arXiv subjects

Congyu Liao

Publications and source records attributed to Congyu Liao.

At least 19 recordsLinked to original sources

arXiv2026

Medical world models in healthcare: foundations, applications, and challenges for trustworthy clinical translation

Medical world models offer a framework for extending medical artificial intelligence beyond static prediction by representing evolving patient states and modelling how they change over time and in response to clinical interventions. This Review defines the conceptual boundaries, technical foundations, application domains, and evidence requirements of the field through a structured narrative synthesis with reproducible evidence mapping. We screened 1,455 unique records and assembled a corpus of 98 sources, including 14 studies that met a strict empirical definition of a medical world model. The field is organised around four capabilities: patient state representation, temporal dynamics modelling, intervention-conditioned simulation, and clinician-supervised planning. Evidence spans medical imaging, longitudinal electronic health records, treatment response modelling, physiological and multimodal state modelling, ultrasound and surgical interaction, and population and health-system simulation; clinical digital twins are treated as a cross-cutting integration framework. Current studies provide early evidence of technical feasibility for trajectory forecasting and comparison of candidate interventions, but most remain retrospective, task-specific, or preclinical. The evidence base is further limited by incomplete longitudinal intervention data, inconsistent action semantics, limited causal identifiability, long-horizon error accumulation, inadequate uncertainty estimation, and limited external validation. Clinical translation will therefore depend on precise intervention representations, robust causal and mechanistic grounding, calibrated trajectory-level uncertainty, safety-constrained planning, and prospective multicentre validation against clinically meaningful endpoints.

cs.CV↗

arXiv2026

Agentic AI in medicine: architectures, applications, evaluation, and challenges for clinical translation

Large language models and multimodal foundation models are enabling medical artificial intelligence (AI) systems to move beyond isolated prediction and undertake multistep clinical tasks that require planning, tool use, memory, iterative correction, and coordination among specialized agents. However, the scope of agentic AI in medicine remains unsettled, and current evaluation practices are not yet aligned with the requirements of clinical use. We conducted a scoping review with systematic evidence mapping across five electronic sources, screened 1,649 exportable records, and provisionally included 557 unique studies that met predefined criteria for goal-directed task execution, tool use, interaction with external resources, feedback-based refinement, or multi-agent collaboration. The included studies describe single agents that use external tools, workflows supported by retrieval and external knowledge, multimodal agents, and multi-agent systems applied to medical question answering, image interpretation, electronic health record analysis, drug safety, and clinical trial prediction. The evidence base remains dominated by public benchmarks, simulated settings, retrospective datasets, and small-scale expert evaluation. Process reliability, evidence traceability, uncertainty, safety, workflow impact, and external validity are evaluated less consistently. Clinical translation will depend on clearer definitions, reproducible evaluation, auditable oversight, interoperable system design, and prospective validation in real-world clinical workflows.

cs.CV↗

arXiv2026

Distortion-Corrected Diffusion MRI Using Rotated-View EPI and Joint Field-Map/Image Estimation with Gaussian Primitives

Echo Planar Imaging (EPI) is the standard acquisition technique for diffusion and functional neuroimaging, enabling rapid imaging but suffering from geometric distortions caused by B0 field inhomogeneities. Existing correction methods first reconstruct distorted images using parallel imaging, then estimate the B0 field and correct the distortion in the image domain. In this sequential process, reconstruction artifacts at high acceleration factors and low SNR at high diffusion b-values degrade B0 estimation and limit the overall correction quality. We propose a physics-informed framework that jointly estimates the B0 field and distortion-free image directly from k-space data, without depending on an intermediate parallel-imaging reconstruction for the correction. The image and the B0 field are each represented as a superposition of Gaussian primitives embedded within an MRI physics forward model. The explicit, continuous parameterization captures both smooth regions and tissue boundaries and supports rotated-view EPI acquisitions without interpolation. The diffusion-weighted image is modeled as real and non-negative, with the image phase absorbed into a per-shot phase factor. Rotated views distribute distortions across multiple phase-encoding orientations, improving point spread function isotropy and providing stronger constraints for B0 estimation. On in vivo brain diffusion EPI, the proposed method attains the closest brain-boundary agreement with a distortion-free structural reference, with the largest improvement over sequential methods at high b-value and high acceleration. Extensive visual comparisons further show improved detail fidelity and noise suppression.

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arXiv2026

A physics-informed foundation model for quantitative diffusion MRI

Understanding the human brain requires access to its microscopic tissue architecture. Diffusion magnetic resonance imaging (MRI) provides the only noninvasive window into whole-brain microstructure in vivo, yet reliable quantitative mapping remains confined to specialized research settings requiring dense sampling and optimized acquisition protocols. To address this gap, we present a physics-informed generative microstructure network (PIGMENT) that learns a universal generative prior of human brain microstructure and adapts it zero-shot to each participant's measured data to recover subject-specific maps. Trained on 11375 scans spanning multiple sites, vendors, and field strengths, PIGMENT enabled reliable quantitative mapping for tensor, kurtosis, and NODDI models across external datasets from five independent centers. It remains effective where conventional fitting becomes unreliable, recovering meaningful maps from extremely sparse acquisitions while supporting downstream tractography and structural connectivity mapping. PIGMENT estimates demonstrated strong biological validity, preserving submillimeter cortical microarchitectural patterns and early-childhood white matter developmental trajectories from 10-fold accelerated scans. Furthermore, PIGMENT enables reliable quantitative tensor mapping on cost-efficient low-field systems and the extraction of tumor-related biomarkers using ultra-fast clinical protocols. Together, these results establish PIGMENT as a physics-informed foundation model that extends quantitative diffusion MRI into regimes traditionally too sparse, heterogeneous, or clinically constrained for reliable analysis.

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arXiv2026

CoilDrop-MRI: Self-supervised physics-guided MRI reconstruction with coil dropout

Self-supervised deep learning-based methods have shown great promise for accelerated magnetic resonance imaging (MRI) reconstruction, achieving high image quality without requiring fully sampled data for training. These methods typically partition the acquired data into two disjoint subsets to construct input-target pairs for optimizing the reconstruction network. However, existing approaches perform this partition exclusively within the spatial frequency (k-space) domain, leaving the coil dimension unexplored. To enforce full exploitation of signal correlation across receiver coils, we propose CoilDrop-MRI, which applies coil-wise dropout to the input and uses the dropped data as training targets in a self-supervised framework. This method is integrated into unrolled architectures in both image-domain (SENSE) and k-space (SPIRiT) formulations. We further demonstrate its versatility by extending CoilDrop-MRI to multi-shot, phase-corrected diffusion MRI (dMRI) reconstruction. CoilDrop-MRI is extensively validated on multi-site, multi-field-strength (0.3T, 0.55T, and 3T), and multi-modality (T1-weighted, T2-weighted, T2-FLAIR, and dMRI) datasets and consistently outperforms state-of-the-art self-supervised methods, achieving quality comparable to supervised reconstruction methods without requiring fully sampled reference training data. Moreover, CoilDrop-MRI exhibits strong data efficiency and robust generalization across imaging conditions, establishing it as a practical and versatile framework for self-supervised parallel MRI reconstruction.

cs.CV↗

arXiv2025

A dynamic shim approach for correcting eddy current effects in diffusion-prepared MRI acquisition using a multi-coil AC/DC shim-array

Purpose: We developed a dynamic B0 shimming approach using a 46-channel AC/DC shim array to correct phase errors caused by eddy currents from diffusion-encoding gradients in diffusion-prepared MRI, enabling high b-value imaging without the SNR loss from the use of magnitude stabilizer. Methods: A 46-channel AC/DC shim array and corresponding amplifier system were built. Spin echo prescans with and without diffusion preparation were then used to rapidly measure eddy current induced phase differences. These phase maps were used as targets in an optimization framework to compute compensatory shim currents for multi-shot 3D diffusion-prepared acquisitions. Results: The proposed method allows flexible use of the AC/DC shim array to correct undesirable eddy current effects in diffusion-prepared MRI. Phantom and in vivo experiments demonstrate whole-brain, cardiac-gated, multi-shot 3D diffusion-prepared imaging without the use of magnitude stabilizers. The approach enables preservation of full SNR while achieving reliable diffusion encoding at b-values up to 2000 s/mm2. Conclusions: This work demonstrates a new strategy for applying an AC/DC shim array to compensate for eddy current induced phase errors in diffusion-prepared MRI. By eliminating the need for magnitude stabilizer, it enables efficient high-quality diffusion imaging with full signal sensitivity retained.

physics.med-ph↗

arXiv2025

Enhancing Diffusion-Weighted Images (DWI) for Diffusion MRI: Is it Enough without Non-Diffusion-Weighted B=0 Reference?

Diffusion MRI (dMRI) is essential for studying brain microstructure, but high-resolution imaging remains challenging due to the inherent trade-offs between acquisition time and signal-to-noise ratio (SNR). Conventional methods often optimize only the diffusion-weighted images (DWIs) without considering their relationship with the non-diffusion-weighted (b=0) reference images. However, calculating diffusion metrics, such as the apparent diffusion coefficient (ADC) and diffusion tensor with its derived metrics like fractional anisotropy (FA) and mean diffusivity (MD), relies on the ratio between each DWI and the b=0 image, which is crucial for clinical observation and diagnostics. In this study, we demonstrate that solely enhancing DWIs using a conventional pixel-wise mean squared error (MSE) loss is insufficient, as the error in ratio between generated DWIs and b=0 diverges. We propose a novel ratio loss, defined as the MSE loss between the predicted and ground-truth log of DWI/b=0 ratios. Our results show that incorporating the ratio loss significantly improves the convergence of this ratio error, achieving lower ratio MSE and slightly enhancing the peak signal-to-noise ratio (PSNR) of generated DWIs. This leads to improved dMRI super-resolution and better preservation of b=0 ratio-based features for the derivation of diffusion metrics.

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arXiv2025

Physics-Informed Implicit Neural Representations for Joint B0 Estimation and Echo Planar Imaging

Echo Planar Imaging (EPI) is widely used for its rapid acquisition but suffers from severe geometric distortions due to B0 inhomogeneities, particularly along the phase encoding direction. Existing methods follow a two-step process: reconstructing blip-up/down EPI images, then estimating B0, which can introduce error accumulation and reduce correction accuracy. This is especially problematic in high B0 regions, where distortions align along the same axis, making them harder to disentangle. In this work, we propose a novel approach that integrates Implicit Neural Representations (INRs) with a physics-informed correction model to jointly estimate B0 inhomogeneities and reconstruct distortion-free images from rotated-view EPI acquisitions. INRs offer a flexible, continuous representation that inherently captures complex spatial variations without requiring predefined grid-based field maps. By leveraging this property, our method dynamically adapts to subject-specific B0 variations and improves robustness across different imaging conditions. Experimental results on 180 slices of brain images from three subjects demonstrate that our approach outperforms traditional methods in terms of reconstruction quality and field estimation accuracy.

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arXiv2024

PRIME: Phase Reversed Interleaved Multi-Echo acquisition enables highly accelerated distortion-free diffusion MRI

Purpose: To develop and evaluate a new pulse sequence for highly accelerated distortion-free diffusion MRI (dMRI) by inserting additional echoes without prolonging TR, when generalized slice dithered enhanced resolution (gSlider) radiofrequency encoding is used for volumetric acquisition. Methods: A phase-reversed interleaved multi-echo acquisition (PRIME) was developed for rapid, high-resolution, and distortion-free dMRI, which includes several echoes where the first echo is for target diffusion-weighted imaging (DWI) acquisition with high-resolution and additional echoes are acquired with either lower resolution for 1) high-fidelity field map estimation, 2) phase navigation for shot-to-shot phase correction, 3) motion navigation across diffusion directions, or with high resolution to enable 4) high fidelity diffusion relaxometry acquisitions. The sequence was evaluated on in vivo data acquired from healthy volunteers on clinical and Connectome 2.0 scanners. Results: In vivo experiments demonstrated that 1) high in-plane acceleration (Rin-plane of 5-fold with 2D partial Fourier) was achieved using the high-fidelity field maps estimated from the second echo, which was made at a lower resolution/acceleration to increase its SNR while matching the effective echo spacing of the first readout, 2) high-resolution diffusion relaxometry parameters were estimated from triple-echo PRIME data using a white matter model of multi-TE spherical mean technique (MTE-SMT), and 3) high-fidelity mesoscale DWI at 490 um isotropic resolution was obtained in vivo by capitalizing on the high-performance gradients of the Connectome 2.0 scanner. Conclusion: The proposed PRIME sequence enabled highly accelerated, high-resolution, and distortion-free dMRI using additional echoes without prolonging scan time when gSlider encoding is utilized.

physics.med-ph↗

arXiv2024

Artificial Intelligence for Neuro MRI Acquisition: A Review

Magnetic resonance imaging (MRI) has significantly benefited from the resurgence of artificial intelligence (AI). By leveraging AI's capabilities in large-scale optimization and pattern recognition, innovative methods are transforming the MRI acquisition workflow, including planning, sequence design, and correction of acquisition artifacts. These emerging algorithms demonstrate substantial potential in enhancing the efficiency and throughput of acquisition steps. This review discusses several pivotal AI-based methods in neuro MRI acquisition, focusing on their technological advances, impact on clinical practice, and potential risks.

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arXiv2024

Advancing low-field MRI with a universal denoising imaging transformer: Towards fast and high-quality imaging

Recent developments in low-field (LF) magnetic resonance imaging (MRI) systems present remarkable opportunities for affordable and widespread MRI access. A robust denoising method to overcome the intrinsic low signal-noise-ratio (SNR) barrier is critical to the success of LF MRI. However, current data-driven MRI denoising methods predominantly handle magnitude images and rely on customized models with constrained data diversity and quantity, which exhibit limited generalizability in clinical applications across diverse MRI systems, pulse sequences, and organs. In this study, we present ImT-MRD: a complex-valued imaging transformer trained on a vast number of clinical MRI scans aiming at universal MR denoising at LF systems. Compared with averaging multiple-repeated scans for higher image SNR, the model obtains better image quality from fewer repetitions, demonstrating its capability for accelerating scans under various clinical settings. Moreover, with its complex-valued image input, the model can denoise intermediate results before advanced post-processing and prepare high-quality data for further MRI research. By delivering universal and accurate denoising across clinical and research tasks, our model holds great promise to expedite the evolution of LF MRI for accessible and equal biomedical applications.

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arXiv2024

Data and Physics driven Deep Learning Models for Fast MRI Reconstruction: Fundamentals and Methodologies

Magnetic Resonance Imaging (MRI) is a pivotal clinical diagnostic tool, yet its extended scanning times often compromise patient comfort and image quality, especially in volumetric, temporal and quantitative scans. This review elucidates recent advances in MRI acceleration via data and physics-driven models, leveraging techniques from algorithm unrolling models, enhancement-based methods, and plug-and-play models to the emerging full spectrum of generative model-based methods. We also explore the synergistic integration of data models with physics-based insights, encompassing the advancements in multi-coil hardware accelerations like parallel imaging and simultaneous multi-slice imaging, and the optimization of sampling patterns. We then focus on domain-specific challenges and opportunities, including image redundancy exploitation, image integrity, evaluation metrics, data heterogeneity, and model generalization. This work also discusses potential solutions and future research directions, with an emphasis on the role of data harmonization and federated learning for further improving the general applicability and performance of these methods in MRI reconstruction.

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arXiv2024

An Efficient Algorithm for Spatial-Spectral Partial Volume Compartment Mapping with Applications to Multicomponent Diffusion and Relaxation MRI

We introduce a new algorithm to solve a regularized spatial-spectral image estimation problem. Our approach is based on the linearized alternating directions method of multipliers (LADMM), which is a variation of the popular ADMM algorithm. Although LADMM has existed for some time, it has not been very widely used in the computational imaging literature. This is in part because there are many possible ways of mapping LADMM to a specific optimization problem, and it is nontrivial to find a computationally efficient implementation out of the many competing alternatives. We believe that our proposed implementation represents the first application of LADMM to the type of optimization problem considered in this work (involving a linear-mixture forward model, spatial regularization, and nonnegativity constraints). We evaluate our algorithm in a variety of multiparametric MRI partial volume mapping scenarios (diffusion-relaxation, relaxation-relaxation, relaxometry, and fingerprinting), where we consistently observe substantial ($\sim$3$\times$-50$\times$) speed improvements. We expect this to reduce barriers to using spatially-regularized partial volume compartment mapping methods. Further, the considerable improvements we observed also suggest the potential value of considering LADMM for a broader set of computational imaging problems.

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arXiv2024

Implicit Representation of GRAPPA Kernels for Fast MRI Reconstruction

MRI data is acquired in Fourier space/k-space. Data acquisition is typically performed on a Cartesian grid in this space to enable the use of a fast Fourier transform algorithm to achieve fast and efficient reconstruction. However, it has been shown that for multiple applications, non-Cartesian data acquisition can improve the performance of MR imaging by providing fast and more efficient data acquisition, and improving motion robustness. Nonetheless, the image reconstruction process of non-Cartesian data is more involved and can be time-consuming, even through the use of efficient algorithms such as non-uniform FFT (NUFFT). Reconstruction complexity is further exacerbated when imaging in the presence of field imperfections. This work (implicit GROG) provides an efficient approach to transform the field corrupted non-Cartesian data into clean Cartesian data, to achieve simpler and faster reconstruction which should help enable non-Cartesian data sampling to be performed more widely in MRI.

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arXiv2023

High-resolution myelin-water fraction and quantitative relaxation mapping using 3D ViSTa-MR fingerprinting

Purpose: This study aims to develop a high-resolution whole-brain multi-parametric quantitative MRI approach for simultaneous mapping of myelin-water fraction (MWF), T1, T2, and proton-density (PD), all within a clinically feasible scan time. Methods: We developed 3D ViSTa-MRF, which combined Visualization of Short Transverse relaxation time component (ViSTa) technique with MR Fingerprinting (MRF), to achieve high-fidelity whole-brain MWF and T1/T2/PD mapping on a clinical 3T scanner. To achieve fast acquisition and memory-efficient reconstruction, the ViSTa-MRF sequence leverages an optimized 3D tiny-golden-angle-shuffling spiral-projection acquisition and joint spatial-temporal subspace reconstruction with optimized preconditioning algorithm. With the proposed ViSTa-MRF approach, high-fidelity direct MWF mapping was achieved without a need for multi-compartment fitting that could introduce bias and/or noise from additional assumptions or priors. Results: The in-vivo results demonstrate the effectiveness of the proposed acquisition and reconstruction framework to provide fast multi-parametric mapping with high SNR and good quality. The in-vivo results of 1mm- and 0.66mm-iso datasets indicate that the MWF values measured by the proposed method are consistent with standard ViSTa results that are 30x slower with lower SNR. Furthermore, we applied the proposed method to enable 5-minute whole-brain 1mm-iso assessment of MWF and T1/T2/PD mappings for infant brain development and for post-mortem brain samples. Conclusions: In this work, we have developed a 3D ViSTa-MRF technique that enables the acquisition of whole-brain MWF, quantitative T1, T2, and PD maps at 1mm and 0.66mm isotropic resolution in 5 and 15 minutes, respectively. This advancement allows for quantitative investigations of myelination changes in the brain.

physics.med-ph↗

arXiv2023

Blip-Up Blip-Down Circular EPI (BUDA-cEPI) for Distortion-Free dMRI with Rapid Unrolled Deep Learning Reconstruction

Purpose: We implemented the blip-up, blip-down circular echo planar imaging (BUDA-cEPI) sequence with readout and phase partial Fourier to reduced off-resonance effect and T2* blurring. BUDA-cEPI reconstruction with S-based low-rank modeling of local k-space neighborhoods (S-LORAKS) is shown to be effective at reconstructing the highly under-sampled BUDA-cEPI data, but it is computationally intensive. Thus, we developed an ML-based reconstruction technique termed "BUDA-cEPI RUN-UP" to enable fast reconstruction. Methods: BUDA-cEPI RUN-UP - a model-based framework that incorporates off-resonance and eddy current effects was unrolled through an artificial neural network with only six gradient updates. The unrolled network alternates between data consistency (i.e., forward BUDA-cEPI and its adjoint) and regularization steps where U-Net plays a role as the regularizer. To handle the partial Fourier effect, the virtual coil concept was also incorporated into the reconstruction to effectively take advantage of the smooth phase prior, and trained to predict the ground-truth images obtained by BUDA-cEPI with S-LORAKS. Results: BUDA-cEPI with S-LORAKS reconstruction enabled the management of off-resonance, partial Fourier, and residual aliasing artifacts. However, the reconstruction time is approximately 225 seconds per slice, which may not be practical in a clinical setting. In contrast, the proposed BUDA-cEPI RUN-UP yielded similar results to BUDA-cEPI with S-LORAKS, with less than a 5% normalized root mean square error detected, while the reconstruction time is approximately 3 seconds. Conclusion: BUDA-cEPI RUN-UP was shown to reduce the reconstruction time by ~88x when compared to the state-of-the-art technique, while preserving imaging details as demonstrated through DTI application.

physics.med-ph↗

arXiv2023

AutoSamp: Autoencoding k-space Sampling via Variational Information Maximization for 3D MRI

Accelerated MRI protocols routinely involve a predefined sampling pattern that undersamples the k-space. Finding an optimal pattern can enhance the reconstruction quality, however this optimization is a challenging task. To address this challenge, we introduce a novel deep learning framework, AutoSamp, based on variational information maximization that enables joint optimization of sampling pattern and reconstruction of MRI scans. We represent the encoder as a non-uniform Fast Fourier Transform that allows continuous optimization of k-space sample locations on a non-Cartesian plane, and the decoder as a deep reconstruction network. Experiments on public 3D acquired MRI datasets show improved reconstruction quality of the proposed AutoSamp method over the prevailing variable density and variable density Poisson disc sampling for both compressed sensing and deep learning reconstructions. We demonstrate that our data-driven sampling optimization method achieves 4.4dB, 2.0dB, 0.75dB, 0.7dB PSNR improvements over reconstruction with Poisson Disc masks for acceleration factors of R = 5, 10, 15, 25, respectively. Prospectively accelerated acquisitions with 3D FSE sequences using our optimized sampling patterns exhibit improved image quality and sharpness. Furthermore, we analyze the characteristics of the learned sampling patterns with respect to changes in acceleration factor, measurement noise, underlying anatomy, and coil sensitivities. We show that all these factors contribute to the optimization result by affecting the sampling density, k-space coverage and point spread functions of the learned sampling patterns.

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arXiv2022

3D-EPI Blip-Up/Down Acquisition (BUDA) with CAIPI and Joint Hankel Structured Low-Rank Reconstruction for Rapid Distortion-Free High-Resolution T2* Mapping

Purpose: This work aims to develop a novel distortion-free 3D-EPI acquisition and image reconstruction technique for fast and robust, high-resolution, whole-brain imaging as well as quantitative T2* mapping. Methods: 3D-Blip-Up and -Down Acquisition (3D-BUDA) sequence is designed for both single- and multi-echo 3D GRE-EPI imaging using multiple shots with blip-up and -down readouts to encode B0 field map information. Complementary k-space coverage is achieved using controlled aliasing in parallel imaging (CAIPI) sampling across the shots. For image reconstruction, an iterative hard-thresholding algorithm is employed to minimize the cost function that combines field map information informed parallel imaging with the structured low-rank constraint for multi-shot 3D-BUDA data. Extending 3D-BUDA to multi-echo imaging permits T2* mapping. For this, we propose constructing a joint Hankel matrix along both echo and shot dimensions to improve the reconstruction. Results: Experimental results on in vivo multi-echo data demonstrate that, by performing joint reconstruction along with both echo and shot dimensions, reconstruction accuracy is improved compared to standard 3D-BUDA reconstruction. CAIPI sampling is further shown to enhance the image quality. For T2* mapping, T2* values from 3D-Joint-CAIPI-BUDA and reference multi-echo GRE are within limits of agreement as quantified by Bland-Altman analysis. Conclusions: The proposed technique enables rapid 3D distortion-free high-resolution imaging and T2* mapping. Specifically, 3D-BUDA enables 1-mm isotropic whole-brain imaging in 22 s at 3 T and 9 s on a 7 T scanner. The combination of multi-echo 3D-BUDA with CAIPI acquisition and joint reconstruction enables distortion-free whole-brain T2* mapping in 47 s at 1.1x1.1x1.0 mm3 resolution.

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