical image generation. By integrating contrastive pretraining and volumetric diffusion, our method offers a scalable and controllable solution for synthesizing clinically meaningful CT volumes from text, paving the way for new applications in data augmentation, medical education, and automated clinical simulation.

Inference-time scaling offers a versatile paradigm for aligning visual generative models with downstream objectives without parameter updates. However, existing approaches that optimize the high-dimensional initial noise suffer from severe inefficiency, as many search directions exert negligible influence on the final generation. We show that this inefficiency is closely related to a spectral bias in generative dynamics: model sensitivity to initial perturbations diminishes rapidly as frequency increases. Building on this insight, we propose Spectral Evolution Search (SES), a plug-and-play framework for initial noise optimization that executes gradient-free evolutionary search within a low-frequency subspace. Theoretically, we derive the Spectral Scaling Prediction from perturbation propagation dynamics, which explains the systematic differences in the impact of perturbations across frequencies. Extensive experiments demonstrate that SES significantly advances the Pareto frontier of generation quality versus computational cost, consistently outperforming strong baselines under equivalent budgets.

In this paper, we introduce fastHDMI, a Python package designed for efficient variable screening in high-dimensional datasets, particularly neuroimaging data. This work pioneers the application of three mutual information estimation methods for neuroimaging variable selection, a novel approach implemented via fastHDMI. These advancements enhance our ability to analyze the complex structures of neuroimaging datasets, providing improved tools for variable selection in high-dimensional spaces. Using the preprocessed ABIDE dataset, we evaluate the performance of these methods through extensive simulations. The tests cover a range of conditions, including linear and nonlinear associations, as well as continuous and binary outcomes. Our results highlight the superiority of the FFTKDE-based mutual information estimation for feature screening in continuous nonlinear outcomes, while binning-based methods outperform others for binary outcomes with nonlinear probability preimages. For linear simulations, both Pearson correlation and FFTKDE-based methods show comparable performance for continuous outcomes, while Pearson excels in binary outcomes with linear probability preimages. A comprehensive case study using the ABIDE dataset further demonstrates fastHDMI's practical utility, showcasing the predictive power of models built from variables selected using our screening techniques. This research affirms the computational efficiency and methodological strength of fastHDMI, significantly enriching the toolkit available for neuroimaging analysis.

Stroke remains a leading cause of global morbidity and mortality, placing a heavy socioeconomic burden. Over the past decade, advances in endovascular reperfusion therapy and the use of CT and MRI imaging for treatment guidance have significantly improved patient outcomes and are now standard in clinical practice. To develop machine learning algorithms that can extract meaningful and reproducible models of brain function for both clinical and research purposes from stroke images - particularly for lesion identification, brain health quantification, and prognosis - large, diverse, and well-annotated public datasets are essential. While only a few datasets with (sub-)acute stroke data were previously available, several large, high-quality datasets have recently been made publicly accessible. However, these existing datasets include only MRI data. In contrast, our dataset is the first to offer comprehensive longitudinal stroke data, including acute CT imaging with angiography and perfusion, follow-up MRI at 2-9 days, as well as acute and longitudinal clinical data up to a three-month outcome. The dataset includes a training dataset of n = 150 and a test dataset of n = 100 scans. Training data is publicly available, while test data will be used exclusively for model validation. We are making this dataset available as part of the 2024 edition of the Ischemic Stroke Lesion Segmentation (ISLES) challenge (https://www.isles-challenge.org/), which continuously aims to establish benchmark methods for acute and sub-acute ischemic stroke lesion segmentation, aiding in creating open stroke imaging datasets and evaluating cutting-edge image processing algorithms.

Diffusion models have recently received a surge of interest due to their impressive performance for image restoration, especially in terms of noise robustness. However, existing diffusion-based methods are trained on a large amount of training data and perform very well in-distribution, but can be quite susceptible to distribution shift. This is especially inappropriate for data-starved hyperspectral image (HSI) restoration. To tackle this problem, this work puts forth a self-supervised diffusion model for HSI restoration, namely Denoising Diffusion Spatio-Spectral Model (DDS2M), which works by inferring the parameters of the proposed Variational Spatio-Spectral Module (VS2M) during the reverse diffusion process, solely using the degraded HSI without any extra training data. In VS2M, a variational inference-based loss function is customized to enable the untrained spatial and spectral networks to learn the posterior distribution, which serves as the transitions of the sampling chain to help reverse the diffusion process. Benefiting from its self-supervised nature and the diffusion process, DDS2M enjoys stronger generalization ability to various HSIs compared to existing diffusion-based methods and superior robustness to noise compared to existing HSI restoration methods. Extensive experiments on HSI denoising, noisy HSI completion and super-resolution on a variety of HSIs demonstrate DDS2M's superiority over the existing task-specific state-of-the-arts.

Medical image arbitrary-scale super-resolution (MIASSR) has recently gained widespread attention, aiming to super sample medical volumes at arbitrary scales via a single model. However, existing MIASSR methods face two major limitations: (i) reliance on high-resolution (HR) volumes and (ii) limited generalization ability, which restricts their application in various scenarios. To overcome these limitations, we propose Cube-based Neural Radiance Field (CuNeRF), a zero-shot MIASSR framework that can yield medical images at arbitrary scales and viewpoints in a continuous domain. Unlike existing MIASSR methods that fit the mapping between low-resolution (LR) and HR volumes, CuNeRF focuses on building a coordinate-intensity continuous representation from LR volumes without the need for HR references. This is achieved by the proposed differentiable modules: including cube-based sampling, isotropic volume rendering, and cube-based hierarchical rendering. Through extensive experiments on magnetic resource imaging (MRI) and computed tomography (CT) modalities, we demonstrate that CuNeRF outperforms state-of-the-art MIASSR methods. CuNeRF yields better visual verisimilitude and reduces aliasing artifacts at various upsampling factors. Moreover, our CuNeRF does not need any LR-HR training pairs, which is more flexible and easier to be used than others. Our code will be publicly available soon.

Surface analysis of the cortex is ubiquitous in human neuroimaging with MRI, e.g., for cortical registration, parcellation, or thickness estimation. The convoluted cortical geometry requires isotropic scans (e.g., 1mm MPRAGEs) and good gray-white matter contrast for 3D reconstruction. This precludes the analysis of most brain MRI scans acquired for clinical purposes. Analyzing such scans would enable neuroimaging studies with sample sizes that cannot be achieved with current research datasets, particularly for underrepresented populations and rare diseases. Here we present the first method for cortical reconstruction, registration, parcellation, and thickness estimation for clinical brain MRI scans of any resolution and pulse sequence. The methods has a learning component and a classical optimization module. The former uses domain randomization to train a CNN that predicts an implicit representation of the white matter and pial surfaces (a signed distance function) at 1mm isotropic resolution, independently of the pulse sequence and resolution of the input. The latter uses geometry processing to place the surfaces while accurately satisfying topological and geometric constraints, thus enabling subsequent parcellation and thickness estimation with existing methods. We present results on 5mm axial FLAIR scans from ADNI and on a highly heterogeneous clinical dataset with 5,000 scans. Code and data are publicly available at https://surfer.nmr.mgh.harvard.edu/fswiki/recon-all-clinical

Medical imaging artificial intelligence has achieved strong performance in isolated image interpretation, but remains poorly aligned with radiological practice, where diagnosis and follow-up rely on comparison across prior studies and analogous reference cases. Here we formulate radiological comparison as an entity-aware cross-image reasoning problem and introduce a framework that supports both reference-case retrieval and temporal comparative interpretation. We construct MedReCo-DB, a large-scale comparative imaging resource derived from routine image-report pairs, comprising more than 690,000 images from over 160,000 patients across eight institutions, four countries and seven imaging modalities. Reports are decomposed into anatomical structures, abnormal findings and pathological conditions to provide supervision for entity-conditioned retrieval and comparative visual question answering. Using this resource, we develop MedReCo, an entity-aware visual encoder for controllable retrieval of clinically analogous cases, and MedReCo-VLM, a vision--language extension for generative interpretation of interval change. Across internal, external and cross-center evaluations, MedReCo achieved the highest Recall@1 in all 12 internal retrieval settings and improved external retrieval by a mean of 6.0 percentage points. In clinically confusable differential groups, it consistently outperformed the strongest baselines. MedReCo-VLM achieved the best performance across all comparative generation evaluations and improved longitudinal follow-up accuracy by 14.5-46.5 percentage points on chest radiographs and 13.0-27.9 percentage points on CT. These findings suggest that entity-aware comparative reasoning can be learned from routine clinical data at scale and may provide a more clinically aligned foundation for medical imaging AI.

Medical image retrieval is essential for clinical decision-making and translational research, relying on discriminative visual representations. Yet, current methods remain fragmented, relying on separate architectures and training strategies for 2D, 3D, and video-based medical data. This modality-specific design hampers scalability and inhibits the development of unified representations. To enable unified learning, we curate a large-scale hybrid-modality dataset comprising 867,653 medical imaging samples, including 2D X-rays and ultrasounds, RGB endoscopy videos, and 3D CT scans. Leveraging this dataset, we train M3Ret, a unified visual encoder without any modality-specific customization. It successfully learns transferable representations using both generative (MAE) and contrastive (SimDINO) self-supervised learning (SSL) paradigms. Our approach sets a new state-of-the-art in zero-shot image-to-image retrieval across all individual modalities, surpassing strong baselines such as DINOv3 and the text-supervised BMC-CLIP. More remarkably, strong cross-modal alignment emerges without paired data, and the model generalizes to unseen MRI tasks, despite never observing MRI during pretraining, demonstrating the generalizability of purely visual self-supervision to unseen modalities. Comprehensive analyses further validate the scalability of our framework across model and data sizes. These findings deliver a promising signal to the medical imaging community, positioning M3Ret as a step toward foundation models for visual SSL in multimodal medical image understanding.

Thermal imaging remains effective under adverse illumination, yet passive long-wave infrared (LWIR) measurements often lack fine texture. Existing thermal texture imaging approaches commonly rely on spectral sensing or registered auxiliary modalities, incurring substantial data throughput or vulnerability to cross-modal degradation. We introduce T^2exture, a sparsely perturbed thermal texture imaging framework that aims to reconstruct temporally dense thermal texture sequences from densely sampled passive frames and a few actively perturbed keyframes. We define thermal texture as the residual between a source-on observation and its corresponding source-off passive state. Under sparse LWIR illumination and rapid quasi-steady paired acquisition, this residual attenuates the passive-emission background and approximates a source-induced reflected response, exposing localized material- and geometry-dependent texture. T^2exture reconstructs a dense sequence of this source-conditioned response through two stages. Stage 1 estimates the unobserved source-off passive state at each active instant from neighboring passive frames to obtain reliable differential texture anchors. Stage 2 combines sparse anchors with passive structural context near each target time to reconstruct the dense sequence. On the simulated benchmark, T^2exture adds only 0.20M parameters to AMT-L while improving PSNR by 6.66 dB. Extensive evaluations on simulated and real acquisitions further show clearer texture recovery and stronger structural preservation than representative VFI baselines. These results establish T^2exture as a practical framework for thermal texture imaging under sparse active acquisition.

While spectral-based optimizers like Muon operate directly on the spectrum of updates, standard adaptive methods such as AdamW do not account for the global spectral structure of weights and gradients, leaving them vulnerable to two empirical issues in large language model (LLM) training: (i) the optimizer updates can have large spectral norms, potentially destabilizing training and degrading generalization; (ii) stochastic gradient noise can exhibit sparse spectral spikes, with a few dominant singular values much larger than the rest. We propose SPECTRA, a general framework addressing these by (i) post-spectral clipping of updates to enforce spectral-norm constraints; (ii) optional pre-spectral clipping of gradients to suppress spectral noise spikes. We prove that post-clipping constitutes a Composite Frank-Wolfe method with spectral-norm constraints and weight regularization, recovering Frobenius and ell_{infty}-norm regularization with SGD-based and sign-based methods. We further analyze how pre-clipping mitigates sparse spectral spikes. We propose efficient soft spectral clipping via Newton-Schulz iterations, avoiding expensive SVD. Experiments on LLM pretraining show SPECTRA uniformly improves validation loss for various optimizers, including AdamW, Signum, and AdEMAMix, with the best-performing variants achieving state-of-the-art results. Models trained with SPECTRA exhibit smaller weight norms, confirming the link between spectral clipping and regularization.