Jana Hutter

Anika Knupfer, Johanna P. Müller, Jordina A. Verdera et al.

Pelvic diseases in women of reproductive age represent a major global health burden, with diagnosis frequently delayed due to high anatomical variability, complicating MRI interpretation. Existing AI approaches are largely disease-specific and lack real-time compatibility, limiting generalizability and clinical integration. To address these challenges, we establish a benchmark framework for disease- and parameter-agnostic, real-time-compatible unsupervised anomaly detection in pelvic MRI. The method uses a residual variational autoencoder trained exclusively on healthy sagittal T2-weighted scans acquired across diverse imaging protocols to model normal pelvic anatomy. During inference, reconstruction error heatmaps indicate deviations from learned healthy structure, enabling detection of pathological regions without labeled abnormal data. The model is trained on 294 healthy scans and augmented with diffusion-generated synthetic data to improve robustness. Quantitative evaluation on the publicly available Uterine Myoma MRI Dataset yields an average area-under-the-curve (AUC) value of 0.736, with 0.828 sensitivity and 0.692 specificity. Additional inter-observer clinical evaluation extends analysis to endometrial cancer, endometriosis, and adenomyosis, revealing the influence of anatomical heterogeneity and inter-observer variability on performance interpretation. With a reconstruction time of approximately 92.6 frames per second, the proposed framework establishes a baseline for unsupervised anomaly detection in the female pelvis and supports future integration into real-time MRI. Code is available upon request (https://github.com/AniKnu/UADPelvis), prospective data sets are available for academic collaboration.

Md Hasan, Nyvenn Castro, Daiqi Liu et al.

Real-time magnetic resonance imaging (rtMRI) of speech production enables non-invasive visualization of dynamic vocal-tract motion and is valuable for speech science and clinical assessment. However, rtMRI is fundamentally constrained by trade-offs among spatial resolution, temporal resolution, and acquisition speed, often leading to undersampled k-space measurements and degraded reconstructions. We propose SIREM, a speech-informed MRI reconstruction framework that uses synchronized speech as a cross-modal prior. The central idea is that vocal-tract configurations during speech are correlated with the produced acoustics, making part of the image content predictable from audio. SIREM models each frame as a fusion of an audio-driven component and an MRI-driven component through a spatial weighting map. The audio branch predicts articulator-related structure from speech, while the MRI branch reconstructs complementary content from measured k-space data. We further introduce a learnable soft weighting profile over spiral arms, enabling a differentiable study of how k-space arm usage interacts with speech-informed fusion. This yields a unified multimodal formulation that combines audio-driven prediction, MRI reconstruction, and sampling adaptation. We evaluate SIREM on the USC speech rtMRI benchmark against standard baselines, including gridding, wavelet-based compressed sensing, and total variation. SIREM introduces a speech-informed reconstruction paradigm that operates in a substantially higher-throughput regime than iterative methods while preserving anatomically plausible vocal-tract structure. These results establish an initial benchmark for multimodal speech-informed rtMRI reconstruction and highlight the potential of synchronized speech as an auxiliary prior for fast reconstruction. The source code is available at https://github.com/mdhasanai/SIREM

Daiqi Liu, Lukas Mulzer, Md Hasan et al.

Segmenting vocal tract articulators in real-time MRI (rtMRI) is a challenging dynamic image segmentation problem characterized by low contrast, rapid motion, and limited spatial resolution. However, while rtMRI acquisitions may provide synchronized acoustic signals, existing methods discard this information, and the few multimodal approaches that incorporate audio cannot be deployed when audio is unavailable. We propose a three-stage framework that leverages acoustic and phonological supervision during training while requiring only the rtMRI image at inference: phonological representations are converted into spatial bounding-box priors for articulator localization, visual and acoustic encoders are aligned via dual-level cross-modal contrastive pretraining, and the learned representations are fused through a cross-attention decoder, effectively transferring multimodal knowledge into a single-modality inference pipeline. Evaluated on 75-Speaker~Annot-16 and USC-TIMIT datasets, our method outperforms existing unimodal and multimodal methods, demonstrating that multimodal supervision provides transferable benefits for precise and clinically deployable vocal tract segmentation.

Daiqi Liu, Tomás Arias-Vergara, Jana Hutter et al.

Accurate classification of articulatory-phonological features plays a vital role in understanding human speech production and developing robust speech technologies, particularly in clinical contexts where targeted phonemic analysis and therapy can improve disease diagnosis accuracy and personalized rehabilitation. In this work, we propose a multimodal deep learning framework that combines real-time magnetic resonance imaging (rtMRI) and speech signals to classify three key articulatory dimensions: manner of articulation, place of articulation, and voicing. We perform classification on 15 phonological classes derived from the aforementioned articulatory dimensions and evaluate the system with four audio/vision configurations: unimodal rtMRI, unimodal audio signals, multimodal middle fusion, and contrastive learning-based audio-vision fusion. Experimental results on the USC-TIMIT dataset show that our contrastive learning-based approach achieves state-of-the-art performance, with an average F1-score of 0.81, representing an absolute increase of 0.23 over the unimodal baseline. The results confirm the effectiveness of contrastive representation learning for multimodal articulatory analysis. Our code and processed dataset will be made publicly available at https://github.com/DaE-plz/AC_Contrastive_Phonology to support future research.

Amine Othmane, Maria Camila Bustos Vivas, Johannes Steuer et al.

Electrohysterography (EHG) enables non-invasive monitoring of uterine contractions but can be contaminated by electrocardiogram (ECG) artifacts. This work presents an ECG removal method using algebraic differentiators, a control-theoretic tool for model-free derivative estimation, that preserves signal shape outside the detected cardiac pulse locations. The differentiator parameters are designed to simultaneously suppress slow physiological artifacts and powerline interference while maximizing output signal-to-noise ratio. Cross-channel clustering distinguishes cardiac pulses from localized artifacts, enabling accurate pulse subtraction without auxiliary ECG references. Implemented as a causal FIR filter, the method is validated on multichannel EHG recordings from female and male subjects and compared to the template subtraction method.

Vladyslav Zalevskyi, Thomas Sanchez, Margaux Roulet et al.

Segmentation of fetal brain tissue from magnetic resonance imaging (MRI) plays a crucial role in the study of in utero neurodevelopment. However, automated tools face substantial domain shift challenges as they must be robust to highly heterogeneous clinical data, often limited in numbers and lacking annotations. Indeed, high variability of the fetal brain morphology, MRI acquisition parameters, and superresolution reconstruction (SR) algorithms adversely affect the model's performance when evaluated out-of-domain. In this work, we introduce FetalSynthSeg, a domain randomization method to segment fetal brain MRI, inspired by SynthSeg. Our results show that models trained solely on synthetic data outperform models trained on real data in out-ofdomain settings, validated on a 120-subject cross-domain dataset. Furthermore, we extend our evaluation to 40 subjects acquired using lowfield (0.55T) MRI and reconstructed with novel SR models, showcasing robustness across different magnetic field strengths and SR algorithms. Leveraging a generative synthetic approach, we tackle the domain shift problem in fetal brain MRI and offer compelling prospects for applications in fields with limited and highly heterogeneous data.

Vladyslav Zalevskyi, Thomas Sanchez, Misha Kaandorp et al.

Accurate fetal brain tissue segmentation and biometric analysis are essential for studying brain development in utero. The FeTA Challenge 2024 advanced automated fetal brain MRI analysis by introducing biometry prediction as a new task alongside tissue segmentation. For the first time, our diverse multi-centric test set included data from a new low-field (0.55T) MRI dataset. Evaluation metrics were also expanded to include the topology-specific Euler characteristic difference (ED). Sixteen teams submitted segmentation methods, most of which performed consistently across both high- and low-field scans. However, longitudinal trends indicate that segmentation accuracy may be reaching a plateau, with results now approaching inter-rater variability. The ED metric uncovered topological differences that were missed by conventional metrics, while the low-field dataset achieved the highest segmentation scores, highlighting the potential of affordable imaging systems when paired with high-quality reconstruction. Seven teams participated in the biometry task, but most methods failed to outperform a simple baseline that predicted measurements based solely on gestational age, underscoring the challenge of extracting reliable biometric estimates from image data alone. Domain shift analysis identified image quality as the most significant factor affecting model generalization, with super-resolution pipelines also playing a substantial role. Other factors, such as gestational age, pathology, and acquisition site, had smaller, though still measurable, effects. Overall, FeTA 2024 offers a comprehensive benchmark for multi-class segmentation and biometry estimation in fetal brain MRI, underscoring the need for data-centric approaches, improved topological evaluation, and greater dataset diversity to enable clinically robust and generalizable AI tools.

Vladyslav Zalevskyi, Thomas Sanchez, Margaux Roulet et al.

Fetal brain tissue segmentation in magnetic resonance imaging (MRI) is a crucial tool that supports understanding of neurodevelopment, yet it faces challenges due to the heterogeneity of data coming from different scanners and settings, as well as data scarcity. Recent approaches based on domain randomization, like SynthSeg, have shown great potential for single-source domain generalization by simulating images with randomized contrast and image resolution from the label maps. In this work, we investigate how to maximize the out-of-domain (OOD) generalization potential of SynthSegbased methods in fetal brain MRI. Specifically, we demonstrate that the simple Gaussian mixture models employed in FetalSynthSeg outperform physics-informed generation methods in terms of OOD generalization. We further show that incorporating intensity clustering significantly enhances generalization in settings with limited label classes by producing more realistic synthetic data. By combining synthetic pretraining with fine-tuning on real images and applying weight-space interpolation between the two models, we propose DRIFTS as an effective and practical solution for single-source domain generalization. DRIFTS consistently outperforms current state-of-the-art models across multiple benchmarks and is, to our knowledge, the first method to achieve accurate brain tissue segmentation on fetal T1-weighted images. We validate our approach on 308 subjects from four datasets acquired at three different sites, covering a range of scanner field strengths (0.55T to 3T) and both T1w and T2w modalities. We conclude with five practical recommendations to guide the development of SynthSeg-based methods for other organs and imaging modalities.

Ziyao Shang, Misha Kaandorp, Kelly Payette et al.

Magnetic resonance imaging (MRI) has played a crucial role in fetal neurodevelopmental research. Structural annotations of MR images are an important step for quantitative analysis of the developing human brain, with Deep learning providing an automated alternative for this otherwise tedious manual process. However, segmentation performances of Convolutional Neural Networks often suffer from domain shift, where the network fails when applied to subjects that deviate from the distribution with which it is trained on. In this work, we aim to train networks capable of automatically segmenting fetal brain MRIs with a wide range of domain shifts pertaining to differences in subject physiology and acquisition environments, in particular shape-based differences commonly observed in pathological cases. We introduce a novel data-driven train-time sampling strategy that seeks to fully exploit the diversity of a given training dataset to enhance the domain generalizability of the trained networks. We adapted our sampler, together with other existing data augmentation techniques, to the SynthSeg framework, a generator that utilizes domain randomization to generate diverse training data, and ran thorough experimentations and ablation studies on a wide range of training/testing data to test the validity of the approaches. Our networks achieved notable improvements in the segmentation quality on testing subjects with intense anatomical abnormalities (p < 1e-4), though at the cost of a slighter decrease in performance in cases with fewer abnormalities. Our work also lays the foundation for future works on creating and adapting data-driven sampling strategies for other training pipelines.

Daiqi Liu, Tomás Arias-Vergara, Johannes Enk et al.

Accurately segmenting articulatory structures in real-time magnetic resonance imaging (rtMRI) remains challenging, as most existing methods rely almost entirely on visual cues. Yet synchronized acoustic and phonological signals provide complementary context that can enrich visual information and improve precision. In this paper, we introduce VocSegMRI, a multimodal framework that integrates video, audio, and phonological inputs through cross-attention fusion for dynamic feature alignment. To further enhance cross-modal representation, we incorporate a contrastive learning objective that improves segmentation performance even when the audio modality is unavailable at inference. Evaluated on a sub-set of USC-75 rtMRI dataset, our approach achieves state-of-the-art performance, with a Dice score of 0.95 and a 95th percentile Hausdorff Distance (HD_95) of 4.20 mm, outperforming both unimodal and multimodal baselines. Ablation studies confirm the contributions of cross-attention and contrastive learning to segmentation precision and robustness. These results highlight the value of integrative multimodal modeling for accurate vocal tract analysis.

Diego Fajardo-Rojas, Levente Baljer, Jordina Aviles Verdera et al.

Preterm birth is a major cause of mortality and lifelong morbidity in childhood. Its complex and multifactorial origins limit the effectiveness of current clinical predictors and impede optimal care. In this study, a dual-branch deep learning architecture (PUUMA) was developed to predict gestational age (GA) at birth using T2* fetal MRI data from 295 pregnancies, encompassing a heterogeneous and imbalanced population. The model integrates both global whole-uterus and local placental features. Its performance was benchmarked against linear regression using cervical length measurements obtained by experienced clinicians from anatomical MRI and other Deep Learning architectures. The GA at birth predictions were assessed using mean absolute error. Accuracy, sensitivity, and specificity were used to assess preterm classification. Both the fully automated MRI-based pipeline and the cervical length regression achieved comparable mean absolute errors (3 weeks) and good sensitivity (0.67) for detecting preterm birth, despite pronounced class imbalance in the dataset. These results provide a proof of concept for automated prediction of GA at birth from functional MRI, and underscore the value of whole-uterus functional imaging in identifying at-risk pregnancies. Additionally, we demonstrate that manual, high-definition cervical length measurements derived from MRI, not currently routine in clinical practice, offer valuable predictive information. Future work will focus on expanding the cohort size and incorporating additional organ-specific imaging to improve generalisability and predictive performance.

Busra Bulut, Maik Dannecker, Thomas Sanchez et al.

T2 mapping in fetal brain MRI has the potential to improve characterization of the developing brain, especially at mid-field (0.55T), where T2 decay is slower. However, this is challenging as fetal MRI acquisition relies on multiple motion-corrupted stacks of thick slices, requiring slice-to-volume reconstruction (SVR) to estimate a high-resolution (HR) 3D volume. Currently, T2 mapping involves repeated acquisitions of these stacks at each echo time (TE), leading to long scan times and high sensitivity to motion. We tackle this challenge with a method that jointly reconstructs data across TEs, addressing severe motion. Our approach combines implicit neural representations with a physics-informed regularization that models T2 decay, enabling information sharing across TEs while preserving anatomical and quantitative T2 fidelity. We demonstrate state-of-the-art performance on simulated fetal brain and in vivo adult datasets with fetal-like motion. We also present the first in vivo fetal T2 mapping results at 0.55T. Our study shows potential for reducing the number of stacks per TE in T2 mapping by leveraging anatomical redundancy.

Johanna P. Müller, Anika Knupfer, Pedro Blöss et al.

Despite significant progress in generative modelling, existing diffusion models often struggle to produce anatomically precise female pelvic images, limiting their application in gynaecological imaging, where data scarcity and patient privacy concerns are critical. To overcome these barriers, we introduce a novel diffusion-based framework for uterine MRI synthesis, integrating both unconditional and conditioned Denoising Diffusion Probabilistic Models (DDPMs) and Latent Diffusion Models (LDMs) in 2D and 3D. Our approach generates anatomically coherent, high fidelity synthetic images that closely mimic real scans and provide valuable resources for training robust diagnostic models. We evaluate generative quality using advanced perceptual and distributional metrics, benchmarking against standard reconstruction methods, and demonstrate substantial gains in diagnostic accuracy on a key classification task. A blinded expert evaluation further validates the clinical realism of our synthetic images. We release our models with privacy safeguards and a comprehensive synthetic uterine MRI dataset to support reproducible research and advance equitable AI in gynaecology.

Paula Andrea Pérez-Toro, Tomás Arias-Vergara, Fangxu Xing et al.

Understanding the relationship between vocal tract motion during speech and the resulting acoustic signal is crucial for aided clinical assessment and developing personalized treatment and rehabilitation strategies. Toward this goal, we introduce an audio-to-video generation framework for creating Real Time/cine-Magnetic Resonance Imaging (RT-/cine-MRI) visuals of the vocal tract from speech signals. Our framework first preprocesses RT-/cine-MRI sequences and speech samples to achieve temporal alignment, ensuring synchronization between visual and audio data. We then employ a modified stable diffusion model, integrating structural and temporal blocks, to effectively capture movement characteristics and temporal dynamics in the synchronized data. This process enables the generation of MRI sequences from new speech inputs, improving the conversion of audio into visual data. We evaluated our framework on healthy controls and tongue cancer patients by analyzing and comparing the vocal tract movements in synthesized videos. Our framework demonstrated adaptability to new speech inputs and effective generalization. In addition, positive human evaluations confirmed its effectiveness, with realistic and accurate visualizations, suggesting its potential for outpatient therapy and personalized simulation of vocal tract visualizations.