Parallel Swin Transformer-Enhanced 3D MRI-to-CT Synthesis for MRI-Only Radiotherapy Planning

MRI provides superior soft tissue contrast without ionizing radiation; however, the absence of electron density information limits its direct use for dose calculation. As a result, current radiotherapy workflows rely on combined MRI and CT acquisitions, increasing registration uncertainty and procedural complexity. Synthetic CT generation enables MRI only planning but remains challenging due to nonlinear MRI-CT relationships and anatomical variability. We propose Parallel Swin Transformer-Enhanced Med2Transformer, a 3D architecture that integrates convolutional encoding with dual Swin Transformer branches to model both local anatomical detail and long-range contextual dependencies. Multi-scale shifted window attention with hierarchical feature aggregation improves anatomical fidelity. Experiments on public and clinical datasets demonstrate higher image similarity and improved geometric accuracy compared with baseline methods. Dosimetric evaluation shows clinically acceptable performance, with a mean target dose error of 1.69%. Code is available at: https://github.com/mobaidoctor/med2transformer.

Towards Segmenting the Invisible: An End-to-End Registration and Segmentation Framework for Weakly Supervised Tumour Analysis

Liver tumour ablation presents a significant clinical challenge: whilst tumours are clearly visible on pre-operative MRI, they are often effectively invisible on intra-operative CT due to minimal contrast between pathological and healthy tissue. This work investigates the feasibility of cross-modality weak supervision for scenarios where pathology is visible in one modality (MRI) but absent in another (CT). We present a hybrid registration-segmentation framework that combines MSCGUNet for inter-modal image registration with a UNet-based segmentation module, enabling registration-assisted pseudo-label generation for CT images. Our evaluation on the CHAOS dataset demonstrates that the pipeline can successfully register and segment healthy liver anatomy, achieving a Dice score of 0.72. However, when applied to clinical data containing tumours, performance degrades substantially (Dice score of 0.16), revealing the fundamental limitations of current registration methods when the target pathology lacks corresponding visual features in the target modality. We analyse the "domain gap" and "feature absence" problems, demonstrating that whilst spatial propagation of labels via registration is feasible for visible structures, segmenting truly invisible pathology remains an open challenge. Our findings highlight that registration-based label transfer cannot compensate for the absence of discriminative features in the target modality, providing important insights for future research in cross-modality medical image analysis. Code an weights are available at: https://github.com/BudhaTronix/Weakly-Supervised-Tumour-Detection

Multi-AD: Cross-Domain Unsupervised Anomaly Detection for Medical and Industrial Applications

Traditional deep learning models often lack annotated data, especially in cross-domain applications such as anomaly detection, which is critical for early disease diagnosis in medicine and defect detection in industry. To address this challenge, we propose Multi-AD, a convolutional neural network (CNN) model for robust unsupervised anomaly detection across medical and industrial images. Our approach employs the squeeze-and-excitation (SE) block to enhance feature extraction via channel-wise attention, enabling the model to focus on the most relevant features and detect subtle anomalies. Knowledge distillation (KD) transfers informative features from the teacher to the student model, enabling effective learning of the differences between normal and anomalous data. Then, the discriminator network further enhances the model's capacity to distinguish between normal and anomalous data. At the inference stage, by integrating multi-scale features, the student model can detect anomalies of varying sizes. The teacher-student (T-S) architecture ensures consistent representation of high-dimensional features while adapting them to enhance anomaly detection. Multi-AD was evaluated on several medical datasets, including brain MRI, liver CT, and retina OCT, as well as industrial datasets, such as MVTec AD, demonstrating strong generalization across multiple domains. Experimental results demonstrated that our approach consistently outperformed state-of-the-art models, achieving the best average AUROC for both image-level (81.4% for medical and 99.6% for industrial) and pixel-level (97.0% for medical and 98.4% for industrial) tasks, making it effective for real-world applications.

Disc-Centric Contrastive Learning for Lumbar Spine Severity Grading

This work examines a disc-centric approach for automated severity grading of lumbar spinal stenosis from sagittal T2-weighted MRI. The method combines contrastive pretraining with disc-level fine-tuning, using a single anatomically localized region of interest per intervertebral disc. Contrastive learning is employed to help the model focus on meaningful disc features and reduce sensitivity to irrelevant differences in image appearance. The framework includes an auxiliary regression task for disc localization and applies weighted focal loss to address class imbalance. Experiments demonstrate a 78.1% balanced accuracy and a reduced severe-to-normal misclassification rate of 2.13% compared with supervised training from scratch. Detecting discs with moderate severity can still be challenging, but focusing on disc-level features provides a practical way to assess the lumbar spinal stenosis.

A Hybrid CNN and ML Framework for Multi-modal Classification of Movement Disorders Using MRI and Brain Structural Features

Atypical Parkinsonian Disorders (APD), also known as Parkinson-plus syndrome, are a group of neurodegenerative diseases that include progressive supranuclear palsy (PSP) and multiple system atrophy (MSA). In the early stages, overlapping clinical features often lead to misdiagnosis as Parkinson's disease (PD). Identifying reliable imaging biomarkers for early differential diagnosis remains a critical challenge. In this study, we propose a hybrid framework combining convolutional neural networks (CNNs) with machine learning (ML) techniques to classify APD subtypes versus PD and distinguish between the subtypes themselves: PSP vs. PD, MSA vs. PD, and PSP vs. MSA. The model leverages multi-modal input data, including T1-weighted magnetic resonance imaging (MRI), segmentation masks of 12 deep brain structures associated with APD, and their corresponding volumetric measurements. By integrating these complementary modalities, including image data, structural segmentation masks, and quantitative volume features, the hybrid approach achieved promising classification performance with area under the curve (AUC) scores of 0.95 for PSP vs. PD, 0.86 for MSA vs. PD, and 0.92 for PSP vs. MSA. These results highlight the potential of combining spatial and structural information for robust subtype differentiation. In conclusion, this study demonstrates that fusing CNN-based image features with volume-based ML inputs improves classification accuracy for APD subtypes. The proposed approach may contribute to more reliable early-stage diagnosis, facilitating timely and targeted interventions in clinical practice.

An Intuitionistic Fuzzy Logic Driven UNet architecture: Application to Brain Image segmentation

Accurate segmentation of MRI brain images is essential for image analysis, diagnosis of neuro-logical disorders and medical image computing. In the deep learning approach, the convolutional neural networks (CNNs), especially UNet, are widely applied in medical image segmentation. However, it is difficult to deal with uncertainty due to the partial volume effect in brain images. To overcome this limitation, we propose an enhanced framework, named UNet with intuitionistic fuzzy logic (IF-UNet), which incorporates intuitionistic fuzzy logic into UNet. The model processes input data in terms of membership, nonmembership, and hesitation degrees, allowing it to better address tissue ambiguity resulting from partial volume effects and boundary uncertainties. The proposed architecture is evaluated on the Internet Brain Segmentation Repository (IBSR) dataset, and its performance is computed using accuracy, Dice coefficient, and intersection over union (IoU). Experimental results confirm that IF-UNet improves segmentation quality with handling uncertainty in brain images.

Med-MMFL: A Multimodal Federated Learning Benchmark in Healthcare

Federated learning (FL) enables collaborative model training across decentralized medical institutions while preserving data privacy. However, medical FL benchmarks remain scarce, with existing efforts focusing mainly on unimodal or bimodal modalities and a limited range of medical tasks. This gap underscores the need for standardized evaluation to advance systematic understanding in medical MultiModal FL (MMFL). To this end, we introduce Med-MMFL, the first comprehensive MMFL benchmark for the medical domain, encompassing diverse modalities, tasks, and federation scenarios. Our benchmark evaluates six representative state-of-the-art FL algorithms, covering different aggregation strategies, loss formulations, and regularization techniques. It spans datasets with 2 to 4 modalities, comprising a total of 10 unique medical modalities, including text, pathology images, ECG, X-ray, radiology reports, and multiple MRI sequences. Experiments are conducted across naturally federated, synthetic IID, and synthetic non-IID settings to simulate real-world heterogeneity. We assess segmentation, classification, modality alignment (retrieval), and VQA tasks. To support reproducibility and fair comparison of future multimodal federated learning (MMFL) methods under realistic medical settings, we release the complete benchmark implementation, including data processing and partitioning pipelines, at https://github.com/bhattarailab/Med-MMFL-Benchmark .

Multiparameter Uncertainty Mapping in Quantitative Molecular MRI using a Physics-Structured Variational Autoencoder (PS-VAE)

Quantitative imaging methods, such as magnetic resonance fingerprinting (MRF), aim to extract interpretable pathology biomarkers by estimating biophysical tissue parameters from signal evolutions. However, the pattern-matching algorithms or neural networks used in such inverse problems often lack principled uncertainty quantification, which limits the trustworthiness and transparency, required for clinical acceptance. Here, we describe a physics-structured variational autoencoder (PS-VAE) designed for rapid extraction of voxelwise multi-parameter posterior distributions. Our approach integrates a differentiable spin physics simulator with self-supervised learning, and provides a full covariance that captures the inter-parameter correlations of the latent biophysical space. The method was validated in a multi-proton pool chemical exchange saturation transfer (CEST) and semisolid magnetization transfer (MT) molecular MRF study, across in-vitro phantoms, tumor-bearing mice, healthy human volunteers, and a subject with glioblastoma. The resulting multi-parametric posteriors are in good agreement with those calculated using a brute-force Bayesian analysis, while providing an orders-of-magnitude acceleration in whole brain quantification. In addition, we demonstrate how monitoring the multi-parameter posterior dynamics across progressively acquired signals provides practical insights for protocol optimization and may facilitate real-time adaptive acquisition.

From Pre- to Intra-operative MRI: Predicting Brain Shift in Temporal Lobe Resection for Epilepsy Surgery

Introduction: In neurosurgery, image-guided Neurosurgery Systems (IGNS) highly rely on preoperative brain magnetic resonance images (MRI) to assist surgeons in locating surgical targets and determining surgical paths. However, brain shift invalidates the preoperative MRI after dural opening. Updated intraoperative brain MRI with brain shift compensation is crucial for enhancing the precision of neuronavigation systems and ensuring the optimal outcome of surgical interventions. Methodology: We propose NeuralShift, a U-Net-based model that predicts brain shift entirely from pre-operative MRI for patients undergoing temporal lobe resection. We evaluated our results using Target Registration Errors (TREs) computed on anatomical landmarks located on the resection side and along the midline, and DICE scores comparing predicted intraoperative masks with masks derived from intraoperative MRI. Results: Our experimental results show that our model can predict the global deformation of the brain (DICE of 0.97) with accurate local displacements (achieve landmark TRE as low as 1.12 mm), compensating for large brain shifts during temporal lobe removal neurosurgery. Conclusion: Our proposed model is capable of predicting the global deformation of the brain during temporal lobe resection using only preoperative images, providing potential opportunities to the surgical team to increase safety and efficiency of neurosurgery and better outcomes to patients. Our contributions will be publicly available after acceptance in https://github.com/SurgicalDataScienceKCL/NeuralShift.

SLIM-Diff: Shared Latent Image-Mask Diffusion with Lp loss for Data-Scarce Epilepsy FLAIR MRI

Focal cortical dysplasia (FCD) lesions in epilepsy FLAIR MRI are subtle and scarce, making joint image--mask generative modeling prone to instability and memorization. We propose SLIM-Diff, a compact joint diffusion model whose main contributions are (i) a single shared-bottleneck U-Net that enforces tight coupling between anatomy and lesion geometry from a 2-channel image+mask representation, and (ii) loss-geometry tuning via a tunable $L_p$ objective. As an internal baseline, we include the canonical DDPM-style objective ($ε$-prediction with $L_2$ loss) and isolate the effect of prediction parameterization and $L_p$ geometry under a matched setup. Experiments show that $x_0$-prediction is consistently the strongest choice for joint synthesis, and that fractional sub-quadratic penalties ($L_{1.5}$) improve image fidelity while $L_2$ better preserves lesion mask morphology. Our code and model weights are available in https://github.com/MarioPasc/slim-diff