White matter hyperintensities (WMH) are important imaging biomarkers for cerebral small vessel disease, and their automatic segmentation across data with different distributions is crucial for assessing brain health and supporting diagnosis. However, cross-domain WMH segmentation remains challenging in privacy-sensitive and label-scarce clinical settings. Existing methods either relied on source domain data, violating privacy constraints, or lacked spatial guidance, which resulted in poor generalization, such as low sensitivity to small lesions. To address these challenges, we developed a source-free domain adaptation (SFDA) framework enhanced by federated spatial prior modeling. Our method used a dual-path pseudo-label generator that leveraged spatial priors to improve boundary accuracy and enhance the detection of small lesions. These priors were optimized via federated learning across multiple sites without sharing raw data, boosting model generalization while preserving privacy. The model was then fine-tuned using refined pseudo-labels. Experimental results demonstrated that our method consistently outperforms state-of-the-art UDA and SFDA methods, achieving 3-10% DSC improvement in most sites across 3 public and 7 private datasets. It also showed superior performance in small lesion detection and boundary delineation. Our method offered a robust, privacy-preserving solution for WMH segmentation and provided valuable support for early diagnosis and risk assessment of cerebrovascular diseases.

Predicting stroke outcome remains challenging due to inherent heterogeneity, misalignment of multimodal clinical data, and the availability of well-annotated longitudinal datasets. Current methodologies often lack robustness and generalizability across these tasks. We propose a few-shot contrastive learning framework that integrates brain MRI images and structured clinical records for cross-task prognosis prediction, addressing both morphological and functional outcomes. Our method combines Model-Agnostic Meta-Learning (MAML) with a two-step contrastive learning strategy including self-awareness learning that captures task-specific features and domain learning that facilitates cross-dataset generalization. To handle inconsistencies in tabular data, a Misalignment Separation technique was adopted. The framework jointly trains a domain encoder on multimodal inputs, capturing shared and task-specific prior knowledge to enhance predictive robustness. Evaluations on 309 patients for morphological outcome and 341 patients for functional outcome, as well as on external validation datasets, demonstrated that our approach outperformed SimCLR and conventional supervised methods, and could effectively integrate cross-task datasets. This framework highlights the potential of multimodal few-shot learning for robust stroke prognosis prediction for small-sample datasets.

Cardiovascular health is vital to human well-being, and cardiac magnetic resonance (CMR) imaging is considered the clinical reference standard for diagnosing cardiovascular disease. However, its adoption is hindered by long scan times, complex contrasts, and inconsistent quality. While deep learning methods perform well on specific CMR imaging sequences, they often fail to generalize across modalities and sampling schemes. The lack of benchmarks for high-quality, fast CMR image reconstruction further limits technology comparison and adoption. The CMRxRecon2024 challenge, attracting over 200 teams from 18 countries, addressed these issues with two tasks: generalization to unseen modalities and robustness to diverse undersampling patterns. We introduced the largest public multi-modality CMR raw dataset, an open benchmarking platform, and shared code. Analysis of the best-performing solutions revealed that prompt-based adaptation and enhanced physics-driven consistency enabled strong cross-scenario performance. These findings establish principles for generalizable reconstruction models and advance clinically translatable AI in cardiovascular imaging.

Time-of-flight magnetic resonance angiography (TOF-MRA) is a prevalent vascular imaging technique for assessing cerebrovascular diseases. Compared to routine 3T TOF-MRA, 7T TOF-MRA provides vascular structures with a higher signal-to-noise ratio (SNR) and better vessel contrast, revealing greater vascular details. However, the inaccessibility of 7T scanners and specific physiological and technical concerns limit its clinical application. Therefore, we aimed to generate high-quality 7T-like TOF-MRA from 3T TOF-MRA. Considering the spatial sparsity of vessel signals, the visibility discrepancy of distal and small vessels between 3T and 7T images, and the subtle spatial misalignment between paired data, we proposed a novel aleatoric-uncertainty-aware maximum intensity projection-based generative adversarial network (AU-MIPGAN). In our method, we employed a knowledge distillation (KD) framework to incorporate multi-directional MIP information into the 3T-to-7T learning process to strengthen the learning of vessels and provide three-dimensional (3D) vascular morphological knowledge for the student model, facilitating accurate generation of vascular structures. Furthermore, we exploited AU modeling to compensate for the spatial misalignment between paired 3T and 7T images during the training procedure, which helped the model concentrate more on learning the intrinsic gap between 3T and 7T images. Qualitative and quantitative results demonstrated that the proposed AU-MIPGAN can achieve promising performance for 7T-like TOF-MRA generation.

The early detection of glaucoma is essential in preventing visual impairment. Artificial intelligence (AI) can be used to analyze color fundus photographs (CFPs) in a cost-effective manner, making glaucoma screening more accessible. While AI models for glaucoma screening from CFPs have shown promising results in laboratory settings, their performance decreases significantly in real-world scenarios due to the presence of out-of-distribution and low-quality images. To address this issue, we propose the Artificial Intelligence for Robust Glaucoma Screening (AIROGS) challenge. This challenge includes a large dataset of around 113,000 images from about 60,000 patients and 500 different screening centers, and encourages the development of algorithms that are robust to ungradable and unexpected input data. We evaluated solutions from 14 teams in this paper and found that the best teams performed similarly to a set of 20 expert ophthalmologists and optometrists. The highest-scoring team achieved an area under the receiver operating characteristic curve of 0.99 (95% CI: 0.98-0.99) for detecting ungradable images on-the-fly. Additionally, many of the algorithms showed robust performance when tested on three other publicly available datasets. These results demonstrate the feasibility of robust AI-enabled glaucoma screening.

Single-Shot Echo Planar Imaging (SSEPI) based Diffusion Weighted Imaging (DWI) has shortcomings such as low resolution and severe distortions. In contrast, Multi-Shot EPI (MSEPI) provides optimal spatial resolution but increases scan time. This study proposed a Multiple b-value mOdel-based Residual Network (MORN) model to reconstruct multiple b-value high-resolution DWI from undersampled k-space data simultaneously. We incorporated Parallel Imaging (PI) into a residual U-net to reconstruct multiple b-value multi-coil data with the supervision of MUltiplexed Sensitivity-Encoding (MUSE) reconstructed Multi-Shot DWI (MSDWI). Moreover, asymmetric concatenations among different b-values and the combined loss to back propagate helped the feature transfer. After training and validation of the MORN in a dataset of 32 healthy cases, additional assessments were performed on 6 patients with different tumor types. The experimental results demonstrated that the MORN model outperformed conventional PI reconstruction (i.e. SENSE) and two state-of-the-art deep learning methods (SENSE-GAN and VSNet) in terms of PSNR (Peak Signal-to-Noise Ratio), SSIM (Structual SIMilarity) and apparent diffusion coefficient maps. In addition, using the pre-trained model under DWI, the MORN achieved consistent fractional anisotrophy and mean diffusivity reconstructed from multiple diffusion directions. Hence, the proposed method shows potential in clinical application according to the observations on tumor patients as well as images of multiple diffusion directions.

OBJECTIVE: Accurate segmentation of liver tumors, which could help physicians make appropriate treatment decisions and assess the effectiveness of surgical treatment, is crucial for the clinical diagnosis of liver cancer. In this study, we propose a 4-dimensional (4D) deep learning model based on 3D convolution and convolutional long short-term memory (C-LSTM) for hepatocellular carcinoma (HCC) lesion segmentation. METHODS: The proposed deep learning model utilizes 4D information on dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) images to assist liver tumor segmentation. Specifically, a shallow U-net based 3D CNN module was designed to extract 3D spatial domain features from each DCE phase, followed by a 4-layer C-LSTM network module for time domain information exploitation. The combined information of multi-phase DCE images and the manner by which tissue imaging features change on multi-contrast images allow the network to more effectively learn the characteristics of HCC, resulting in better segmentation performance. RESULTS: The proposed model achieved a Dice score of 0.825± 0.077, a Hausdorff distance of 12.84± 8.14 mm, and a volume similarity of 0.891± 0.080 for liver tumor segmentation, which outperformed the 3D U-net model, RA-UNet model and other models in the ablation study in both internal and external test sets. Moreover, the performance of the proposed model is comparable to the nnU-Net model, which showed state-of-the-art performance in many segmentation tasks, with significantly reduced prediction time. CONCLUSION: The proposed 3D convolution and C-LSTM based model can achieve accurate segmentation of HCC lesions.

MOTIVATION: Advances in neuroimaging and sequencing techniques provide an unprecedented opportunity to map the function of brain regions and identify the roots of psychiatric diseases. However, the results from most neuroimaging studies, i.e. activated clusters/regions or functional connectivities between brain regions, frequently cannot be conveniently and systematically interpreted, rendering the biological meaning unclear. RESULTS: We describe a brain annotation toolbox that generates functional and genetic annotations for neuroimaging results. The voxel-level functional description from the Neurosynth database and gene expression profile from the Allen Human Brain Atlas are used to generate functional/genetic information for region-level neuroimaging results. The validity of the approach is demonstrated by showing that the functional and genetic annotations for specific brain regions are consistent with each other; and further the region by region functional similarity network and genetic similarity network are highly correlated for major brain atlases. One application of brain annotation toolbox is to help provide functional/genetic annotations for newly discovered regions with unknown functions, e.g. the 97 new regions identified in the Human Connectome Project. Importantly, this toolbox can help understand differences between psychiatric patients and controls, and this is demonstrated using schizophrenia and autism data, for which the functional and genetic annotations for the neuroimaging changes in patients are consistent with each other and help interpret the results. AVAILABILITY AND IMPLEMENTATION: BAT is implemented as a free and open-source MATLAB toolbox and is publicly available at http://123.56.224.61:1313/post/bat. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.