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Julia A. Schnabel

Publications and source records attributed to Julia A. Schnabel.

At least 19 recordsLinked to original sources
arXiv2026

PET Quantification-Preserving Registration for Longitudinal Whole-Body PSMA PET/CT

We adapt the diffeomorphic coarse-to-fine LapIRN architecture for longitudinal whole-body PSMA PET/CT registration in the Learn2Reg 2026 PSMAReg challenge. The method combines affine pre-registration, multi-modal deformable registration, and test-time instance optimization. We further introduce PET biomarker preservation losses for metabolic tumor volume (MTV) and total lesion glycolysis (TLG), including Jacobian-based constraints, and a per-structure rigidity regularization for skeletal structures. The submitted configuration achieved 81.0% DSC and 6.17 mm HD95, with MTV and TLG errors of 3.3% and 3.3%, respectively, on our evaluation protocol. Code is available at https://github.com/koegl/psmareg.

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arXiv2026

nnFoundation: 3D Foundation Models for Radiology

Radiological artificial intelligence has advanced rapidly, yet most systems remain narrowly task-specific, data-intensive, and fragile under domain shift. Foundation models promise more transferable and data-efficient solutions, but existing approaches are limited in scale, evaluated narrowly, and often assume that a single pretrained model can support diverse downstream tasks. Here we present nnFoundation, complementary convolutional and transformer-based 3D radiological foundation models. Developed within the Human Radiome Project (THRP), nnFoundation is trained on 2.1 million CT, MRI, and PET image volumes from 125 institutional and public datasets. We evaluate them across 108 tasks spanning segmentation, detection, classification, report generation, and image retrieval, including evaluations under domain shift, by external partners and in low-data and low-compute regimes. Across all task types, our convolution- and transformer-based nnFoundation models consistently outperform both prior 3D foundation models and training from scratch, establishing state-of-the-art performance for radiological imaging. However, performance follows a consistent task-dependent structure: the convolutional nnFoundation model dominates spatially localized tasks, whereas the transformer-based nnFoundation model excels in tasks requiring global semantic reasoning and in frozen-feature settings. Dynamically aligning the foundation model topology with the dataset characteristics post-hoc further improves transfer across heterogeneous 3D settings. These results show that transferable 3D radiological performance is governed not by a single universal model, but by the interplay of scalable pretraining, complementary architectures, and dataset-aware adaptation. We release nnFoundation models integrated into nnU-Net and nnDetection, enabling immediate application across established radiology workflows.

cs.CV↗
arXiv2026

Applications of Neural Cellular Automata: State of the Art, Challenges and Opportunities

Neural Cellular Automata (NCAs) are a new type of neural network architecture which enable accurate and robust inference at extremely small model sizes. Recently, NCAs have advanced to become interesting low-resource alternatives to convolution- and attention-based architectures for various tasks such as image analysis, synthetic image generation, and simulation. The rapid development and increased research interest necessitate a comprehensive review of the emerging technology. This review provides an overview of the fundamentals of NCAs, applications to medical imaging, as well as insights into the state of the art. We analyze recent modifications to the originally proposed NCA architecture with respect to their efficiency and accuracy. Furthermore, we review practical applications in real-world scenarios with a focus on medical image analysis, segmentation, classification, registration, depth estimation, and image synthesis. Finally, we identify several advantages of NCAs, research gaps, and conclude with an analysis of future opportunities for NCAs in medical applications in confined settings or areas that have particular demands for robustness or efficient data processing.

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arXiv2026

Generative Priors for Total-Body PET Reconstruction

Total-body positron emission tomography (TB-PET) enables fast, low-dose, and dynamic imaging over a long axial field of view, but reconstruction remains challenging due to reduced counts, large image volumes, and increased data dimensionality. Generative models offer powerful learned priors for low-count PET, yet explicit PET measurement conditioning at TB scale has not been demonstrated. Inspired by PET decomposed diffusion sampling (PET-DDS), we propose TB-PET-DDS, a reconstruction framework that combines a CT-conditioned generative prior with patient-specific list-mode PET data. During reverse diffusion, PET consistency is enforced using a closed-form 3D TB-PET maximum-a-posteriori expectation maximisation fusion update, rather than relying solely on image-domain conditioning. The synthetic measurements are generated from the low-dose vendor reconstruction, providing a controlled inverse problem and retaining a full-dose reference. Proof-of-concept evaluation was performed on a single clinical TB-PET acquisition, with reconstruction hyperparameters selected against the full-dose reconstruction from the same case for all models. TB-PET-DDS improved NRMSE and SSIM relative to the DDIM and Image-DDS baselines, improving through-plane consistency in coronal views while enhancing agreement with the measured PET data. Although smoothed low-dose vendor reconstructions achieved the best global voxel-wise metrics, TB-PET-DDS produced the lowest liver coefficient of variation. These results demonstrate the feasibility of measurement conditioned diffusion reconstruction at TB scale and provide an initial route towards learned, projector-consistent generative reconstruction for low-count TB-PET imaging.

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arXiv2026

Atlas of MICCAI: 28 Years of Representation, Collaboration, and the Road to Inclusion

Scientific knowledge in medical image analysis is shaped by venues such as the Medical Image Computing and Computer-Assisted Intervention (MICCAI) conference, which influence research agendas, professional credibility, and access to opportunity. As AI methods increasingly depend on large-scale data and compute, these dynamics risk further concentrating influence within already well-resourced regions and institutions. Prior meta-research on MICCAI has examined reproducibility, evaluation, and citation practices, but offers limited insight into who participates in and shapes the field. To better understand these dynamics, we conduct a longitudinal bibliometric analysis of the geographic and institutional structure of the MICCAI community, drawing on 9,748 papers published between 1998 and 2025. We find that the USA and China together account for nearly half of all publications, that high-income countries dominate collaboration networks as central and bridging nodes, while lower-income countries remain peripheral, and that participation inequality (Gini index 0.86-0.91 among contributing countries) has declined only marginally over 28 years. We further analyze the evolution of research topics between 2021 and 2025, distinguishing stable core pillars (e.g., segmentation, diagnosis, MRI/CT) from emerging paradigms (e.g., foundation models), and identify a persistent long tail of underexplored application-method and organ-modality intersections. To support transparency and reproducibility, we introduce the Atlas of MICCAI dataset and an interactive dashboard. We contextualize these findings within existing MICCAI equity initiatives, and propose actionable recommendations to reduce participation barriers, build research capacity, and recognize a wider range of scientific contributions.

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arXiv2026

Whole-Body MRI Classification via Prompt-Based Clinical Conditioning

Combining whole-body magnetic resonance imaging (WB-MRI) with clinical variables has the potential to improve systemic disease diagnosis by leveraging complementary sources of patient information. However, structured clinical variables are often incomplete or missing, limiting the applicability of conventional multimodal fusion methods that assume fixed inputs. In this work, we propose TACTIC (Tabular-Attribute Conditioned Transformer for Image Classification), a prompt-based multimodal framework that integrates WB-MRI and structured clinical data through conditional visual feature learning. By encoding clinical attributes as prompts, TACTIC supports an arbitrary number of tabular inputs and naturally handles missing data without requiring imputation or fixed input structures. We evaluate TACTIC on five WB-MRI classification tasks spanning systemic and oncologic applications, including diabetes, chronic obstructive pulmonary disease (COPD), breast cancer, prostate cancer, and metastasis diagnosis. Across all tasks, TACTIC consistently improves performance over image-only baselines when clinical information is available while maintaining strong predictive capability under incomplete tabular inputs. Our results demonstrate the effectiveness of prompt-based models as a flexible approach for improving WB-MRI analysis using clinical context. The model weights and code are available at https://github.com/lauradaza/TACTIC

cs.CV↗
arXiv2026

CUPA-T2*: Covariance-Aware Uncertainty Propagation and Alignment for T2* Mapping in Accelerated MRI

Quantitative T2* maps have strong potential for biomarker discovery but are limited by long scan times, rendering them impractical in clinical settings. Significant acceleration can be achieved through undersampling in k-space combined with learning-based reconstruction. However, reconstruction artifacts and noise can propagate into downstream T2* fitting, degrading its accuracy. We introduce CUPA-T2*, a framework that explicitly propagates voxel-wise inter-echo uncertainty from stochastic Monte Carlo dropout reconstructions to downstream T2* fitting via covariance-aware sampling. T2* fitting is performed with a heteroscedastic MLP and a correlation-based regularizer that encourages alignment between predicted variance and reconstruction uncertainty. Experiments on accelerated brain MRI data show tissue-dependent behavior: CUPA-T2* achieves competitive overall T2* fitting performance and improves white-matter performance at higher accelerations. Compared with a heteroscedastic baseline, the proposed framework substantially increases alignment between reconstruction uncertainty and predicted T2* variance, while also revealing a trade-off with calibration (ECE) and selective prediction performance (AURC). CUPA-T2* enables reconstruction uncertainty-aware T2* fitting and delivers voxel-wise uncertainty maps to support the interpretation of quantitative T2* estimates.

cs.CV↗
arXiv2026

Primitive Representation Learning for Unsupervised Dynamic Contrast Enhanced MRI Reconstruction

Reliable quantitative analysis of dynamic contrast-enhanced MRI requires high-quality spatiotemporal reconstructions at high undersampling rates. Scan-specific reconstructions using Gaussian and Gabor primitives have shown promising results without the need for large training datasets, but have not addressed the additional dimension of dynamic contrast. We propose a multi-dimensional, primitive based framework for dynamic contrast-enhanced MRI reconstruction that disentangles the underlying anatomy, the dynamic contrast enhancement, and residual motion into separate temporal basis functions, thereby enabling a geometrical interpretation of the representation. We show that this architecture achieves performance competitive with conventional reconstruction methods, both in reconstruction quality and in the accuracy of extracted aorta and kidney enhancement curves. The modular tier design extends naturally to additional dynamic factors and higher acceleration rates. Code available at https://github.com/compai-lab/2026-GaborDCE-spieker.

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arXiv2026

Dense Temporal Contrast Synthesis via Conditioned Latent Transport

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is essential for breast cancer management, but reliance on gadolinium-based contrast agents (GBCAs) restricts use in contraindicated populations, prolongs scan protocols, and presents environmental toxicity concerns. Contrast synthesis offers a non-invasive alternative; however, existing approaches struggle to balance spatial realism with temporal continuity, suffer from slow iterative sampling, underutilize structural priors, and lack clinical validation. We propose a novel conditioned latent transport framework that predicts contrast enhancement in a single forward pass. By anchoring the latent trajectory to the pre-contrast anatomy and applying continuous time conditioning, the model synthesizes patient-specific contrast evolution at any acquisition time. The proposed approach outperforms baseline and the state-of-the-art models across spatial, perceptual, temporal, and distributional metrics. Evaluated on an independent external cohort, the method demonstrates robustness to domain shifts induced by scanner noise as well as differing acquisition protocol. Furthermore, our synthetic contrast enhancement significantly improved downstream tumor segmentation performance, yielding a 22.4% relative increase in Dice coefficient (0.60 vs. 0.49 baseline pre-contrast, p < 0.01), reducing boundary segmentation error by over 39%, while outperforming all other generative model baselines. Finally, a reader study involving four breast radiologists evaluated the image quality, kinetic fidelity, and diagnostic viability of our synthesized sequences across 40 randomly selected cases. The results demonstrated that in 70% of cases, synthesized images provided sufficient clinical information to support the same management decisions as real DCE-MRI, suggesting a path toward safer and faster contrast-free or contrast-reduced imaging workflows.

cs.CV↗
arXiv2026

Graph Representation Learning of Longitudinal Medical Imaging Trajectories for Treatment Response Prediction

In patients with breast cancer, pathological complete response (pCR) has been established as a clinically meaningful surrogate marker for long-term outcomes. While commonly treated with neoadjuvant chemotherapy (NACT), effective treatment decision-making remains challenging, as therapeutic response can vary substantially across patients, calling for predictive models capable of accurately estimating individualized treatment response. To address this, we propose an imaging-based 3D spatio-temporal framework for treatment response prediction that integrates a state-of-the-art graph neural network with relational modeling of temporal interactions across timepoints alongside three novel complementary self-supervised treatment trajectory representation learning objectives. Experiments across a cohort of 585 patients from the public ISPY-2 dataset demonstrate that our method substantially outperforms both vision and self-supervised learning baselines across several classification metrics. Alongside establishing a breast cancer pCR prediction benchmark, we include a principled ablation of our method and further introduce and empirically assess the impact of the available number of DCE-MRI timepoints per patient trajectory and the inclusion of inter-scan time-differences. Overall, our study substantiates the utility of clinically meaningful longitudinal medical imagaging modeling for predicting NACT-induced pCR. We will publicly share our code repository and a user-friendly PyPI library for dataset curation upon publication, effectively promoting reproducible open-source research.

cs.CV↗
arXiv2026

Entropy Minimization without Model Collapse: Mitigating Prediction Bias in Medical Imaging

Entropy minimization (EM) is the dominant objective for test-time adaptation, yet its failure mode, model collapse, remains poorly understood. In this work, we show that distribution shifts can cause feature clusters corresponding to distinct classes in the model's representation space to merge, while the decision boundary remains fixed. This induces a systematic skew in the predicted class distribution, referred to as prediction bias. Prediction bias refers to a shift in the predicted class distribution, with some classes overrepresented and others suppressed. We show that entropy minimization amplifies this prediction bias by tightening the existing clusters, reinforcing the incorrect groupings until all predictions collapse to a trivial solution. Next, to demonstrate the significance of prediction bias and mitigate it, we further propose Distribution Shift Bias Reduction (DSBR), a bias-correcting objective that specifically targets this failure mode by equalizing the contribution of each predicted class to the unsupervised entropy minimization loss. To study this failure mode, we design suitable adaptation settings using four medical-imaging datasets and additionally evaluate on ImageNet-C. We find that DSBR consistently stabilizes test-time adaptation, prevents model collapse, and matches or outperforms state-of-the-art methods. Moreover, DSBR operates solely at test-time.

cs.LG↗
arXiv2026

Dynamic Decision Learning: Test-Time Evolution for Abnormality Grounding in Rare Diseases

Clinical abnormality grounding for rare diseases is often hindered by data scarcity, making supervised fine-tuning impractical and single-pass inference highly unstable. We propose Dynamic Decision Learning (DDL), a framework that enables frozen large vision-language models (LVLMs) to refine their decisions across both language and visual spaces by optimizing instructions and consolidating predictions under visual perturbations. This process improves localization quality and produces a consensus-based reliability score that quantifies model confidence. Results on brain imaging benchmarks, including a rare-disease dataset with 281 pathology types across models ranging from 3B to 72B parameters, show that DDL improves mAP@75 by up to 105% on rare-disease cases and outperforms adaptation baselines and supervised fine-tuning. Furthermore, DDL demonstrates stronger calibration between reliability scores and localization accuracy under severe distribution shifts and increasing task difficulty. Code is available at: https://lijunrio.github.io/DDL/

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arXiv2026

Hierarchical Adaptive networks with Task vectors for Test-Time Adaptation

Test-time adaptation allows pretrained models to adjust to incoming data streams, addressing distribution shifts between source and target domains. However, standard methods rely on single-dimensional linear classification layers, which often fail to handle diverse and complex shifts. We propose Hierarchical Adaptive Networks with Task Vectors (Hi-Vec), which leverages multiple layers of increasing size for dynamic test-time adaptation. By decomposing the encoder's representation space into such hierarchically organized layers, Hi-Vec, in a plug-and-play manner, allows existing methods to adapt to shifts of varying complexity. Our contributions are threefold: First, we propose dynamic layer selection for automatic identification of the optimal layer for adaptation to each test batch. Second, we propose a mechanism that merges weights from the dynamic layer to other layers, ensuring all layers receive target information. Third, we propose linear layer agreement that acts as a gating function, preventing erroneous fine-tuning by adaptation on noisy batches. We rigorously evaluate the performance of Hi-Vec in challenging scenarios and on multiple target datasets, proving its strong capability to advance state-of-the-art methods. Our results show that Hi-Vec improves robustness, addresses uncertainty, and handles limited batch sizes and increased outlier rates.

cs.LG↗
arXiv2026

Gabor Primitives for Accelerated Cardiac Cine MRI Reconstruction

Accelerated cardiac cine MRI requires reconstructing spatiotemporal images from highly undersampled k-space data. Implicit neural representations (INRs) enable scan-specific reconstruction without large training datasets, but encode content implicitly in network weights without physically interpretable parameters. Gaussian primitives provide an explicit and geometrically interpretable alternative, but their spectra are confined near the k-space origin, limiting high-frequency representation. We propose Gabor primitives for MRI reconstruction, modulating each Gaussian envelope with a complex exponential to place its spectral support at an arbitrary k-space location, enabling efficient representation of both smooth structures and sharp boundaries. To exploit spatiotemporal redundancy in cardiac cine, we decompose per-primitive temporal variation into a low-rank geometry basis capturing cardiac motion and a signal-intensity basis modeling contrast changes. Experiments on cardiac cine data with Cartesian and radial trajectories show that Gabor primitives consistently outperform compressed sensing, Gaussian primitives, and hash-grid INR baselines, while providing a compact, continuous-resolution representation with physically meaningful parameters.

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arXiv2026

The Mean is the Mirage: Entropy-Adaptive Model Merging under Heterogeneous Domain Shifts in Medical Imaging

Model merging under unseen test-time distribution shifts often renders naive strategies, such as mean averaging unreliable. This challenge is especially acute in medical imaging, where models are fine-tuned locally at clinics on private data, producing domain-specific models that differ by scanner, protocol, and population. When deployed at an unseen clinical site, test cases arrive in unlabeled, non-i.i.d. batches, and the model must adapt immediately without labels. In this work, we introduce an entropy-adaptive, fully online model-merging method that yields a batch-specific merged model via only forward passes, effectively leveraging target information. We further demonstrate why mean merging is prone to failure and misaligned under heterogeneous domain shifts. Next, we mitigate encoder classifier mismatch by decoupling the encoder and classification head, merging with separate merging coefficients. We extensively evaluate our method with state-of-the-art baselines using two backbones across nine medical and natural-domain generalization image classification datasets, showing consistent gains across standard evaluation and challenging scenarios. These performance gains are achieved while retaining single-model inference at test-time, thereby demonstrating the effectiveness of our method.

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arXiv2026

MedDIFT: Multi-Scale Diffusion-Based Correspondence in 3D Medical Imaging

Accurate spatial correspondence between medical images is essential for longitudinal analysis, lesion tracking, and image-guided interventions. Medical image registration methods rely on local intensity-based similarity measures, which fail to capture global semantic structure and often yield mismatches in low-contrast or anatomically variable regions. Recent advances in diffusion models suggest that their intermediate representations encode rich geometric and semantic information. We present MedDIFT, a training-free 3D correspondence framework that leverages multi-scale features from a pretrained latent medical diffusion model as voxel descriptors. MedDIFT fuses diffusion activations into rich voxel-wise descriptors and matches them via cosine similarity, with an optional local-search prior. On a publicly available lung CT dataset, MedDIFT shows promising capability in identifying anatomical correspondence without requiring any task-specific model training. Ablation experiments confirm that multi-level feature fusion and modest diffusion noise improve performance. Code is available online.

cs.CV↗
arXiv2026

A Master Class on Reproducibility: A Student Hackathon on Advanced MRI Reconstruction Methods

We report the design, protocol, and outcomes of a student reproducibility hackathon focused on replicating the results of three influential MRI reconstruction papers: (a) MoDL, an unrolled model-based network with learned denoising; (b) HUMUS-Net, a hybrid unrolled multiscale CNN+Transformer architecture; and (c) an untrained, physics-regularized dynamic MRI method that uses a quantitative MR model for early stopping. We describe the setup of the hackathon and present reproduction outcomes alongside additional experiments, and we detail fundamental practices for building reproducible codebases.

cs.LG↗
arXiv2026

LocBAM: Advancing 3D Patch-Based Image Segmentation by Integrating Location Contex

Patch-based methods are widely used in 3D medical image segmentation to address memory constraints in processing high-resolution volumetric data. However, these approaches often neglect the patch's location within the global volume, which can limit segmentation performance when anatomical context is important. In this paper, we investigate the role of location context in patch-based 3D segmentation and propose a novel attention mechanism, LocBAM, that explicitly processes spatial information. Experiments on BTCV, AMOS22, and KiTS23 demonstrate that incorporating location context stabilizes training and improves segmentation performance, particularly under low patch-to-volume coverage where global context is missing. Furthermore, LocBAM consistently outperforms classical coordinate encoding via CoordConv. Code is publicly available at https://github.com/compai-lab/2026-ISBI-hooft

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