arXiv subjects

Paolo Soda

Publications and source records attributed to Paolo Soda.

At least 19 recordsLinked to original sources

arXiv2026

3D CT-to-PET Translation via Latent Brownian Bridge Diffusion

Computed tomography (CT) and positron emission tomography (PET) provide complementary anatomical and functional information for cancer diagnosis and treatment planning. However, the widespread use of PET is limited by high radiation exposure, elevated costs, and restricted availability. To address these limitations, deep learning-based CT-to-PET translation has emerged as a promising approach for synthesizing PET-like information directly from CT images, although accurately modeling the large cross-modal gap remains challenging. In this work, we propose a 3D CT-to-PET translation framework based on latent Brownian Bridge Diffusion (BBDM). The method consists of two stages. First, a Variational Autoencoder (VAE) is trained on paired CT-PET patches, integrating contrastive learning to improve latent alignment between anatomical and metabolic representations. Second, a BBDM is trained in the latent space to translate CT latent representations into their corresponding PET counterparts. The translated PET latents are then decoded and stitched to reconstruct the final 3D PET volume. We evaluate the proposed approach on two publicly available datasets. Quantitative results based on image fidelity and lesion-level PET-specific metrics demonstrate improved performance compared with competing methods. In particular, the proposed approach improves PET signal fidelity, better preserves clinically relevant uptake patterns, and shows improved performance in preserving small-lesion metabolic activation, paving the way for virtual imaging applications.

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arXiv2026

VegSim: A Geospatial World Model for Scenario-Conditioned Vegetation Simulation

Vegetation monitoring under climate stress requires answering not only how it will evolve given the expected weather, but how it would respond to alternative meteorological conditions. Forecasting models return the expected vegetation state for the observed weather and cannot answer these scenario-conditioned questions, because future weather is fixed to the recorded trajectory. We present VegSim, a geospatial world model for scenario-conditioned vegetation simulation. VegSim infers a latent vegetation state from sparse satellite-derived NDVI histories, past meteorological covariates, and static spatial context, propagates it forward under future weather forcing through recurrent latent dynamics, and decodes predictive NDVI quantiles at each lead time. Because future forcing enters as a controllable input, the same trained model supports probabilistic forecasting under observed weather and conditional simulation under user-defined meteorological forcing, without supervision on scenario responses. We evaluate VegSim on GreenEarthNet across in-distribution data and spatial, temporal, and joint spatio-temporal shifts, where it achieves strong point and probabilistic accuracy against time series and Earth Observation forecasting baselines while using a compact architecture. We then simulate vegetation responses across Europe under two contrasting meteorological scenarios, obtaining a weak but broadly positive response under winter wet warming and a widespread negative response under summer drought. The code is available at https://github.com/arco-group/vegsim.

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arXiv2026

Compositional Cross-Modality Translation via Whole-Volume Multitask Latent Flow Matching

Cross-modality medical image translation can reduce the burden of multi-modal acquisitions, yet the field remains constrained by two coupled limitations: methods operate on 2D slices or 3D patches rather than whole volumes, and train a separate model for each translation task. Both stem from a single cause, the absence of a sufficiently strong volumetric prior, which forces generative models to learn anatomical appearance and cross-modality mapping simultaneously, an ill-posed problem at the scale of available paired datasets. We propose to decouple these objectives. A large-scale pretrained 3D variational autoencoder provides a compact latent representation of volumetric appearance, reducing translation to a conditional flow-matching problem. This compression makes whole-volume processing tractable, while a resolution-aware sampling strategy preserves native anatomical scale. We train a single model jointly across inter-modality (MRI$\to$CT, CBCT$\to$CT) and intra-modality (MRI$\to$MRI) tasks over three multi-center datasets. Across all tasks, whole-volume processing outperforms its patch-based counterpart, and the multi-task model matches task-specific baselines while replacing $N$ networks with one. Crucially, joint training unlocks capabilities inaccessible to task-specific approaches: zero-shot generalization to anatomical regions unseen during training, within 0.15 SSIM of the fully supervised model, and compositional cross-dataset translation along paths never directly supervised. These results suggest that combining a strong volumetric prior with multitask training is a scalable route toward synthesis systems that generalize beyond their training distribution. Code is available at https://github.com/arco-group/Whole-Volume-Latent-FM.

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arXiv2026

Is Self-Pretraining really useful to improve diagnosis in medical Time Series?

Inspired by recent evidence that transformer architectures benefit from Self-PreTraining (SPT) on long-context benchmarks, we investigate whether similar gains extend to multimodal, multivariate, and even simple univariate medical time series. Our objective is to assess the impact of SPT on the performance and scalability of transformer-based models across diverse medical applications, particularly under limited data conditions. We evaluate transformer architectures on three representative medical time-series tasks: rehabilitation robotics (Camargo dataset), stress detection (Non-EEG Stress), and Parkinson's disease detection (Gait Parkinson's Disease). Models are trained either from scratch or through SPT using four masking-based objectives designed to promote temporal and cross-modal representation learning, and we systematically vary model depth to examine how capacity interacts with pre-training benefits. Across datasets and configurations, SPT consistently improves classification accuracy by 0-6 percentage points depending on masking strategy, dataset and architecture, with gains observed not only in multivariate settings but also when models are restricted to simple univariate inputs. The improvements increase for deeper models that can better exploit the enriched temporal representations learned during pre-training. These findings indicate that SPT is a simple and general strategy that enhances transformer performance on medical time-series tasks without requiring task-specific architectural changes, supporting its potential to improve robustness and accuracy in data-limited clinical settings.

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arXiv2026

SHOVIR: A Benchmark for Evaluating Vision Shortcut Learning in Radiology Report Generation

Current evaluation protocols for Vision-Language Models (VLMs) in Radiology Report Generation (RRG) rely on report-level metrics that measure lexical overlap or aggregate clinical correctness. However, such metrics do not test whether individual diagnostic statements stem from the actual pathological evidence visible in the image. This allows models to achieve competitive scores by exploiting learned priors or spurious correlations, a failure mode we refer to as vision shortcut. We introduce SHOVIR, a benchmark for evaluating vision shortcut behavior in RRG. SHOVIR extends two spatially annotated chest X-ray datasets, MIMIC-CXR and PadChest-GR, with per-box CheXpert labels, and defines image-level and disease-level occlusion experiments that contrast baseline performance on clean images against localized, region-specific perturbations. Comparing predictions across these conditions isolates two failure modes at the disease-class level: direct shortcuts, where a finding persists after its visual evidence is removed, and contextual shortcuts, where detection degrades once co-occurring pathologies are occluded despite the target region remaining intact. Benchmarking eight state-of-the-art VLMs, we find that shortcut behavior varies substantially across architectures and datasets. Models achieving the highest baseline report quality do not necessarily rank highest in spatial grounding, revealing that clinically fluent generation can coexist with shallow reliance on visual evidence. These findings expose a blind spot in current RRG evaluation and motivate region-aware assessment protocols.

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arXiv2026

Probabilistic NDVI Forecasting from Sparse Satellite Time Series and Weather Covariates

Short-term forecasting of vegetation dynamics is a key enabler for data-driven decision support in precision agriculture. Normalized Difference Vegetation Index (NDVI) forecasting from satellite observations, however, remains challenging due to sparse and irregular sampling caused by cloud masking, as well as the heterogeneous climatic conditions under which crops evolve. In this work, we propose a probabilistic forecasting framework for field-level NDVI prediction under sparse, irregular clear-sky acquisitions. The architecture separates the encoding of historical NDVI and meteorological observations from future exogenous covariates, fusing both representations for multi-step quantile prediction. To address irregular revisit patterns and horizon-dependent uncertainty, we introduce a temporal-distance weighted quantile loss that aligns the training objective with the effective forecasting horizon. In addition, we incorporate cumulative and extreme-weather feature engineering to capture delayed meteorological effects relevant to vegetation response. Experiments on European satellite data show that the proposed approach outperforms statistical, deep learning, and time-series baselines on both pointwise and probabilistic evaluation metrics. Ablation studies confirm that target history is the primary driver of performance, with meteorological covariates providing additional gains in the full multimodal setting. The code is available at https://github.com/arco-group/ndvi-forecasting.

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arXiv2026

Retrieval-Augmented Anatomical Guidance for Text-to-CT Generation

Text-conditioned generative models for volumetric medical imaging provide semantic control but lack explicit anatomical guidance, often resulting in outputs that are spatially ambiguous or anatomically inconsistent. In contrast, structure-driven methods ensure strong anatomical consistency but typically assume access to ground-truth annotations, which are unavailable when the target image is to be synthesized. We propose a retrieval-augmented approach for Text-to-CT generation that integrates semantic and anatomical information under a realistic inference setting. Given a radiology report, our method retrieves a semantically related clinical case using a 3D vision-language encoder and leverages its associated anatomical annotation as a structural proxy. This proxy is injected into a text-conditioned latent diffusion model via a ControlNet branch, providing coarse anatomical guidance while maintaining semantic flexibility. Experiments on the CT-RATE dataset show that retrieval-augmented generation improves image fidelity and clinical consistency compared to text-only baselines, while additionally enabling explicit spatial controllability, a capability inherently absent in such approaches. Further analysis highlights the importance of retrieval quality, with semantically aligned proxies yielding consistent gains across all evaluation axes. This work introduces a principled and scalable mechanism to bridge semantic conditioning and anatomical plausibility in volumetric medical image synthesis. Code is available at https://github.com/arco-group/RAGText2CT.

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arXiv2026

MATNet: Multi-Level Fusion Transformer-Based Model for Day-Ahead PV Generation Forecasting

Accurate forecasting of renewable generation is crucial to facilitate the integration of Renewable Energy Sources into the power system. Focusing on photovoltaic (PV) units, forecasting methods can be divided into two main categories: physics-based and data-based strategies, with Artificial Intelligence (AI)-based models providing state-of-the-art performance. However, while these AI-based models can capture complex patterns and relationships in the data, they ignore the underlying physical prior knowledge of the phenomenon. Therefore, in this paper, we propose MATNet, a novel transformer-based multimodal architecture for multi-step day-ahead PV power generation forecasting. The model is fed with historical PV data and historical and forecast weather data through a multi-level joint fusion approach, employing a soft-attention mechanism at multiple fusion stages. We evaluate the effectiveness of MATNet on the Ausgrid benchmark dataset, where it significantly outperforms various baseline models, achieving an RMSE of 0.0445, corresponding to a relative improvement of approximately 65% compared to the best-performing baseline method. The analysis is further enriched by a comprehensive set of ablation studies, a sensitivity analysis on missing data, which highlights MATNet's resilience to input degradation, a cross-site zero-shot generalization evaluation on five external PV datasets, demonstrating MATNet's robustness under significant domain shifts, and an assessment of the model's computational complexity, confirming its favorable balance between predictive accuracy and computational efficiency. These results highlight MATNet's potential as a reliable and efficient solution to facilitate the integration of PV energy into the power grid. The code is available at https://github.com/arco-group/MATNet.

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arXiv2026

Hybrid Quantum Neural Network for Multivariate Clinical Time Series Forecasting

Forecasting physiological signals can support proactive monitoring and timely clinical intervention by anticipating critical changes in patient status. In this work, we address multivariate multi-horizon forecasting of physiological time series by jointly predicting heart rate, oxygen saturation, pulse rate, and respiratory rate at forecasting horizons of 15, 30, and 60 seconds. We propose a hybrid quantum-classical architecture that integrates a Variational Quantum Circuit (VQC) within a recurrent neural backbone. A GRU encoder summarizes the historical observation window into a latent representation, which is then projected into quantum angles used to parameterize the VQC. The quantum layer acts as a learnable non-linear feature mixer, modeling cross-variable interactions before the final prediction stage. We evaluate the proposed approach on the BIDMC PPG and Respiration dataset under a Leave-One-Patient-Out protocol. The results show competitive accuracy compared with classical and deep learning baselines, together with greater robustness to noise and missing inputs. These findings suggest that hybrid quantum layers can provide useful inductive biases for physiological time series forecasting in small-cohort clinical settings. The code is available at https://github.com/arco-group/quantum-ml.

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arXiv2026

Towards Understanding Self-Pretraining for Sequence Classification

Amos et al. (2024) showed that the accuracy of Transformer models in sequence classification can be significantly improved by first pretraining with a masked token prediction objective without external data or augmentation, a procedure referred to as self-pretraining (SPT). While the primary objective of Amos et al. (2024) was to showcase that Transformers can achieve strong performance on the Long-Range Arena (LRA), their pipeline raises more fundamental questions: How does SPT drive optimization to better solutions? Why can standard supervised training fail in Transformers? To better understand this, we replicate and systematically ablate the findings of Amos et al. (2024). Our ablations suggest that a central bottleneck in the studied settings is not depth or generalization alone, but the ability of label supervision to learn useful query-key Attention patterns from random initialization. With a minimal setup, we identify learning proximity interactions - turning absolute positional encodings into proximity-biased Attention scores - as a key source of the improvements brought by SPT. Finally, in a simplified theoretical setup, we show that label supervision can be locally blind to certain Attention-score directions that are instead detectable through masked reconstruction.

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arXiv2026

Cross Modality Image Translation In Medical Imaging Using Generative Frameworks

Medical image-to-image (I2I) translation enables virtual scanning, i.e. the synthesis of a target imaging modality from a source one without additional acquisitions. Despite growing interest, most proposed methods operate on 2D slices, are evaluated on isolated tasks with different experimental set-ups and lack clinical validation. The primary contribution of this work is a reproducible, standardized comparative evaluation of 3D I2I translation methods in oncological imaging, designed to standardize preprocessing, splitting, inference, and multi-level evaluation across heterogeneous clinical tasks. Within this framework, we compare seven generative models, three Generative Adversarial Networks (GANs: Pix2Pix, CycleGAN, SRGAN) and four latent generative models (Latent Diffusion Model, Latent Diffusion Model+ControlNet, Brownian Bridge, Flow Matching), across eleven datasets spanning three anatomical regions (head/neck, lung, pelvis) and four translation directions (cone-beam CT to CT, MRI to CT, CT to PET, MRI T2-weighted to T2-FLAIR), for a total of 77 experiments under uniform training, inference, and evaluation conditions. The results show that GANs outperform latent generative models across all tasks, with SRGAN achieving statistically significant superiority. Our lesion-level analysis reveals that all models struggle with small lesions and that, in CT to PET synthesis, models reproduce lesion shape more reliably than absolute uptake-related intensity. We also performed a Visual Turing test administered to 17 physicians, including 15 radiologists, which shows near-chance classification accuracy (56.7%), confirming that synthetic volumes are largely indistinguishable from real acquisitions, while exposing a dissociation between quantitative metrics and clinical preference.

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arXiv2026

Resilient Vision-Tabular Multimodal Learning under Modality Missingness

Multimodal deep learning has shown strong potential in medical applications by integrating heterogeneous data sources such as medical images and structured clinical variables. However, most existing approaches implicitly assume complete modality availability, an assumption that rarely holds in real-world clinical settings where entire modalities and individual features are frequently missing. In this work, we propose a multimodal transformer framework for joint vision-tabular learning explicitly designed to operate under pervasive modality missingness, without relying on imputation or heuristic model switching. The architecture integrates three components: a vision, a tabular, and a multimodal fusion encoder. Unimodal representations are weighted through learnable modality tokens and fused via intermediate fusion with masked self-attention, which excludes missing tokens and modalities from information aggregation and gradient propagation. To further enhance resilience, we introduce a modality-dropout regularization strategy that stochastically removes available modalities during training, encouraging the model to exploit complementary information under partial data availability. We evaluate our approach on the MIMIC-CXR dataset paired with structured clinical data from MIMIC-IV for multilabel classification of 14 diagnostic findings with incomplete annotations. Two parallel systematic stress-test protocols progressively increase training and inference missingness in each modality separately, spanning fully multimodal to fully unimodal scenarios. Across all missingness regimes, the proposed method consistently outperforms representative baselines, showing smoother performance degradation and improved robustness. Ablation studies further demonstrate that attention-level masking and intermediate fusion with joint fine-tuning are key to resilient multimodal inference.

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arXiv2026

Multimodal Stepwise Clinically-Guided Attention Learning for Pathological Complete Response Prediction in Breast Cancer

Pathological complete response (pCR) is a key prognostic factor in breast cancer patients undergoing neoadjuvant therapy, strongly associated with long-term survival and treatment personalization. However, accurate pre-treatment pCR prediction remains challenging due to severe class imbalance and limited generalizability across diverse clinical settings. In this work, we propose a multimodal stepwise clinically-guided attention learning framework for pCR prediction from breast magnetic resonance imaging (MRI), designed to address these limitations through medically grounded spatial guidance and multimodal integration. The approach follows a stepwise training strategy inspired by physician reasoning: the model first learns global discriminative imaging patterns, then attention mechanisms are introduced to constrain the network toward tumor regions, and finally clinical variables are integrated to refine decision-making. This guidance strategy encourages prioritization of task-relevant features, improving identification of responders despite their limited representation in the dataset. Moreover, grounding attention in anatomically consistent tumor regions reduces reliance on dataset-specific patterns, thereby enhancing cross-institutional generalization. The framework is evaluated through external validation across heterogeneous MRI cohorts. Compared to non-guided single-stage baselines, the proposed approach improves sensitivity while maintaining competitive specificity, and produces anatomically coherent attention maps that support interpretation of the model's predictions. These findings highlight the potential of clinically-guided multimodal attention learning for robust and generalizable pCR prediction in breast cancer.

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arXiv2026

Virtual Scanning for NSCLC Histology: Investigating the Discriminatory Power of Synthetic PET

Accurate histological differentiation between adenocarcinoma (ADC) and squamous cell carcinoma (SCC) is critical for personalized treatment in non-small cell lung cancer (NSCLC). While [$^{18}$F]FDG PET/CT is a standard tool for the clinical evaluation of lung cancer, its utility is often limited by high costs and radiation exposure. In this paper, we investigate the feasibility of "virtual scanning" as a feature-enhancement strategy by evaluating whether synthetic PET data can provide complementary feature representations to supplement anatomical CT scans in histological subtype classification. We propose a framework that leverages a 3D Pix2Pix Generative Adversarial Network (GAN), pretrained on the FDG-PET/CT Lesions dataset, to synthesize pseudo-PET volumes from anatomical CT scans. These synthetic volumes are integrated with structural CT data within the MINT framework, a multi-stage intermediate fusion architecture. Our experiments, conducted on a multi-center dataset of 714 subjects, demonstrate that the inclusion of synthetic metabolic features significantly improves classification performance over a CT-only baseline. The multimodal approach achieved a statistically significant increase in the Area Under the Curve (AUC) from 0.489 to 0.591 and improved the Geometric Mean (GMean) from 0.305 to 0.524. These results suggest that synthetic PET scans provide discriminatory metabolic cues that enable deep learning models to exploit complementary cross-modal information, offering a potential feature-enhancement strategy for clinical scenarios where physical PET scans are unavailable.

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arXiv2026

Handling Missing Modalities in Multimodal Survival Prediction for Non-Small Cell Lung Cancer

Accurate survival prediction in Non-Small Cell Lung Cancer (NSCLC) requires integrating clinical, radiological, and histopathological data. Multimodal Deep Learning (MDL) can improve precision prognosis, but small cohorts and missing modalities limit its clinical applicability, as conventional approaches enforce complete case filtering or imputation. We present a missing-aware multimodal survival framework that combines Computed Tomography (CT), Whole-Slide Histopathology Images (WSI), and structured clinical variables for overall survival modeling in unresectable stage II-III NSCLC. The framework uses Foundation Models (FMs) for modality-specific feature extraction and a missing-aware encoding strategy that enables intermediate multimodal fusion under naturally incomplete modality profiles. By design, the architecture processes all available data without dropping patients during training or inference. Intermediate fusion outperforms unimodal baselines and both early and late fusion strategies, with the trimodal configuration reaching a C-index of 74.42. Modality-importance analyses show that the fusion model adapts its reliance on each data stream according to representation informativeness, shaped by the alignment between FM pretraining objectives and the survival task. The learned risk scores produce clinically meaningful stratification of disease progression and metastatic risk, with statistically significant log-rank tests across all modality combinations, supporting the translational relevance of the proposed framework.

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arXiv2026

Learning from Limited and Incomplete Data: A Multimodal Framework for Predicting Pathological Response in NSCLC

Major pathological response (pR) following neoadjuvant therapy is a clinically meaningful endpoint in non-small cell lung cancer, strongly associated with improved survival. However, accurate preoperative prediction of pR remains challenging, particularly in real-world clinical settings characterized by limited data availability and incomplete clinical profiles. In this study, we propose a multimodal deep learning framework designed to address these constraints by integrating foundation model-based CT feature extraction with a missing-aware architecture for clinical variables. This approach enables robust learning from small cohorts while explicitly modeling missing clinical information, without relying on conventional imputation strategies. A weighted fusion mechanism is employed to leverage the complementary contributions of imaging and clinical modalities, yielding a multimodal model that consistently outperforms both unimodal imaging and clinical baselines. These findings underscore the added value of integrating heterogeneous data sources and highlight the potential of multimodal, missing-aware systems to support pR prediction under realistic clinical conditions.

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arXiv2026

A Systematic Benchmark of GAN Architectures for MRI-to-CT Synthesis

The translation from Magnetic resonance imaging (MRI) to Computed tomography (CT) has been proposed as an effective solution to facilitate MRI-only clinical workflows while limiting exposure to ionizing radiation. Although numerous Generative Adversarial Network (GAN) architectures have been proposed for MRI-to-CT translation, systematic and fair comparisons across heterogeneous models remain limited. We present a comprehensive benchmark of ten GAN architectures evaluated on the SynthRAD2025 dataset across three anatomical districts (abdomen, thorax, head-and-neck). All models were trained under a unified validation protocol with identical preprocessing and optimization settings. Performance was assessed using complementary metrics capturing voxel-wise accuracy, structural fidelity, perceptual quality, and distribution-level realism, alongside an analysis of computational complexity. Supervised Paired models consistently outperformed Unpaired approaches, confirming the importance of voxel-wise supervision. Pix2Pix achieved the most balanced performance across districts while maintaining a favorable quality-to-complexity trade-off. Multi-district training improved structural robustness, whereas intra-district training maximized voxel-wise fidelity. This benchmark provides quantitative and computational guidance for model selection in MRI-only radiotherapy workflows and establishes a reproducible framework for future comparative studies. To ensure the reproducibility of our experiments we make our code public, together with the overall results, at the following link:https://github.com/arco-group/MRI_TO_CT.git

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arXiv2026

Longitudinal NSCLC Treatment Progression via Multimodal Generative Models

Predicting tumor evolution during radiotherapy is a clinically critical challenge, particularly when longitudinal changes are driven by both anatomy and treatment. In this work, we introduce a Virtual Treatment (VT) framework that formulates non-small cell lung cancer (NSCLC) progression as a dose-aware multimodal conditional image-to-image translation problem. Given a CT scan, baseline clinical variables, and a specified radiation dose increment, VT aims to synthesize plausible follow-up CT images reflecting treatment-induced anatomical changes. We evaluate the proposed framework on a longitudinal dataset of 222 stage III NSCLC patients, comprising 895 CT scans acquired during radiotherapy under irregular clinical schedules. The generative process is conditioned on delivered dose increments together with demographic and tumor-related clinical variables. Representative GAN-based and diffusion-based models are benchmarked across 2D and 2.5D configurations. Quantitative and qualitative results indicate that diffusion-based models benefit more consistently from multimodal, dose-aware conditioning and produce more stable and anatomically plausible tumor evolution trajectories than GAN-based baselines, supporting the potential of VT as a tool for in-silico treatment monitoring and adaptive radiotherapy research in NSCLC.

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