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Sina Amirrajab

Publications and source records attributed to Sina Amirrajab.

At least 19 recordsLinked to original sources
arXiv2026

Foundation Models Adaptation for Multi-View Multi-modal Cardiac MRI Segmentation and Direct Ejection Fraction Estimation

Foundation models have shown strong transferability in cardiac MRI (CMR), but their effectiveness for heterogeneous multi-view and multi-sequence CMR analysis remains unclear. In this work, we explore the effectiveness of fine-tuning and combining different CMR foundation models for the Universal Multi-Sequence, Multi-Center and Multi-View CMR Segmentation (CMR-Multi) Challenge. CineMA was fine-tuned for cine and late gadolinium enhancement (LGE) segmentation across short-axis and long-axis views. For direct left-ventricular ejection fraction (LVEF) estimation, we used two recent frozen CMR foundation models to extract embedding vectors that were then combined using attention-based multiple-instance learning for LVEF regression. In the challenge validation set, cine segmentation achieved Dice scores of 0.862, 0.883, and 0.902 for short-axis, two-chamber and four-chamber cine MRI, respectively. LGE segmentation achieved Dice scores between 0.621 and 0.846 across views. The direct LVEF regression model achieved an MAE of 4.96 percentage points and a Pearson correlation of 0.91. These results indicate that foundation models can be effectively adapted and combined for multi-view CMR analysis, while accurate LGE scar segmentation remains a challenging task.

cs.CV↗
arXiv2026

Pre- to Post-Contrast Synthesis of Breast DCE-MRI using Latent Bridge Matching

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is central to breast cancer imaging, but gadolinium administration increases scan burden and motivates contrast-reduced alternatives, including synthetic contrast generation. We propose a latent bridge matching (LBM) framework for synthesizing peak-enhanced breast DCE-MRI from pre-contrast images in the MAMA-SYNTH challenge setting. Instead of starting from Gaussian noise as in conventional latent diffusion models (LDMs), the proposed model learns a conditional bridge between paired pre-contrast and peak-enhanced VAE latents. A latent UNet predicts the remaining correction from intermediate bridge states to the peak-enhanced latent, enabling iterative refinement while keeping the trajectory anchored to patient-specific anatomy. We evaluated two LBM conditioning variants on 91 DUKE validation cases. For the tumor-conditioned variant, tumor masks were used as conditioning inputs. Tumor-conditioning improved performance compared with pre-contrast conditioning, reducing MSE from 1.023 to 0.940 and FRD from 7.523 to 4.716, while increasing tumor SSIM from 0.355 to 0.429. The tumor-conditioned LBM also outperformed the evaluated LDM baseline on this validation cohort. These results suggest that latent bridge matching is a promising pre-contrast-anchored formulation for virtual contrast enhancement, while further work is needed to validate generalization and remove dependence on ground-truth tumor masks at inference.

eess.IV↗
arXiv2026

Development of an automated, reliable, and clinically meaningful artificial intelligence (AI) tool for diagnosing cardiac disease from conventional cardiovascular magnetic resonance (CMR) images

Aims: Cardiovascular magnetic resonance (CMR) imaging enables non-invasive assessment of myocardial structure, function, and pathology, but requires substantial experience in interpretation of CMR images that could be supported by artificial intelligence (AI)-based models. However, use of AI models for enhanced CMR reading is limited by labor-intensive data curation, suboptimal model performance, and unclear implementation pathways. Methods and results: We developed an automated data curation pipeline for CMR-based cardiovascular disease (CVD) diagnosis, integrating open-source locally-run large language models (LLMs) to extract diagnostic labels from narrative CMR reports and preprocessing multimodal imaging data, including cine and late-gadolinium-enhancement (LGE) CMR sequences. Three vision foundation models (DINO, VST, UMedPT) were fine-tuned across these modalities in a two-stage approach. The dataset comprised hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), ischemic cardiomyopathy (ICM), cardiac amyloidosis (CA), and normal controls (NOR). A total of 988 curated cases were randomly divided into 742 for training and 246 for validation. Fine-tuned AI-models achieved high discriminative diagnostic performance on an independent test set comprising 1067 patients , with individual AUC-ROC values of up to 0.937 for the correct diagnosis of HCM and 0.945 for cardiac amyloidosis. Ensemble strategies combining multiple models and modalities further improved AI-based diagnostic accuracy and robustness, achieving the highest overall diagnostic performance for HCM (AUC=0.959, CI [0.936-0.978]), CA (AUC=0.966, CI [0.939-0.986]), NOR (AUC=0.872, CI [0.852-0.894]), DCM (AUC=0.848, CI [0.808-0.885]) and ICM (AUC=0.840, CI [0.809-0.868]). All training and inference code, along with the trained model weights, are publicly available on https://github.com/sinaamirrajab/CMR_CVD.

cs.CV↗
arXiv2026

Towards Brain MRI Foundation Models for the Clinic: Findings from the FOMO25 Challenge

Clinical deployment of automated brain MRI analysis faces a fundamental challenge: clinical data is heterogeneous and noisy, and high-quality labels are prohibitively costly to obtain. Self-supervised learning (SSL) can address this by leveraging the vast amounts of unlabeled data produced in clinical workflows to train robust \textit{foundation models} that adapt out-of-domain with minimal supervision. However, the development of foundation models for brain MRI has been limited by small pretraining datasets and in-domain benchmarking focused on high-quality, research-grade data. To address this gap, we organized the FOMO25 challenge as a satellite event at MICCAI 2025. FOMO25 provided participants with a large pretraining dataset, FOMO60K, and evaluated models on data sourced directly from clinical workflows in few-shot and out-of-domain settings. Tasks covered infarct classification, meningioma segmentation, and brain age regression, and considered both models trained on FOMO60K (method track) and any data (open track). Nineteen foundation models from sixteen teams were evaluated using a standardized containerized pipeline. Results show that (a) self-supervised pretraining improves generalization on clinical data under domain shift, with the strongest models trained \textit{out-of-domain} surpassing supervised baselines trained \textit{in-domain}. (b) No single pretraining objective benefits all tasks: MAE favors segmentation, hybrid reconstruction-contrastive objectives favor classification, and (c) strong performance was achieved by small pretrained models, and improvements from scaling model size and training duration did not yield reliable benefits.

cs.CV↗
arXiv2026

Data-driven Synthesis of Magnetic Resonance Spectroscopy Data using a Variational Autoencoder

The development of deep learning methods for magnetic resonance spectroscopy (MRS) is often hindered by limited availability of large, high-quality training datasets. While physics-based simulations are commonly used to mitigate this limitation, accurately modeling all in-vivo signal components remains challenging. In this work, we propose a data-driven framework for synthesizing in-vivo MRS data using a variational autoencoder (VAE) trained exclusively on measured single-voxel spectroscopy data. The model learns a low-dimensional latent representation of complex-valued spectra and enables generation of new samples through latent-space sampling and interpolation. The generative performance of the proposed approach is evaluated using a comprehensive set of complementary analyses, including reconstruction quality, feature-level similarity using low-dimensional embeddings, application-based signal quality metrics, and metabolite quantification agreement. The results demonstrate that the VAE accurately reconstructs dominant spectral patterns and generates synthetic spectra that occupy the same feature space as in-vivo data. In an example application targeting GABA-edited spectroscopy, augmenting limited subsets of transients with synthetic spectra improves signal quality metrics such as signal-to-noise ratio, linewidth, and shape scores. However, the results also reveal limitations of the generative approach, including under-representation of stochastic noise and reduced accuracy in absolute metabolite quantification, particularly for applications sensitive to concentration estimates. These findings highlight both potential and limitations of data-driven MRS synthesis. Beyond the proposed model, this study introduces a structured evaluation framework for generative MRS methods, emphasizing the importance of application-aware validation when synthetic data are used for downstream analysis.

physics.med-ph↗
arXiv2026

Large-scale modality-invariant foundation models for brain MRI analysis: Application to lesion segmentation

The field of computer vision is undergoing a paradigm shift toward large-scale foundation model pre-training via self-supervised learning (SSL). Leveraging large volumes of unlabeled brain MRI data, such models can learn anatomical priors that improve few-shot performance in diverse neuroimaging tasks. However, most SSL frameworks are tailored to natural images, and their adaptation to capture multi-modal MRI information remains underexplored. This work proposes a modality-invariant representation learning setup and evaluates its effectiveness in stroke and epilepsy lesion segmentation, following large-scale pre-training. Experimental results suggest that despite successful cross-modality alignment, lesion segmentation primarily benefits from preserving fine-grained modality-specific features. Model checkpoints and code are made publicly available.

eess.IV↗
arXiv2026

A Pre-trained Foundation Model Framework for Multiplanar MRI Classification of Extramural Vascular Invasion and Mesorectal Fascia Invasion in Rectal Cancer

Objectives Accurate MRI-based identification of extramural vascular invasion (EVI) and mesorectal fascia invasion (MFI) is crucial for risk-stratified rectal cancer treatment. However, subjective visual assessment and inter-institutional variability limit diagnostic consistency. This study developed and externally evaluated a multi-centre, foundation model-driven framework that automatically classifies EVI and MFI on axial and sagittal MRI. Methods A total of 331 pre-treatment rectal cancer T2-weighted MRI scans from three European hospitals were retrospectively recruited. A self-supervised frequency domain harmonization strategy was applied to reduce scanner variability. Three classifiers, SeResNet, the universal biomedical pretrained model (UMedPT) with a multilayer perceptron head, and a logistic-regression variant using frozen UMedPT features (UMedPT_LR), were trained (n=265) and tested (n=66). Gradient-weighted class activation mapping (Grad-CAM) visualized model predictions. Results UMedPT_LR achieved the best EVI performance with multiplanar fusion (AUC=0.82, test set). For MFI, UMedPT trained on axial harmonized images yielded the highest performance (AUC = 0.77). Both tasks outperformed the CHAIMELEON 2024 benchmark (EVI: 0.82 vs 0.74; MFI: 0.77 vs 0.75). Harmonization enhanced MFI classification, and multiplanar fusion further boosted EVI performance. Grad-CAM confirmed biologically plausible attention on peritumoral regions (EVI) and mesorectal fascia margins (MFI). Conclusion The proposed foundation model-driven framework, leveraging frequency domain harmonization and multiplanar fusion, achieves state-of-the-art performance for automated EVI and MFI classification on MRI, demonstrating strong generalizability across multiple centers.

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arXiv2025

Radiology Report Conditional 3D CT Generation with Multi Encoder Latent diffusion Model

Text to image latent diffusion models have recently advanced medical image synthesis, but applications to 3D CT generation remain limited. Existing approaches rely on simplified prompts, neglecting the rich semantic detail in full radiology reports, which reduces text image alignment and clinical fidelity. We propose Report2CT, a radiology report conditional latent diffusion framework for synthesizing 3D chest CT volumes directly from free text radiology reports, incorporating both findings and impression sections using multiple text encoder. Report2CT integrates three pretrained medical text encoders (BiomedVLP CXR BERT, MedEmbed, and ClinicalBERT) to capture nuanced clinical context. Radiology reports and voxel spacing information condition a 3D latent diffusion model trained on 20000 CT volumes from the CT RATE dataset. Model performance was evaluated using Frechet Inception Distance (FID) for real synthetic distributional similarity and CLIP based metrics for semantic alignment, with additional qualitative and quantitative comparisons against GenerateCT model. Report2CT generated anatomically consistent CT volumes with excellent visual quality and text image alignment. Multi encoder conditioning improved CLIP scores, indicating stronger preservation of fine grained clinical details in the free text radiology reports. Classifier free guidance further enhanced alignment with only a minor trade off in FID. We ranked first in the VLM3D Challenge at MICCAI 2025 on Text Conditional CT Generation and achieved state of the art performance across all evaluation metrics. By leveraging complete radiology reports and multi encoder text conditioning, Report2CT advances 3D CT synthesis, producing clinically faithful and high quality synthetic data.

cs.CV↗
arXiv2025

Extreme Cardiac MRI Analysis under Respiratory Motion: Results of the CMRxMotion Challenge

Deep learning models have achieved state-of-the-art performance in automated Cardiac Magnetic Resonance (CMR) analysis. However, the efficacy of these models is highly dependent on the availability of high-quality, artifact-free images. In clinical practice, CMR acquisitions are frequently degraded by respiratory motion, yet the robustness of deep learning models against such artifacts remains an underexplored problem. To promote research in this domain, we organized the MICCAI CMRxMotion challenge. We curated and publicly released a dataset of 320 CMR cine series from 40 healthy volunteers who performed specific breathing protocols to induce a controlled spectrum of motion artifacts. The challenge comprised two tasks: 1) automated image quality assessment to classify images based on motion severity, and 2) robust myocardial segmentation in the presence of motion artifacts. A total of 22 algorithms were submitted and evaluated on the two designated tasks. This paper presents a comprehensive overview of the challenge design and dataset, reports the evaluation results for the top-performing methods, and further investigates the impact of motion artifacts on five clinically relevant biomarkers. All resources and code are publicly available at: https://github.com/CMRxMotion

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arXiv2025

Comparative analysis of privacy-preserving open-source LLMs regarding extraction of diagnostic information from clinical CMR imaging reports

Purpose: We investigated the utilization of privacy-preserving, locally-deployed, open-source Large Language Models (LLMs) to extract diagnostic information from free-text cardiovascular magnetic resonance (CMR) reports. Materials and Methods: We evaluated nine open-source LLMs on their ability to identify diagnoses and classify patients into various cardiac diagnostic categories based on descriptive findings in 109 clinical CMR reports. Performance was quantified using standard classification metrics including accuracy, precision, recall, and F1 score. We also employed confusion matrices to examine patterns of misclassification across models. Results: Most open-source LLMs demonstrated exceptional performance in classifying reports into different diagnostic categories. Google's Gemma2 model achieved the highest average F1 score of 0.98, followed by Qwen2.5:32B and DeepseekR1-32B with F1 scores of 0.96 and 0.95, respectively. All other evaluated models attained average scores above 0.93, with Mistral and DeepseekR1-7B being the only exceptions. The top four LLMs outperformed our board-certified cardiologist (F1 score of 0.94) across all evaluation metrics in analyzing CMR reports. Conclusion: Our findings demonstrate the feasibility of implementing open-source, privacy-preserving LLMs in clinical settings for automated analysis of imaging reports, enabling accurate, fast and resource-efficient diagnostic categorization.

cs.CY↗
arXiv2025

Explainable Anatomy-Guided AI for Prostate MRI: Foundation Models and In Silico Clinical Trials for Virtual Biopsy-based Risk Assessment

We present a fully automated, anatomically guided deep learning pipeline for prostate cancer (PCa) risk stratification using routine MRI. The pipeline integrates three key components: an nnU-Net module for segmenting the prostate gland and its zones on axial T2-weighted MRI; a classification module based on the UMedPT Swin Transformer foundation model, fine-tuned on 3D patches with optional anatomical priors and clinical data; and a VAE-GAN framework for generating counterfactual heatmaps that localize decision-driving image regions. The system was developed using 1,500 PI-CAI cases for segmentation and 617 biparametric MRIs with metadata from the CHAIMELEON challenge for classification (split into 70% training, 10% validation, and 20% testing). Segmentation achieved mean Dice scores of 0.95 (gland), 0.94 (peripheral zone), and 0.92 (transition zone). Incorporating gland priors improved AUC from 0.69 to 0.72, with a three-scale ensemble achieving top performance (AUC = 0.79, composite score = 0.76), outperforming the 2024 CHAIMELEON challenge winners. Counterfactual heatmaps reliably highlighted lesions within segmented regions, enhancing model interpretability. In a prospective multi-center in-silico trial with 20 clinicians, AI assistance increased diagnostic accuracy from 0.72 to 0.77 and Cohen's kappa from 0.43 to 0.53, while reducing review time per case by 40%. These results demonstrate that anatomy-aware foundation models with counterfactual explainability can enable accurate, interpretable, and efficient PCa risk assessment, supporting their potential use as virtual biopsies in clinical practice.

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arXiv2024

Enhancing Reconstruction-Based Out-of-Distribution Detection in Brain MRI with Model and Metric Ensembles

Out-of-distribution (OOD) detection is crucial for safely deploying automated medical image analysis systems, as abnormal patterns in images could hamper their performance. However, OOD detection in medical imaging remains an open challenge, and we address three gaps: the underexplored potential of a simple OOD detection model, the lack of optimization of deep learning strategies specifically for OOD detection, and the selection of appropriate reconstruction metrics. In this study, we investigated the effectiveness of a reconstruction-based autoencoder for unsupervised detection of synthetic artifacts in brain MRI. We evaluated the general reconstruction capability of the model, analyzed the impact of the selected training epoch and reconstruction metrics, assessed the potential of model and/or metric ensembles, and tested the model on a dataset containing a diverse range of artifacts. Among the metrics assessed, the contrast component of SSIM and LPIPS consistently outperformed others in detecting homogeneous circular anomalies. By combining two well-converged models and using LPIPS and contrast as reconstruction metrics, we achieved a pixel-level area under the Precision-Recall curve of 0.66. Furthermore, with the more realistic OOD dataset, we observed that the detection performance varied between artifact types; local artifacts were more difficult to detect, while global artifacts showed better detection results. These findings underscore the importance of carefully selecting metrics and model configurations, and highlight the need for tailored approaches, as standard deep learning approaches do not always align with the unique needs of OOD detection.

eess.IV↗
arXiv2024

WAND: Wavelet Analysis-based Neural Decomposition of MRS Signals for Artifact Removal

Accurate quantification of metabolites in magnetic resonance spectroscopy (MRS) is challenged by low signal-to-noise ratio (SNR), overlapping metabolites, and various artifacts. Particularly, unknown and unparameterized baseline effects obscure the quantification of low-concentration metabolites, limiting MRS reliability. This paper introduces wavelet analysis-based neural decomposition (WAND), a novel data-driven method designed to decompose MRS signals into their constituent components: metabolite-specific signals, baseline, and artifacts. WAND takes advantage of the enhanced separability of these components within the wavelet domain. The method employs a neural network, specifically a U-Net architecture, trained to predict masks for wavelet coefficients obtained through the continuous wavelet transform. These masks effectively isolate desired signal components in the wavelet domain, which are then inverse-transformed to obtain separated signals. Notably, an artifact mask is created by inverting the sum of all known signal masks, enabling WAND to capture and remove even unpredictable artifacts. The effectiveness of WAND in achieving accurate decomposition is demonstrated through numerical evaluations using simulated spectra. Furthermore, WAND's artifact removal capabilities significantly enhance the quantification accuracy of linear combination model fitting. The method's robustness is further validated using data from the 2016 MRS Fitting Challenge and in-vivo experiments.

eess.SP↗
arXiv2024

Generative AI for Synthetic Data Across Multiple Medical Modalities: A Systematic Review of Recent Developments and Challenges

This paper presents a comprehensive systematic review of generative models (GANs, VAEs, DMs, and LLMs) used to synthesize various medical data types, including imaging (dermoscopic, mammographic, ultrasound, CT, MRI, and X-ray), text, time-series, and tabular data (EHR). Unlike previous narrowly focused reviews, our study encompasses a broad array of medical data modalities and explores various generative models. Our search strategy queries databases such as Scopus, PubMed, and ArXiv, focusing on recent works from January 2021 to November 2023, excluding reviews and perspectives. This period emphasizes recent advancements beyond GANs, which have been extensively covered previously. The survey reveals insights from three key aspects: (1) Synthesis applications and purpose of synthesis, (2) generation techniques, and (3) evaluation methods. It highlights clinically valid synthesis applications, demonstrating the potential of synthetic data to tackle diverse clinical requirements. While conditional models incorporating class labels, segmentation masks and image translations are prevalent, there is a gap in utilizing prior clinical knowledge and patient-specific context, suggesting a need for more personalized synthesis approaches and emphasizing the importance of tailoring generative approaches to the unique characteristics of medical data. Additionally, there is a significant gap in using synthetic data beyond augmentation, such as for validation and evaluation of downstream medical AI models. The survey uncovers that the lack of standardized evaluation methodologies tailored to medical images is a barrier to clinical application, underscoring the need for in-depth evaluation approaches, benchmarking, and comparative studies to promote openness and collaboration.

cs.LG↗
arXiv2023

Histogram- and Diffusion-Based Medical Out-of-Distribution Detection

Out-of-distribution (OOD) detection is crucial for the safety and reliability of artificial intelligence algorithms, especially in the medical domain. In the context of the Medical OOD (MOOD) detection challenge 2023, we propose a pipeline that combines a histogram-based method and a diffusion-based method. The histogram-based method is designed to accurately detect homogeneous anomalies in the toy examples of the challenge, such as blobs with constant intensity values. The diffusion-based method is based on one of the latest methods for unsupervised anomaly detection, called DDPM-OOD. We explore this method and propose extensive post-processing steps for pixel-level and sample-level anomaly detection on brain MRI and abdominal CT data provided by the challenge. Our results show that the proposed DDPM method is sensitive to blur and bias field samples, but faces challenges with anatomical deformation, black slice, and swapped patches. These findings suggest that further research is needed to improve the performance of DDPM for OOD detection in medical images.

cs.CV↗
arXiv2023

Pathology Synthesis of 3D-Consistent Cardiac MR Images using 2D VAEs and GANs

We propose a method for synthesizing cardiac magnetic resonance (MR) images with plausible heart pathologies and realistic appearances for the purpose of generating labeled data for the application of supervised deep-learning (DL) training. The image synthesis consists of label deformation and label-to-image translation tasks. The former is achieved via latent space interpolation in a VAE model, while the latter is accomplished via a label-conditional GAN model. We devise three approaches for label manipulation in the latent space of the trained VAE model; i) \textbf{intra-subject synthesis} aiming to interpolate the intermediate slices of a subject to increase the through-plane resolution, ii) \textbf{inter-subject synthesis} aiming to interpolate the geometry and appearance of intermediate images between two dissimilar subjects acquired with different scanner vendors, and iii) \textbf{pathology synthesis} aiming to synthesize a series of pseudo-pathological synthetic subjects with characteristics of a desired heart disease. Furthermore, we propose to model the relationship between 2D slices in the latent space of the VAE prior to reconstruction for generating 3D-consistent subjects from stacking up 2D slice-by-slice generations. We demonstrate that such an approach could provide a solution to diversify and enrich an available database of cardiac MR images and to pave the way for the development of generalizable DL-based image analysis algorithms. We quantitatively evaluate the quality of the synthesized data in an augmentation scenario to achieve generalization and robustness to multi-vendor and multi-disease data for image segmentation. Our code is available at https://github.com/sinaamirrajab/CardiacPathologySynthesis.

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arXiv2023

A Review of Machine Learning Applications for the Proton Magnetic Resonance Spectroscopy Workflow

This literature review presents a comprehensive overview of machine learning (ML) applications in proton magnetic resonance spectroscopy (MRS). As the use of ML techniques in MRS continues to grow, this review aims to provide the MRS community with a structured overview of the state-of-the-art methods. Specifically, we examine and summarize studies published between 2017 and 2023 from major journals in the magnetic resonance field. We categorize these studies based on a typical MRS workflow, including data acquisition, processing, analysis, and artificial data generation. Our review reveals that ML in MRS is still in its early stages, with a primary focus on processing and analysis techniques, and less attention given to data acquisition. We also found that many studies use similar model architectures, with little comparison to alternative architectures. Additionally, the generation of artificial data is a crucial topic, with no consistent method for its generation. Furthermore, many studies demonstrate that artificial data suffers from generalization issues when tested on in-vivo data. We also conclude that risks related to ML models should be addressed, particularly for clinical applications. Therefore, output uncertainty measures and model biases are critical to investigate. Nonetheless, the rapid development of ML in MRS and the promising results from the reviewed studies justify further research in this field.

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