arXiv subjects

Lianrui Zuo

Publications and source records attributed to Lianrui Zuo.

At least 19 recordsLinked to original sources

arXiv2026

SliceBridge: context-consistent repair of corrupted slice intervals in T1-weighted MRI

Structural magnetic resonance imaging (MRI) images are sometimes corrupted over a contiguous set of slices, where acquisition, motion, hardware, or reconstruction effects leave a single slice or short interval inconsistent with its neighbors while the rest of the image remains usable. Such localized corruption can bias downstream morphometric analysis, yet discarding or reacquiring an otherwise usable image is costly. We formulate this as an image restoration problem: given the location of the affected interval, reconstruct those slices from the surrounding anatomical and imaging context. We propose SliceBridge, a framework for restoring corrupted slice intervals in T1-weighted MRI using rectified flow matching conditioned on the surrounding intact slices and their relative slice positions. Through-plane consistency is encouraged by coupling the slices within the interval through interval-correlated initial noise, a shared flow time, and synchronized sampling. The restored interval is then inserted back, leaving all other slices unchanged. We trained and validated the model on 9,877 T1-weighted brain MRI volumes from four datasets and evaluated it on 581 external subjects using clean interval withholding and controlled corruptions. Compared with a matched model that reconstructed target slices independently, SliceBridge reduced error in slice-to-slice changes within repaired intervals by 32.9%-41.3% across interval lengths and achieved higher SSIM at every interval length. In controlled-corruption cases, SliceBridge reduced the median error in regional brain volume estimates produced by a downstream segmentation model from 1.95% in corrupted volumes to 1.05%.

cs.CV↗

arXiv2026

Harmonizing MR Images Across 100+ Scanners: Multi-site Validation with Traveling Subjects and Real-world Protocols

Reliable harmonization of heterogeneous magnetic resonance~(MR) image datasets, especially those acquired in pragmatic clinical trials, is critical to advance multi-center neuroimaging studies and translational machine learning in healthcare. We present an enhanced and rigorously validated version of the HACA3 harmonization algorithm, which we refer to as HACA3$^+$, incorporating key methodological enhancements: (1)~an improved artifact encoder to better isolate and mitigate image artifacts, (2)~background and foreground-sensitive attention mechanisms to increase harmonization specificity, and (3)~extensive training using data spanning 100+ scanners from 64 independent sites, providing a broader diversity of scanners than other harmonization methods. Our study focuses on four commonly acquired MR image contrasts (T1-weighted, T2-weighted, proton density, \& fluid-attenuated inversion recovery), reflecting realistic clinical protocols. We perform inter-site harmonization experiments using traveling subjects to assess the generalization and robustness of the harmonization model. We compare the results of the publicly available version of HACA3 and our implementation, HACA3$^+$. Downstream relevance is further established through whole brain segmentation and image imputation. Finally, we justify each enhancement through an ablation experiment. Pre-trained weights and code for HACA3$^+$ are made publicly available at https://github.com/shays15/haca3-plus.

eess.IV↗

arXiv2026

Beyond the LUMIR challenge: The pathway to foundational registration models

Medical image challenges have played a transformative role in advancing the field, catalyzing innovation and establishing new performance benchmarks. Image registration, a foundational task in neuroimaging, has similarly advanced through the Learn2Reg initiative. Building on this, we introduce the Large-scale Unsupervised Brain MRI Image Registration (LUMIR) challenge, a next-generation benchmark for unsupervised brain MRI registration. Previous challenges relied upon anatomical label maps, however LUMIR provides 4,014 unlabeled T1-weighted MRIs for training, encouraging biologically plausible deformation modeling through self-supervision. Evaluation includes 590 in-domain test subjects and extensive zero-shot tasks across disease populations, imaging protocols, and species. Deep learning methods consistently achieved state-of-the-art performance and produced anatomically plausible, diffeomorphic deformation fields. They outperformed several leading optimization-based methods and remained robust to most domain shifts. These findings highlight the growing maturity of deep learning in neuroimaging registration and its potential to serve as a foundation model for general-purpose medical image registration.

eess.IV↗

arXiv2026

Unsupervised learning of acquisition variability in structural connectomes via hybrid latent space modeling

Acquisition differences across sites, scanners, and protocols in dMRI introduce variability that complicates structural connectome analysis. This motivates deep learning models that can represent high-dimensional connectomes in a low-dimensional space while explicitly separating acquisition-related effects from biological variation. Conventional dimensionality reduction methods model all variance as continuous, so acquisition effects often get absorbed into a continuous latent space. Recent hybrid latent-space models combine discrete and continuous components to address this, but typically require manual capacity tuning to ensure the discrete component captures the intended variability. We introduce an unsupervised framework that removes this manual tuning by architecturally annealing encoder outputs before decoding, allowing the model to adaptively balance discrete and continuous latent variables during training. To evaluate it, we curated a dataset of N=7,416 structural connectomes derived from dMRI, spanning ages 2 to 102 and 13 studies with 25 unique acquisition-parameter combinations. Of these, 5,900 are cognitively unimpaired, 877 have mild cognitive impairment (MCI), and 639 have Alzheimer's disease (AD). We compare against a standard VAE, PCA with k-means clustering, and hybrid models that anneal only through the loss function. Our architectural annealing produces stronger site learning (ARI=0.53, p<0.05) than these baselines. Results show that a hybrid continuous-discrete latent space, with architectural rather than loss-based annealing, provides a useful unsupervised mechanism for capturing acquisition variability in dMRI: by jointly modeling smooth and categorical structure, the Joint-VAE recovers clusters aligned with scanner and protocol differences.

cs.LG↗

arXiv2026

Evaluation of neuroCombat and deep learning harmonization for multi-site magnetic resonance neuroimaging in youth with prenatal alcohol exposure

In cases of prevalent diseases and disorders, such as Prenatal Alcohol Exposure (PAE), multi-site data collection allows for increased study samples. However, multi-site studies introduce additional variability through heterogeneous collection materials, such as scanner and acquisition protocols, which confound with biologically relevant signals. Neuroscientists often utilize statistical methods on image-derived metrics, such as volume of regions of interest, after all image processing to minimize site-related variance. HACA3, a deep learning harmonization method, offers an opportunity to harmonize image signals prior to metric quantification; however, HACA3 has not yet been validated in a pediatric cohort. In this work, we investigate HACA3's ability to remove site-related variance and preserve biologically relevant signal compared to a statistical method, neuroCombat, and pair HACA3 processing with neuroCombat to evaluate the efficacy of multiple harmonization methods in a pediatric (age 7 to 21) population across three unique scanners with controls and cases of PAE with downstream MaCRUISE volume metrics. We find that HACA3 qualitatively improves inter-site contrast variations, but statistical methods reduce greater site-related variance within the MaCRUISE volume metrics following an ANCOVA test, and HACA3 relies on follow-up statistical methods to approach maximal biological preservation in this context.

eess.IV↗

arXiv2026

An Artifact-based Agent Framework for Adaptive and Reproducible Medical Image Processing

Medical imaging research is increasingly shifting from controlled benchmark evaluation toward real-world clinical deployment. In such settings, applying analytical methods extends beyond model design to require dataset-aware workflow configuration and provenance tracking. Two requirements therefore become central: \textbf{adaptability}, the ability to configure workflows according to dataset-specific conditions and evolving analytical goals; and \textbf{reproducibility}, the guarantee that all transformations and decisions are explicitly recorded and re-executable. Here, we present an artifact-based agent framework that introduces a semantic layer to augment medical image processing. The framework formalizes intermediate and final outputs through an artifact contract, enabling structured interrogation of workflow state and goal-conditioned assembly of configurations from a modular rule library. Execution is delegated to a workflow executor to preserve deterministic computational graph construction and provenance tracking, while the agent operates locally to comply with most privacy constraints. We evaluate the framework on real-world clinical CT and MRI cohorts, demonstrating adaptive configuration synthesis, deterministic reproducibility across repeated executions, and artifact-grounded semantic querying. These results show that adaptive workflow configuration can be achieved without compromising reproducibility in heterogeneous clinical environments.

cs.AI↗

arXiv2025

MetaVoxel: Joint Diffusion Modeling of Imaging and Clinical Metadata

Modern deep learning methods have achieved impressive results across tasks from disease classification, estimating continuous biomarkers, to generating realistic medical images. Most of these approaches are trained to model conditional distributions defined by a specific predictive direction with a specific set of input variables. We introduce MetaVoxel, a generative joint diffusion modeling framework that models the joint distribution over imaging data and clinical metadata by learning a single diffusion process spanning all variables. By capturing the joint distribution, MetaVoxel unifies tasks that traditionally require separate conditional models and supports flexible zero-shot inference using arbitrary subsets of inputs without task-specific retraining. Using more than 10,000 T1-weighted MRI scans paired with clinical metadata from nine datasets, we show that a single MetaVoxel model can perform image generation, age estimation, and sex prediction, achieving performance comparable to established task-specific baselines. Additional experiments highlight its capabilities for flexible inference. Together, these findings demonstrate that joint multimodal diffusion offers a promising direction for unifying medical AI models and enabling broader clinical applicability.

cs.CV↗

arXiv2025

Synthetic multi-inversion time magnetic resonance images for visualization of subcortical structures

Purpose: Visualization of subcortical gray matter is essential in neuroscience and clinical practice, particularly for disease understanding and surgical planning.While multi-inversion time (multi-TI) T$_1$-weighted (T$_1$-w) magnetic resonance (MR) imaging improves visualization, it is rarely acquired in clinical settings. Approach: We present SyMTIC (Synthetic Multi-TI Contrasts), a deep learning method that generates synthetic multi-TI images using routinely acquired T$_1$-w, T$_2$-weighted (T$_2$-w), and FLAIR images. Our approach combines image translation via deep neural networks with imaging physics to estimate longitudinal relaxation time (T$_1$) and proton density (PD) maps. These maps are then used to compute multi-TI images with arbitrary inversion times. Results: SyMTIC was trained using paired MPRAGE and FGATIR images along with T$_2$-w and FLAIR images. It accurately synthesized multi-TI images from standard clinical inputs, achieving image quality comparable to that from explicitly acquired multi-TI data.The synthetic images, especially for TI values between 400-800 ms, enhanced visualization of subcortical structures and improved segmentation of thalamic nuclei. Conclusion: SyMTIC enables robust generation of high-quality multi-TI images from routine MR contrasts. It generalizes well to varied clinical datasets, including those with missing FLAIR images or unknown parameters, offering a practical solution for improving brain MR image visualization and analysis.

eess.IV↗

arXiv2025

Characterizing Continuous and Discrete Hybrid Latent Spaces for Structural Connectomes

Structural connectomes are detailed graphs that map how different brain regions are physically connected, offering critical insight into aging, cognition, and neurodegenerative diseases. However, these connectomes are high-dimensional and densely interconnected, which makes them difficult to interpret and analyze at scale. While low-dimensional spaces like PCA and autoencoders are often used to capture major sources of variation, their latent spaces are generally continuous and cannot fully reflect the mixed nature of variability in connectomes, which include both continuous (e.g., connectivity strength) and discrete factors (e.g., imaging site). Motivated by this, we propose a variational autoencoder (VAE) with a hybrid latent space that jointly models the discrete and continuous components. We analyze a large dataset of 5,761 connectomes from six Alzheimer's disease studies with ten acquisition protocols. Each connectome represents a single scan from a unique subject (3579 females, 2182 males), aged 22 to 102, with 4338 cognitively normal, 809 with mild cognitive impairment (MCI), and 614 with Alzheimer's disease (AD). Each connectome contains 121 brain regions defined by the BrainCOLOR atlas. We train our hybrid VAE in an unsupervised way and characterize what each latent component captures. We find that the discrete space is particularly effective at capturing subtle site-related differences, achieving an Adjusted Rand Index (ARI) of 0.65 with site labels, significantly outperforming PCA and a standard VAE followed by clustering (p < 0.05). These results demonstrate that the hybrid latent space can disentangle distinct sources of variability in connectomes in an unsupervised manner, offering potential for large-scale connectome analysis.

q-bio.NC↗

arXiv2025

Phenotype discovery of traumatic brain injury segmentations from heterogeneous multi-site data

Traumatic brain injury (TBI) is intrinsically heterogeneous, and typical clinical outcome measures like the Glasgow Coma Scale complicate this diversity. The large variability in severity and patient outcomes render it difficult to link structural damage to functional deficits. The Federal Interagency Traumatic Brain Injury Research (FITBIR) repository contains large-scale multi-site magnetic resonance imaging data of varying resolutions and acquisition parameters (25 shared studies with 7,693 sessions that have age, sex and TBI status defined - 5,811 TBI and 1,882 controls). To reveal shared pathways of injury of TBI through imaging, we analyzed T1-weighted images from these sessions by first harmonizing to a local dataset and segmenting 132 regions of interest (ROIs) in the brain. After running quality assurance, calculating the volumes of the ROIs, and removing outliers, we calculated the z-scores of volumes for all participants relative to the mean and standard deviation of the controls. We regressed out sex, age, and total brain volume with a multivariate linear regression, and we found significant differences in 37 ROIs between subjects with TBI and controls (p < 0.05 with independent t-tests with false discovery rate correction). We found that differences originated in 1) the brainstem, occipital pole and structures posterior to the orbit, 2) subcortical gray matter and insular cortex, and 3) cerebral and cerebellar white matter using independent component analysis and clustering the component loadings of those with TBI.

q-bio.QM↗

arXiv2025

MSRepaint: Multiple Sclerosis Repaint with Conditional Denoising Diffusion Implicit Model for Bidirectional Lesion Filling and Synthesis

In multiple sclerosis, lesions interfere with automated magnetic resonance imaging analyses such as brain parcellation and deformable registration, while lesion segmentation models are hindered by the limited availability of annotated training data. To address both issues, we propose MSRepaint, a unified diffusion-based generative model for bidirectional lesion filling and synthesis that restores anatomical continuity for downstream analyses and augments segmentation through realistic data generation. MSRepaint conditions on spatial lesion masks for voxel-level control, incorporates contrast dropout to handle missing inputs, integrates a repainting mechanism to preserve surrounding anatomy during lesion filling and synthesis, and employs a multi-view DDIM inversion and fusion pipeline for 3D consistency with fast inference. Extensive evaluations demonstrate the effectiveness of MSRepaint across multiple tasks. For lesion filling, we evaluate both the accuracy within the filled regions and the impact on downstream tasks including brain parcellation and deformable registration. MSRepaint outperforms the traditional lesion filling methods FSL and NiftySeg, and achieves accuracy on par with FastSurfer-LIT, a recent diffusion model-based inpainting method, while offering over 20 times faster inference. For lesion synthesis, state-of-the-art MS lesion segmentation models trained on MSRepaint-synthesized data outperform those trained on CarveMix-synthesized data or real ISBI challenge training data across multiple benchmarks, including the MICCAI 2016 and UMCL datasets. Additionally, we demonstrate that MSRepaint's unified bidirectional filling and synthesis capability, with full spatial control over lesion appearance, enables high-fidelity simulation of lesion evolution in longitudinal MS progression.

eess.IV↗

arXiv2025

Self-supervised learning of imaging and clinical signatures using a multimodal joint-embedding predictive architecture

The development of multimodal models for pulmonary nodule diagnosis is limited by the scarcity of labeled data and the tendency for these models to overfit on the training distribution. In this work, we leverage self-supervised learning from longitudinal and multimodal archives to address these challenges. We curate an unlabeled set of patients with CT scans and linked electronic health records from our home institution to power joint embedding predictive architecture (JEPA) pretraining. After supervised finetuning, we show that our approach outperforms an unregularized multimodal model and imaging-only model in an internal cohort (ours: 0.91, multimodal: 0.88, imaging-only: 0.73 AUC), but underperforms in an external cohort (ours: 0.72, imaging-only: 0.75 AUC). We develop a synthetic environment that characterizes the context in which JEPA may underperform. This work innovates an approach that leverages unlabeled multimodal medical archives to improve predictive models and demonstrates its advantages and limitations in pulmonary nodule diagnosis.

cs.CV↗

arXiv2025

Pitfalls of defacing whole-head MRI: re-identification risk with diffusion models and compromised research potential

Defacing is often applied to head magnetic resonance image (MRI) datasets prior to public release to address privacy concerns. The alteration of facial and nearby voxels has provoked discussions about the true capability of these techniques to ensure privacy as well as their impact on downstream tasks. With advancements in deep generative models, the extent to which defacing can protect privacy is uncertain. Additionally, while the altered voxels are known to contain valuable anatomical information, their potential to support research beyond the anatomical regions directly affected by defacing remains uncertain. To evaluate these considerations, we develop a refacing pipeline that recovers faces in defaced head MRIs using cascaded diffusion probabilistic models (DPMs). The DPMs are trained on images from 180 subjects and tested on images from 484 unseen subjects, 469 of whom are from a different dataset. To assess whether the altered voxels in defacing contain universally useful information, we also predict computed tomography (CT)-derived skeletal muscle radiodensity from facial voxels in both defaced and original MRIs. The results show that DPMs can generate high-fidelity faces that resemble the original faces from defaced images, with surface distances to the original faces significantly smaller than those of a population average face (p < 0.05). This performance also generalizes well to previously unseen datasets. For skeletal muscle radiodensity predictions, using defaced images results in significantly weaker Spearman's rank correlation coefficients compared to using original images (p < 10-4). For shin muscle, the correlation is statistically significant (p < 0.05) when using original images but not statistically significant (p > 0.05) when any defacing method is applied, suggesting that defacing might not only fail to protect privacy but also eliminate valuable information.

eess.IV↗

arXiv2025

Brain age identification from diffusion MRI synergistically predicts neurodegenerative disease

Estimated brain age from magnetic resonance image (MRI) and its deviation from chronological age can provide early insights into potential neurodegenerative diseases, supporting early detection and implementation of prevention strategies. Diffusion MRI (dMRI) presents an opportunity to build an earlier biomarker for neurodegenerative disease prediction because it captures subtle microstructural changes that precede more perceptible macrostructural changes. However, the coexistence of macro- and micro-structural information in dMRI raises the question of whether current dMRI-based brain age estimation models are leveraging the intended microstructural information or if they inadvertently rely on the macrostructural information. To develop a microstructure-specific brain age, we propose a method for brain age identification from dMRI that mitigates the model's use of macrostructural information by non-rigidly registering all images to a standard template. Imaging data from 13,398 participants across 12 datasets were used for the training and evaluation. We compare our brain age models, trained with and without macrostructural information mitigated, with an architecturally similar T1-weighted (T1w) MRI-based brain age model and two recent, popular, openly available T1w MRI-based brain age models that primarily use macrostructural information. We observe difference between our dMRI-based brain age and T1w MRI-based brain age across stages of neurodegeneration, with dMRI-based brain age being older than T1w MRI-based brain age in participants transitioning from cognitively normal (CN) to mild cognitive impairment (MCI), but younger in participants already diagnosed with Alzheimer's disease (AD). Furthermore, dMRI-based brain age may offer advantages over T1w MRI-based brain age in predicting the transition from CN to MCI up to five years before diagnosis.

cs.CV↗

arXiv2025

Surrogate Supervision for Robust and Generalizable Deformable Image Registration

Objective: Deep learning-based deformable image registration has achieved strong accuracy, but remains sensitive to variations in input image characteristics such as artifacts, field-of-view mismatch, or modality difference. We aim to develop a general training paradigm that improves the robustness and generalizability of registration networks. Methods: We introduce surrogate supervision, which decouples the input domain from the supervision domain by applying estimated spatial transformations to surrogate images. This allows training on heterogeneous inputs while ensuring supervision is computed in domains where similarity is well defined. We evaluate the framework through three representative applications: artifact-robust brain MR registration, mask-agnostic lung CT registration, and multi-modal MR registration. Results: Across tasks, surrogate supervision demonstrated strong resilience to input variations including inhomogeneity field, inconsistent field-of-view, and modality differences, while maintaining high performance on well-curated data. Conclusions: Surrogate supervision provides a principled framework for training robust and generalizable deep learning-based registration models without increasing complexity. Significance: Surrogate supervision offers a practical pathway to more robust and generalizable medical image registration, enabling broader applicability in diverse biomedical imaging scenarios.

cs.CV↗

arXiv2025

UNISELF: A Unified Network with Instance Normalization and Self-Ensembled Lesion Fusion for Multiple Sclerosis Lesion Segmentation

Automated segmentation of multiple sclerosis (MS) lesions using multicontrast magnetic resonance (MR) images improves efficiency and reproducibility compared to manual delineation, with deep learning (DL) methods achieving state-of-the-art performance. However, these DL-based methods have yet to simultaneously optimize in-domain accuracy and out-of-domain generalization when trained on a single source with limited data, or their performance has been unsatisfactory. To fill this gap, we propose a method called UNISELF, which achieves high accuracy within a single training domain while demonstrating strong generalizability across multiple out-of-domain test datasets. UNISELF employs a novel test-time self-ensembled lesion fusion to improve segmentation accuracy, and leverages test-time instance normalization (TTIN) of latent features to address domain shifts and missing input contrasts. Trained on the ISBI 2015 longitudinal MS segmentation challenge training dataset, UNISELF ranks among the best-performing methods on the challenge test dataset. Additionally, UNISELF outperforms all benchmark methods trained on the same ISBI training data across diverse out-of-domain test datasets with domain shifts and missing contrasts, including the public MICCAI 2016 and UMCL datasets, as well as a private multisite dataset. These test datasets exhibit domain shifts and/or missing contrasts caused by variations in acquisition protocols, scanner types, and imaging artifacts arising from imperfect acquisition. Our code is available at https://github.com/uponacceptance.

eess.IV↗

arXiv2025

Multi-Modality Conditioned Variational U-Net for Field-of-View Extension in Brain Diffusion MRI

An incomplete field-of-view (FOV) in diffusion magnetic resonance imaging (dMRI) can severely hinder the volumetric and bundle analyses of whole-brain white matter connectivity. Although existing works have investigated imputing the missing regions using deep generative models, it remains unclear how to specifically utilize additional information from paired multi-modality data and whether this can enhance the imputation quality and be useful for downstream tractography. To fill this gap, we propose a novel framework for imputing dMRI scans in the incomplete part of the FOV by integrating the learned diffusion features in the acquired part of the FOV to the complete brain anatomical structure. We hypothesize that by this design the proposed framework can enhance the imputation performance of the dMRI scans and therefore be useful for repairing whole-brain tractography in corrupted dMRI scans with incomplete FOV. We tested our framework on two cohorts from different sites with a total of 96 subjects and compared it with a baseline imputation method that treats the information from T1w and dMRI scans equally. The proposed framework achieved significant improvements in imputation performance, as demonstrated by angular correlation coefficient (p < 1E-5), and in downstream tractography accuracy, as demonstrated by Dice score (p < 0.01). Results suggest that the proposed framework improved imputation performance in dMRI scans by specifically utilizing additional information from paired multi-modality data, compared with the baseline method. The imputation achieved by the proposed framework enhances whole brain tractography, and therefore reduces the uncertainty when analyzing bundles associated with neurodegenerative.

cs.CV↗

arXiv2025

Multipath cycleGAN for harmonization of paired and unpaired low-dose lung computed tomography reconstruction kernels

Reconstruction kernels in computed tomography (CT) affect spatial resolution and noise characteristics, introducing systematic variability in quantitative imaging measurements such as emphysema quantification. Choosing an appropriate kernel is therefore essential for consistent quantitative analysis. We propose a multipath cycleGAN model for CT kernel harmonization, trained on a mixture of paired and unpaired data from a low-dose lung cancer screening cohort. The model features domain-specific encoders and decoders with a shared latent space and uses discriminators tailored for each domain.We train the model on 42 kernel combinations using 100 scans each from seven representative kernels in the National Lung Screening Trial (NLST) dataset. To evaluate performance, 240 scans from each kernel are harmonized to a reference soft kernel, and emphysema is quantified before and after harmonization. A general linear model assesses the impact of age, sex, smoking status, and kernel on emphysema. We also evaluate harmonization from soft kernels to a reference hard kernel. To assess anatomical consistency, we compare segmentations of lung vessels, muscle, and subcutaneous adipose tissue generated by TotalSegmentator between harmonized and original images. Our model is benchmarked against traditional and switchable cycleGANs. For paired kernels, our approach reduces bias in emphysema scores, as seen in Bland-Altman plots (p<0.05). For unpaired kernels, harmonization eliminates confounding differences in emphysema (p>0.05). High Dice scores confirm preservation of muscle and fat anatomy, while lung vessel overlap remains reasonable. Overall, our shared latent space multipath cycleGAN enables robust harmonization across paired and unpaired CT kernels, improving emphysema quantification and preserving anatomical fidelity.

eess.IV↗