Multi-contrast magnetic resonance imaging (MRI) has important value in clinical applications because it can reflect comprehensive tissue characterization from anatomy and function to metabolism. Previous studies utilize abundant details in high-resolution (HR) reference (Ref) images to guide the super-resolution (SR) of low-resolution (LR) images, termed multi-contrast MRI SR. Yet, their clinical applications are hindered by: 1) discrepancies in MRI equipment and acquisition protocols across hospitals (which lead to gaps in data distribution), and 2) lack of paired LR and HR images in certain modalities for supervised training. Herein, we rethink multi-contrast MRI from a clinical perspective, and propose an implicit sampling and generation (ISG) network plus an unsupervised fine-tuning (FT) framework. Briefly, the ISG network possesses a powerful representation capability, enabling arbitrary-scale LR inputs and SR outputs. The fine-tuning framework, as a test-time training technique, allows models to be adapted to testing data. Experiments are conducted on two clinical datasets containing amide proton transfer weighted (APTw) images from tumor patients and fluid-attenuated inversion recovery (FLAIR) images from a 5T scanner, respectively. For tumor patients, our ISG+FT proves $4{\times }$ SR capacity in APTw metabolic images, receiving good recognition from radiologists. In both quantitative and qualitative evaluations, ISG+FT outperforms state-of-the-art baselines. The ablation and robustness study further demonstrate the rationality of ISG+FT. Overall, our proposed method shows considerable promise in clinical scenarios.

Chemical Exchange Saturation Transfer Magn-etic Resonance Imaging (CEST-MRI) is a promising approach for detecting tissue metabolic changes. However, due to the constraints of scan time and contrast-noise-ratio, CEST-MRI always exhibits low spatial resolution, hindering the clinical applications especially for detection of small lesions. Many super-resolution (SR) methods have shown good performance in medical images. However, when applied to CEST-MRI, these methods have two shortcomings that may limit their performance. Firstly, CEST-MRI has an additional frequency dimension, but the information along this dimension is not fully utilized. The second is that these SR methods mainly focus on improving the quality of the CEST-weighted images, while the accuracy of the quantitative maps is the most concerned aspect for CEST-MRI. To address these shortcomings, we propose a Cross-space Optimization-based Mutual learning nETwork (COMET) for SR of CEST-MRI. COMET incorporates novel spatio-frequency extraction modules and a mutual learning module to leverage and combine information from both spatial and frequency spaces, thereby enhancing the SR performance. Furthermore, we propose a novel CEST-based normalization loss to address the normalization-induced distribution problem and preserve the sharpness of quantitative maps, enabling more accurate CEST-MRI quantification. COMET is evaluated on an ischemia rat brain dataset and a human brain dataset. The results demonstrate COMET achieves 8-fold SR, providing accurate quantitative maps. Moreover, COMET outperforms all other state-of-the-art SR methods. Additionally, COMET exhibits its potential in prospective study.

Multi-modality medical imaging is crucial in clinical treatment as it can provide complementary information for medical image segmentation. However, collecting multi-modal data in clinical is difficult due to the limitation of the scan time and other clinical situations. As such, it is clinically meaningful to develop an image segmentation paradigm to handle this missing modality problem. In this paper, we propose a prototype knowledge distillation (ProtoKD) method to tackle the challenging problem, especially for the toughest scenario when only single modal data can be accessed. Specifically, our ProtoKD can not only distillate the pixel-wise knowledge of multi-modality data to single-modality data but also transfer intra-class and inter-class feature variations, such that the student model could learn more robust feature representation from the teacher model and inference with only one single modality data. Our method achieves state-of-the-art performance on BraTS benchmark.

Multi-contrast magnetic resonance imaging can provide comprehensive information for clinical diagnosis. However, multi-contrast imaging suffers from long acquisition time, which makes it inhibitive for daily clinical practice. Subsampling k-space is one of the main methods to speed up scan time. Missing k-space samples will lead to inevitable serious artifacts and noise. Considering the assumption that different contrast modalities share some mutual information, it may be possible to exploit this redundancy to accelerate multi-contrast imaging acquisition. Recently, generative adversarial network shows superior performance in image reconstruction and synthesis. Some studies based on k-space reconstruction also exhibit superior performance over conventional state-of-art method. In this study, we propose a cross-domain two-stage generative adversarial network for multi-contrast images reconstruction based on prior full-sampled contrast and undersampled information. The new approach integrates reconstruction and synthesis, which estimates and completes the missing k-space and then refines in image space. It takes one fully-sampled contrast modality data and highly undersampled data from several other modalities as input, and outputs high quality images for each contrast simultaneously. The network is trained and tested on a public brain dataset from healthy subjects. Quantitative comparisons against baseline clearly indicate that the proposed method can effectively reconstruct undersampled images. Even under high acceleration, the network still can recover texture details and reduce artifacts.