Abstract:Simultaneous functional PET/MR (sf-PET/MR) presents a cutting-edge multimodal neuroimaging technique. It provides an unprecedented opportunity for concurrently monitoring and integrating multifaceted brain networks built by spatiotemporally covaried metabolic activity, neural activity, and cerebral blood flow (perfusion). Albeit high scientific/clinical values, short in hardware accessibility of PET/MR hinders its applications, let alone modern AI-based PET/MR fusion models. Our objective is to develop a clinically feasible AI-based disease diagnosis model trained on comprehensive sf-PET/MR data with the power of, during inferencing, allowing single modality input (e.g., PET only) as well as enforcing multimodal-based accuracy. To this end, we propose MX-ARM, a multimodal MiXture-of-experts Alignment and Reconstruction Model. It is modality detachable and exchangeable, allocating different multi-layer perceptrons dynamically ("mixture of experts") through learnable weights to learn respective representations from different modalities. Such design will not sacrifice model performance in uni-modal situation. To fully exploit the inherent complex and nonlinear relation among modalities while producing fine-grained representations for uni-modal inference, we subsequently add a modal alignment module to line up a dominant modality (e.g., PET) with representations of auxiliary modalities (MR). We further adopt multimodal reconstruction to promote the quality of learned features. Experiments on precious multimodal sf-PET/MR data for Mild Cognitive Impairment diagnosis showcase the efficacy of our model toward clinically feasible precision medicine.