Zhengyao Ding

Haitao Li, Ziyu Li, Yiheng Mao et al.

Accurate segmentation of brain images typically requires the integration of complementary information from multiple image modalities. However, clinical data for all modalities may not be available for every patient, creating a significant challenge. To address this, previous studies encode multiple modalities into a shared latent space. While somewhat effective, it remains suboptimal, as each modality contains distinct and valuable information. In this study, we propose DC-Seg (Disentangled Contrastive Learning for Segmentation), a new method that explicitly disentangles images into modality-invariant anatomical representation and modality-specific representation, by using anatomical contrastive learning and modality contrastive learning respectively. This solution improves the separation of anatomical and modality-specific features by considering the modality gaps, leading to more robust representations. Furthermore, we introduce a segmentation-based regularizer that enhances the model's robustness to missing modalities. Extensive experiments on the BraTS 2020 and a private white matter hyperintensity(WMH) segmentation dataset demonstrate that DC-Seg outperforms state-of-the-art methods in handling incomplete multimodal brain tumor segmentation tasks with varying missing modalities, while also demonstrate strong generalizability in WMH segmentation. The code is available at https://github.com/CuCl-2/DC-Seg.

Haitao Li, Che Liu, Zhengyao Ding et al.

Electrocardiograms (ECGs) are essential for diagnosing cardiovascular diseases. However, existing ECG-Report contrastive learning methods focus on whole-ECG and report alignment, missing the link between local ECG features and individual report tags. In this paper, we propose FG-CLEP (Fine-Grained Contrastive Language ECG Pre-training), which achieves fine-grained alignment between specific ECG segments and each tag in the report via tag-specific ECG representations. Furthermore, we found that nearly 55\% of ECG reports in the MIMIC-ECG training dataset lack detailed waveform features, which hinders fine-grained alignment. To address this, we introduce a coarse-to-fine training process that leverages large language models (LLMs) to recover these missing waveform features and validate the LLM outputs using a coarse model. Additionally, fine-grained alignment at the tag level, rather than at the report level, exacerbates the false negative problem, as different reports may share common tags. To mitigate this, we introduce a semantic similarity matrix to guide the model in identifying and correcting false negatives. Experiments on six datasets demonstrate that FG-CLEP significantly improves fine-grained alignment, outperforming state-of-the-art methods in both zero-shot prediction and linear probing. Meanwhile, the fine-grained reports we generate also enhance the performance of other methods.

Ziyu Li, Yujian Hu, Zhengyao Ding et al.

Cardiac Magnetic Resonance (CMR) imaging is a vital non-invasive tool for diagnosing heart diseases and evaluating cardiac health. However, the limited availability of large-scale, high-quality CMR datasets poses a major challenge to the effective application of artificial intelligence (AI) in this domain. Even the amount of unlabeled data and the health status it covers are difficult to meet the needs of model pretraining, which hinders the performance of AI models on downstream tasks. In this study, we present Cardiac Phenotype-Guided CMR Generation (CPGG), a novel approach for generating diverse CMR data that covers a wide spectrum of cardiac health status. The CPGG framework consists of two stages: in the first stage, a generative model is trained using cardiac phenotypes derived from CMR data; in the second stage, a masked autoregressive diffusion model, conditioned on these phenotypes, generates high-fidelity CMR cine sequences that capture both structural and functional features of the heart in a fine-grained manner. We synthesized a massive amount of CMR to expand the pretraining data. Experimental results show that CPGG generates high-quality synthetic CMR data, significantly improving performance on various downstream tasks, including diagnosis and cardiac phenotypes prediction. These gains are demonstrated across both public and private datasets, highlighting the effectiveness of our approach. Code is availabel at https://anonymous.4open.science/r/CPGG.

Xiaocheng Fang, Zhengyao Ding, Jieyi Cai et al.

Cardiac Magnetic Resonance (CMR) imaging provides a comprehensive assessment of cardiac structure and function but remains constrained by high acquisition costs and reliance on expert annotations, limiting the availability of large-scale labeled datasets. In contrast, electrocardiograms (ECGs) are inexpensive, widely accessible, and offer a promising modality for conditioning the generative synthesis of cine CMR. To this end, we propose ECGFlowCMR, a novel ECG-to-CMR generative framework that integrates a Phase-Aware Masked Autoencoder (PA-MAE) and an Anatomy-Motion Disentangled Flow (AMDF) to address two fundamental challenges: (1) the cross-modal temporal mismatch between multi-beat ECG recordings and single-cycle CMR sequences, and (2) the anatomical observability gap due to the limited structural information inherent in ECGs. Extensive experiments on the UK Biobank and a proprietary clinical dataset demonstrate that ECGFlowCMR can generate realistic cine CMR sequences from ECG inputs, enabling scalable pretraining and improving performance on downstream cardiac disease classification and phenotype prediction tasks.

Zhengyao Ding, Ziyu Li, Yujian Hu et al.

Cardiovascular diseases (CVDs) are the leading cause of global mortality, necessitating accessible and accurate diagnostic tools. While cardiac magnetic resonance imaging (CMR) provides gold-standard insights into cardiac structure and function, its clinical utility is limited by high cost and complexity. In contrast, electrocardiography (ECG) is inexpensive and widely available but lacks the granularity of CMR. We propose CardioNets, a deep learning framework that translates 12-lead ECG signals into CMR-level functional parameters and synthetic images, enabling scalable cardiac assessment. CardioNets integrates cross-modal contrastive learning and generative pretraining, aligning ECG with CMR-derived cardiac phenotypes and synthesizing high-resolution CMR images via a masked autoregressive model. Trained on 159,819 samples from five cohorts, including the UK Biobank (n=42,483) and MIMIC-IV-ECG (n=164,550), and externally validated on independent clinical datasets (n=3,767), CardioNets achieved strong performance across disease screening and phenotype estimation tasks. In the UK Biobank, it improved cardiac phenotype regression R2 by 24.8% and cardiomyopathy AUC by up to 39.3% over baseline models. In MIMIC, it increased AUC for pulmonary hypertension detection by 5.6%. Generated CMR images showed 36.6% higher SSIM and 8.7% higher PSNR than prior approaches. In a reader study, ECG-only CardioNets achieved 13.9% higher accuracy than human physicians using both ECG and real CMR. These results suggest that CardioNets offers a promising, low-cost alternative to CMR for large-scale CVD screening, particularly in resource-limited settings. Future efforts will focus on clinical deployment and regulatory validation of ECG-based synthetic imaging.

Yujian Hu, Yilang Xiang, Yan-Jie Zhou et al.

The accurate and timely diagnosis of acute aortic syndromes (AAS) in patients presenting with acute chest pain remains a clinical challenge. Aortic CT angiography (CTA) is the imaging protocol of choice in patients with suspected AAS. However, due to economic and workflow constraints in China, the majority of suspected patients initially undergo non-contrast CT as the initial imaging testing, and CTA is reserved for those at higher risk. In this work, we present an artificial intelligence-based warning system, iAorta, using non-contrast CT for AAS identification in China, which demonstrates remarkably high accuracy and provides clinicians with interpretable warnings. iAorta was evaluated through a comprehensive step-wise study. In the multi-center retrospective study (n = 20,750), iAorta achieved a mean area under the receiver operating curve (AUC) of 0.958 (95% CI 0.950-0.967). In the large-scale real-world study (n = 137,525), iAorta demonstrated consistently high performance across various non-contrast CT protocols, achieving a sensitivity of 0.913-0.942 and a specificity of 0.991-0.993. In the prospective comparative study (n = 13,846), iAorta demonstrated the capability to significantly shorten the time to correct diagnostic pathway. For the prospective pilot deployment that we conducted, iAorta correctly identified 21 out of 22 patients with AAS among 15,584 consecutive patients presenting with acute chest pain and under non-contrast CT protocol in the emergency department (ED) and enabled the average diagnostic time of these 21 AAS positive patients to be 102.1 (75-133) mins. Last, the iAorta can help avoid delayed or missed diagnosis of AAS in settings where non-contrast CT remains the unavoidable the initial or only imaging test in resource-constrained regions and in patients who cannot or did not receive intravenous contrast.