V ox2Cortex: Fast explicit reconstruction of cortical surfaces from 3D MRI scans with geometric deep neural networks.

V ox2Cortex: Fast explicit reconstruction of cortical surfaces from 3D MRI scans with geometric deep neural networks.

Accurate forecasting of individualized, high-resolution cortical thickness (CTh) trajectories is essential for detecting subtle cortical changes, providing invaluable insights into neurodegenerative processes and facilitating earlier and more precise intervention strategies. However, CTh forecasting is a challenging task due to the intricate non-Euclidean geometry of the cerebral cortex and the need to integrate multi-modal data for subject-specific predictions. To address these challenges, we introduce the Spherical Brownian Bridge Diffusion Model (SBDM). Specifically, we propose a bidirectional conditional Brownian bridge diffusion process to forecast CTh trajectories at the vertex level of registered cortical surfaces. Our technical contribution includes a new denoising model, the conditional spherical U-Net (CoS-UNet), which combines spherical convolutions and dense cross-attention to integrate cortical surfaces and tabular conditions seamlessly. Compared to previous approaches, SBDM achieves significantly reduced prediction errors, as demonstrated by our experiments based on longitudinal datasets from the ADNI and OASIS. Additionally, we demonstrate SBDM's ability to generate individual factual and counterfactual CTh trajectories, offering a novel framework for exploring hypothetical scenarios of cortical development.

Accurate estimation of postmenstrual age (PMA) at scan is crucial for assessing neonatal development and health. While deep learning models have achieved high accuracy in predicting PMA from brain MRI, they often function as black boxes, offering limited transparency and interpretability in clinical decision support. In this work, we address the dual challenge of accuracy and interpretability by adapting a multimodal large language model (MLLM) to perform both precise PMA prediction and clinically relevant explanation generation. We introduce a parameter-efficient fine-tuning (PEFT) strategy using instruction tuning and Low-Rank Adaptation (LoRA) applied to the Qwen2.5-VL-7B model. The model is trained on four 2D cortical surface projection maps derived from neonatal MRI scans. By employing distinct prompts for training and inference, our approach enables the MLLM to handle a regression task during training and generate clinically relevant explanations during inference. The fine-tuned model achieves a low prediction error with a 95 percent confidence interval of 0.78 to 1.52 weeks, while producing interpretable outputs grounded in developmental features, marking a significant step toward transparent and trustworthy AI systems in perinatal neuroscience.

Interpretable models are crucial for supporting clinical decision-making, driving advances in their development and application for medical images. However, the nature of 3D volumetric data makes it inherently challenging to visualize and interpret intricate and complex structures like the cerebral cortex. Cortical surface renderings, on the other hand, provide a more accessible and understandable 3D representation of brain anatomy, facilitating visualization and interactive exploration. Motivated by this advantage and the widespread use of surface data for studying neurological disorders, we present the eXplainable Surface Vision Transformer (X-SiT). This is the first inherently interpretable neural network that offers human-understandable predictions based on interpretable cortical features. As part of X-SiT, we introduce a prototypical surface patch decoder for classifying surface patch embeddings, incorporating case-based reasoning with spatially corresponding cortical prototypes. The results demonstrate state-of-the-art performance in detecting Alzheimer's disease and frontotemporal dementia while additionally providing informative prototypes that align with known disease patterns and reveal classification errors.

Three-dimensional reconstruction of cortical surfaces from MRI for morphometric analysis is fundamental for understanding brain structure. While high-field MRI (HF-MRI) is standard in research and clinical settings, its limited availability hinders widespread use. Low-field MRI (LF-MRI), particularly portable systems, offers a cost-effective and accessible alternative. However, existing cortical surface analysis tools are optimized for high-resolution HF-MRI and struggle with the lower signal-to-noise ratio and resolution of LF-MRI. In this work, we present a machine learning method for 3D reconstruction and analysis of portable LF-MRI across a range of contrasts and resolutions. Our method works "out of the box" without retraining. It uses a 3D U-Net trained on synthetic LF-MRI to predict signed distance functions of cortical surfaces, followed by geometric processing to ensure topological accuracy. We evaluate our method using paired HF/LF-MRI scans of the same subjects, showing that LF-MRI surface reconstruction accuracy depends on acquisition parameters, including contrast type (T1 vs T2), orientation (axial vs isotropic), and resolution. A 3mm isotropic T2-weighted scan acquired in under 4 minutes, yields strong agreement with HF-derived surfaces: surface area correlates at r=0.96, cortical parcellations reach Dice=0.98, and gray matter volume achieves r=0.93. Cortical thickness remains more challenging with correlations up to r=0.70, reflecting the difficulty of sub-mm precision with 3mm voxels. We further validate our method on challenging postmortem LF-MRI, demonstrating its robustness. Our method represents a step toward enabling cortical surface analysis on portable LF-MRI. Code is available at https://surfer.nmr.mgh.harvard.edu/fswiki/ReconAny

Accurately discriminating progressive stages of Alzheimer's Disease (AD) is crucial for early diagnosis and prevention. It often involves multiple imaging modalities to understand the complex pathology of AD, however, acquiring a complete set of images is challenging due to high cost and burden for subjects. In the end, missing data become inevitable which lead to limited sample-size and decrease in precision in downstream analyses. To tackle this challenge, we introduce a holistic imaging feature imputation method that enables to leverage diverse imaging features while retaining all subjects. The proposed method comprises two networks: 1) An encoder to extract modality-independent embeddings and 2) A decoder to reconstruct the original measures conditioned on their imaging modalities. The encoder includes a novel {\em ordinal contrastive loss}, which aligns samples in the embedding space according to the progression of AD. We also maximize modality-wise coherence of embeddings within each subject, in conjunction with domain adversarial training algorithms, to further enhance alignment between different imaging modalities. The proposed method promotes our holistic imaging feature imputation across various modalities in the shared embedding space. In the experiments, we show that our networks deliver favorable results for statistical analysis and classification against imputation baselines with Alzheimer's Disease Neuroimaging Initiative (ADNI) study.

Characterizing a preclinical stage of Alzheimer's Disease (AD) via single imaging is difficult as its early symptoms are quite subtle. Therefore, many neuroimaging studies are curated with various imaging modalities, e.g., MRI and PET, however, it is often challenging to acquire all of them from all subjects and missing data become inevitable. In this regards, in this paper, we propose a framework that generates unobserved imaging measures for specific subjects using their existing measures, thereby reducing the need for additional examinations. Our framework transfers modality-specific style while preserving AD-specific content. This is done by domain adversarial training that preserves modality-agnostic but AD-specific information, while a generative adversarial network adds an indistinguishable modality-specific style. Our proposed framework is evaluated on the Alzheimer's Disease Neuroimaging Initiative (ADNI) study and compared with other imputation methods in terms of generated data quality. Small average Cohen's $d$ $< 0.19$ between our generated measures and real ones suggests that the synthetic data are practically usable regardless of their modality type.