Background and Objective: Plane reformatting for four-dimensional phase contrast MRI (4D flow MRI) is time-consuming and prone to inter-observer variability, which limits fast cardiovascular flow assessment. Deep reinforcement learning (DRL) trains agents to iteratively adjust plane position and orientation, enabling accurate plane reformatting without the need for detailed landmarks, making it suitable for images with limited contrast and resolution such as 4D flow MRI. However, current DRL methods assume that test volumes share the same spatial alignment as the training data, limiting generalization across scanners and institutions. To address this limitation, we introduce AdaPR (Adaptive Plane Reformatting), a DRL framework that uses a local coordinate system to navigate volumes with arbitrary positions and orientations. Methods: We implemented AdaPR using the Asynchronous Advantage Actor-Critic (A3C) algorithm and validated it on 88 4D flow MRI datasets acquired from multiple vendors, including patients with congenital heart disease. Results: AdaPR achieved a mean angular error of 6.32 +/- 4.15 degrees and a distance error of 3.40 +/- 2.75 mm, outperforming global-coordinate DRL methods and alternative non-DRL methods. AdaPR maintained consistent accuracy under different volume orientations and positions. Flow measurements from AdaPR planes showed no significant differences compared to two manual observers, with excellent correlation (R^2 = 0.972 and R^2 = 0.968), comparable to inter-observer agreement (R^2 = 0.969). Conclusion: AdaPR provides robust, orientation-independent plane reformatting for 4D flow MRI, achieving flow quantification comparable to expert observers. Its adaptability across datasets and scanners makes it a promising candidate for medical imaging applications beyond 4D flow MRI.

Extracranial tissues visible on brain magnetic resonance imaging (MRI) may hold significant value for characterizing health conditions and clinical decision-making, yet they are rarely quantified. Current tools have not been widely validated, particularly in settings of developing brains or underlying pathology. We present TissUnet, a deep learning model that segments skull bone, subcutaneous fat, and muscle from routine three-dimensional T1-weighted MRI, with or without contrast enhancement. The model was trained on 155 paired MRI-computed tomography (CT) scans and validated across nine datasets covering a wide age range and including individuals with brain tumors. In comparison to AI-CT-derived labels from 37 MRI-CT pairs, TissUnet achieved a median Dice coefficient of 0.79 [IQR: 0.77-0.81] in a healthy adult cohort. In a second validation using expert manual annotations, median Dice was 0.83 [IQR: 0.83-0.84] in healthy individuals and 0.81 [IQR: 0.78-0.83] in tumor cases, outperforming previous state-of-the-art method. Acceptability testing resulted in an 89% acceptance rate after adjudication by a tie-breaker(N=108 MRIs), and TissUnet demonstrated excellent performance in the blinded comparative review (N=45 MRIs), including both healthy and tumor cases in pediatric populations. TissUnet enables fast, accurate, and reproducible segmentation of extracranial tissues, supporting large-scale studies on craniofacial morphology, treatment effects, and cardiometabolic risk using standard brain T1w MRI.

Accurate morphometric assessment of cartilage-such as thickness/volume-via MRI is essential for monitoring knee osteoarthritis. Segmenting cartilage remains challenging and dependent on extensive expert-annotated datasets, which are heavily subjected to inter-reader variability. Recent advancements in Visual Foundational Models (VFM), especially memory-based approaches, offer opportunities for improving generalizability and robustness. This study introduces a deep learning (DL) method for cartilage and meniscus segmentation from 3D MRIs using interactive, memory-based VFMs. To improve spatial awareness and convergence, we incorporated a Hybrid Shuffling Strategy (HSS) during training and applied a segmentation mask propagation technique to enhance annotation efficiency. We trained four AI models-a CNN-based 3D-VNet, two automatic transformer-based models (SaMRI2D and SaMRI3D), and a transformer-based promptable memory-based VFM (SAMRI-2)-on 3D knee MRIs from 270 patients using public and internal datasets and evaluated on 57 external cases, including multi-radiologist annotations and different data acquisitions. Model performance was assessed against reference standards using Dice Score (DSC) and Intersection over Union (IoU), with additional morphometric evaluations to further quantify segmentation accuracy. SAMRI-2 model, trained with HSS, outperformed all other models, achieving an average DSC improvement of 5 points, with a peak improvement of 12 points for tibial cartilage. It also demonstrated the lowest cartilage thickness errors, reducing discrepancies by up to threefold. Notably, SAMRI-2 maintained high performance with as few as three user clicks per volume, reducing annotation effort while ensuring anatomical precision. This memory-based VFM with spatial awareness offers a novel approach for reliable AI-assisted knee MRI segmentation, advancing DL in musculoskeletal imaging.

To reduce scan time, approach to quantitative MRI, enabling the mapping of multiple MRF uses short-length acquisition sequences to encode multiple tissue properties from a single, accelerated scan. However, tissue properties simultaneously and applies compressed achieving accurate reconstructions remains challenging, sensing to subsample only a fraction of the spatiotemporal particularly in highly accelerated and undersampled acquisitions, k-space data. However, faster scans lead to challenges in image which are crucial for reducing scan times. While deep reconstruction, including aliasing artifacts from k-space learning techniques have advanced image reconstruction, the undersampling and limited tissue property information due recent introduction of diffusion models offers new possibilities to the truncated acquisition sequences. Effective image reconstruction for imaging tasks, though their application in the medical algorithms are needed to tackle these challenges field is still emerging. Notably, diffusion models have not yet and improve the accuracy and precision of tissue parameter been explored for the MRF problem. In this work, we propose estimation.

Magnetic resonance imaging (MRI) is a crucial tool for clinical diagnosis while facing the challenge of long scanning time. To reduce the acquisition time, fast MRI reconstruction aims to restore high-quality images from the undersampled k-space. Existing methods typically train deep learning models to map the undersampled data to artifact-free MRI images. However, these studies often overlook the unique properties of k-space and directly apply general networks designed for image processing to k-space recovery, leaving the precise learning of k-space largely underexplored. In this work, we propose a continuous k-space recovery network from a new perspective of implicit neural representation with image domain guidance, which boosts the performance of MRI reconstruction. Specifically, (1) an implicit neural representation based encoder-decoder structure is customized to continuously query unsampled k-values. (2) an image guidance module is designed to mine the semantic information from the low-quality MRI images to further guide the k-space recovery. (3) a multi-stage training strategy is proposed to recover dense k-space progressively. Extensive experiments conducted on CC359, fastMRI, and IXI datasets demonstrate the effectiveness of our method and its superiority over other competitors.

Purpose: To develop an MRI technique for free-breathing 3D whole-liver quantification of water T1, water T2, proton density fat fraction (PDFF), R2*. Methods: An Eight-echo spoiled gradient echo pulse sequence with spiral readout was developed by interleaving inversion recovery and T2 magnetization preparation. We propose a neural network based on a 4D and a 3D implicit neural representation (INR) which simultaneously learns the motion deformation fields and the static reference frame MRI subspace images respectively. Water and fat singular images were separated during network training, with no need of performing retrospective water-fat separation. T1, T2, R2* and proton density fat fraction (PDFF) produced by the proposed method were validated in vivo on 10 healthy subjects, using quantitative maps generated from conventional scans as reference. Results: Our results showed minimal bias and narrow 95% limits of agreement on T1, T2, R2* and PDFF values in the liver compared to conventional breath-holding scans. Conclusions: INR-MRF enabled co-registered 3D whole liver T1, T2, R2* and PDFF mapping in a single free-breathing scan.

Objective: Gadolinium-based contrast agents (GBCAs) are commonly used in MRI scans of patients with gliomas to enhance brain tumor characterization using T1-weighted (T1W) MRI. However, there is growing concern about GBCA toxicity. This study develops a deep-learning framework to generate T1-postcontrast (T1C) from pre-contrast multiparametric MRI. Approach: We propose the tumor-aware vision transformer (TA-ViT) model that predicts high-quality T1C images. The predicted tumor region is significantly improved (P < .001) by conditioning the transformer layers from predicted segmentation maps through adaptive layer norm zero mechanism. The predicted segmentation maps were generated with the multi-parametric residual (MPR) ViT model and transformed into a latent space to produce compressed, feature-rich representations. The TA-ViT model predicted T1C MRI images of 501 glioma cases. Selected patients were split into training (N=400), validation (N=50), and test (N=51) sets. Main Results: Both qualitative and quantitative results demonstrate that the TA-ViT model performs superior against the benchmark MRP-ViT model. Our method produces synthetic T1C MRI with high soft tissue contrast and more accurately reconstructs both the tumor and whole brain volumes. The synthesized T1C images achieved remarkable improvements in both tumor and healthy tissue regions compared to the MRP-ViT model. For healthy tissue and tumor regions, the results were as follows: NMSE: 8.53 +/- 4.61E-4; PSNR: 31.2 +/- 2.2; NCC: 0.908 +/- .041 and NMSE: 1.22 +/- 1.27E-4, PSNR: 41.3 +/- 4.7, and NCC: 0.879 +/- 0.042, respectively. Significance: The proposed method generates synthetic T1C images that closely resemble real T1C images. Future development and application of this approach may enable contrast-agent-free MRI for brain tumor patients, eliminating the risk of GBCA toxicity and simplifying the MRI scan protocol.

The estimation of multi-parametric quantitative maps from Magnetic Resonance Fingerprinting (MRF) compressed sampled acquisitions, albeit successful, remains a challenge due to the high underspampling rate and artifacts naturally occuring during image reconstruction. Whilst state-of-the-art DL methods can successfully address the task, to fully exploit their capabilities they often require training on a paired dataset, in an area where ground truth is seldom available. In this work, we propose a method that combines a deep image prior (DIP) module that, without ground truth and in conjunction with a Bloch consistency enforcing autoencoder, can tackle the problem, resulting in a method faster and of equivalent or better accuracy than DIP-MRF.

The goals of functional Magnetic Resonance Imaging (fMRI) include high spatial and temporal resolutions with a high signal-to-noise ratio (SNR). To simultaneously improve spatial and temporal resolutions and maintain the high SNR advantage of OSSI, we present novel pipelines for fast acquisition and high-resolution fMRI reconstruction and physics parameter quantification. We propose a patch-tensor low-rank model, a physics-based manifold model, and a voxel-wise attention network. With novel models for acquisition and reconstruction, we demonstrate that we can improve SNR and resolution simultaneously without compromising scan time. All the proposed models outperform other comparison approaches with higher resolution and more functional information.

Background and purpose: The unanticipated detection by magnetic resonance imaging (MRI) in the brain of asymptomatic subjects of white matter lesions suggestive of multiple sclerosis (MS) has been named radiologically isolated syndrome (RIS). As the difference between early MS [i.e. clinically isolated syndrome (CIS)] and RIS is the occurrence of a clinical event, it is logical to improve detection of the subclinical form without interfering with MRI as there are radiological diagnostic criteria for that. Our objective was to use machine-learning classification methods to identify morphometric measures that help to discriminate patients with RIS from those with CIS. Methods: We used a multimodal 3-T MRI approach by combining MRI biomarkers (cortical thickness, cortical and subcortical grey matter volume, and white matter integrity) of a cohort of 17 patients with RIS and 17 patients with CIS for single-subject level classification. Results: The best proposed models to predict the diagnosis of CIS and RIS were based on the Naive Bayes, Bagging and Multilayer Perceptron classifiers using only three features: the left rostral middle frontal gyrus volume and the fractional anisotropy values in the right amygdala and right lingual gyrus. The Naive Bayes obtained the highest accuracy [overall classification, 0.765; area under the receiver operating characteristic (AUROC), 0.782]. Conclusions: A machine-learning approach applied to multimodal MRI data may differentiate between the earliest clinical expressions of MS (CIS and RIS) with an accuracy of 78%. Keywords: Bagging; Multilayer Perceptron; Naive Bayes classifier; clinically isolated syndrome; diffusion tensor imaging; machine-learning; magnetic resonance imaging; multiple sclerosis; radiologically isolated syndrome.