Low-dose computed tomography (LDCT) lower potential risks linked to radiation exposure while relying on advanced denoising algorithms to maintain diagnostic quality in reconstructed images. The reigning paradigm in LDCT denoising is based on neural network models that learn data-driven image priors to separate noise evoked by dose reduction from underlying tissue signals. Naturally, the fidelity of these priors depend on the model's ability to capture the broad range of contextual features evident in CT images. Earlier convolutional neural networks (CNN) are highly adept at efficiently capturing short-range spatial context, but their limited receptive fields reduce sensitivity to interactions over longer distances. Although transformers based on self-attention mechanisms have recently been posed to increase sensitivity to long-range context, they can suffer from suboptimal performance and efficiency due to elevated model complexity, particularly for high-resolution CT images. For high-quality restoration of LDCT images, here we introduce DenoMamba, a novel denoising method based on state-space modeling (SSM), that efficiently captures short- and long-range context in medical images. Following an hourglass architecture with encoder-decoder stages, DenoMamba employs a spatial SSM module to encode spatial context and a novel channel SSM module equipped with a secondary gated convolution network to encode latent features of channel context at each stage. Feature maps from the two modules are then consolidated with low-level input features via a convolution fusion module (CFM). Comprehensive experiments on LDCT datasets with 25\% and 10\% dose reduction demonstrate that DenoMamba outperforms state-of-the-art denoisers with average improvements of 1.4dB PSNR, 1.1% SSIM, and 1.6% RMSE in recovered image quality.

Chest X-ray is an essential diagnostic tool in the identification of chest diseases given its high sensitivity to pathological abnormalities in the lungs. However, image-driven diagnosis is still challenging due to heterogeneity in size and location of pathology, as well as visual similarities and co-occurrence of separate pathology. Since disease-related regions often occupy a relatively small portion of diagnostic images, classification models based on traditional convolutional neural networks (CNNs) are adversely affected given their locality bias. While CNNs were previously augmented with attention maps or spatial masks to guide focus on potentially critical regions, learning localization guidance under heterogeneity in the spatial distribution of pathology is challenging. To improve multi-label classification performance, here we propose a novel method, HydraViT, that synergistically combines a transformer backbone with a multi-branch output module with learned weighting. The transformer backbone enhances sensitivity to long-range context in X-ray images, while using the self-attention mechanism to adaptively focus on task-critical regions. The multi-branch output module dedicates an independent branch to each disease label to attain robust learning across separate disease classes, along with an aggregated branch across labels to maintain sensitivity to co-occurrence relationships among pathology. Experiments demonstrate that, on average, HydraViT outperforms competing attention-guided methods by 1.2%, region-guided methods by 1.4%, and semantic-guided methods by 1.0% in multi-label classification performance.

Deep learning analyses have offered sensitivity leaps in detection of cognitive states from functional MRI (fMRI) measurements across the brain. Yet, as deep models perform hierarchical nonlinear transformations on their input, interpreting the association between brain responses and cognitive states is challenging. Among common explanation approaches for deep fMRI classifiers, attribution methods show poor specificity and perturbation methods show limited plausibility. While counterfactual generation promises to address these limitations, previous methods use variational or adversarial priors that yield suboptimal sample fidelity. Here, we introduce the first diffusion-driven counterfactual method, DreaMR, to enable fMRI interpretation with high specificity, plausibility and fidelity. DreaMR performs diffusion-based resampling of an input fMRI sample to alter the decision of a downstream classifier, and then computes the minimal difference between the original and counterfactual samples for explanation. Unlike conventional diffusion methods, DreaMR leverages a novel fractional multi-phase-distilled diffusion prior to improve sampling efficiency without compromising fidelity, and it employs a transformer architecture to account for long-range spatiotemporal context in fMRI scans. Comprehensive experiments on neuroimaging datasets demonstrate the superior specificity, fidelity and efficiency of DreaMR in sample generation over state-of-the-art counterfactual methods for fMRI interpretation.

Deep-learning models have enabled performance leaps in analysis of high-dimensional functional MRI (fMRI) data. Yet, many previous methods are suboptimally sensitive for contextual representations across diverse time scales. Here, we present BolT, a blood-oxygen-level-dependent transformer model, for analyzing multi-variate fMRI time series. BolT leverages a cascade of transformer encoders equipped with a novel fused window attention mechanism. Encoding is performed on temporally-overlapped windows within the time series to capture local representations. To integrate information temporally, cross-window attention is computed between base tokens in each window and fringe tokens from neighboring windows. To gradually transition from local to global representations, the extent of window overlap and thereby number of fringe tokens are progressively increased across the cascade. Finally, a novel cross-window regularization is employed to align high-level classification features across the time series. Comprehensive experiments on large-scale public datasets demonstrate the superior performance of BolT against state-of-the-art methods. Furthermore, explanatory analyses to identify landmark time points and regions that contribute most significantly to model decisions corroborate prominent neuroscientific findings in the literature.

Multi-institutional collaborations are key for learning generalizable MRI synthesis models that translate source- onto target-contrast images. To facilitate collaboration, federated learning (FL) adopts decentralized training and mitigates privacy concerns by avoiding sharing of imaging data. However, FL-trained synthesis models can be impaired by the inherent heterogeneity in the data distribution, with domain shifts evident when common or variable translation tasks are prescribed across sites. Here we introduce the first personalized FL method for MRI Synthesis (pFLSynth) to improve reliability against domain shifts. pFLSynth is based on an adversarial model that produces latents specific to individual sites and source-target contrasts, and leverages novel personalization blocks to adaptively tune the statistics and weighting of feature maps across the generator stages given latents. To further promote site specificity, partial model aggregation is employed over downstream layers of the generator while upstream layers are retained locally. As such, pFLSynth enables training of a unified synthesis model that can reliably generalize across multiple sites and translation tasks. Comprehensive experiments on multi-site datasets clearly demonstrate the enhanced performance of pFLSynth against prior federated methods in multi-contrast MRI synthesis.