Orso Pusterla

Xinyang Wu, Muheng Li, Xia Li et al.

Four-dimensional MRI (4D-MRI) is an promising technique for capturing respiratory-induced motion in radiation therapy planning and delivery. Conventional 4D reconstruction methods, which typically rely on phase binning or separate template scans, struggle to capture temporal variability, complicate workflows, and impose heavy computational loads. We introduce a neural representation framework that considers respiratory motion as a smooth, continuous deformation steered by a 1D surrogate signal, completely replacing the conventional discrete sorting approach. The new method fuses motion modeling with image reconstruction through two synergistic networks: the Spatial Anatomy Network (SAN) encodes a continuous 3D anatomical representation, while a Temporal Motion Network (TMN), guided by Transformer-derived respiratory signals, produces temporally consistent deformation fields. Evaluation using a free-breathing dataset of 19 volunteers demonstrates that our template- and phase-free method accurately captures both regular and irregular respiratory patterns, while preserving vessel and bronchial continuity with high anatomical fidelity. The proposed method significantly improves efficiency, reducing the total processing time from approximately five hours required by conventional discrete sorting methods to just 15 minutes of training. Furthermore, it enables inference of each 3D volume in under one second. The framework accurately reconstructs 3D images at any respiratory state, achieves superior performance compared to conventional methods, and demonstrates strong potential for application in 4D radiation therapy planning and real-time adaptive treatment.

D. Abler, O. Pusterla, A. Joye-Kühnis et al.

Background: Radiomics shows promise in characterizing glioblastoma, but its added value over clinical and molecular predictors has yet to be proven. This study assessed the added value of conventional radiomics (CR) and deep learning (DL) MRI radiomics for glioblastoma prognosis (<= 6 vs > 6 months survival) on a large multi-center dataset. Methods: After patient selection, our curated dataset gathers 1152 glioblastoma (WHO 2016) patients from five Swiss centers and one public source. It included clinical (age, gender), molecular (MGMT, IDH), and baseline MRI data (T1, T1 contrast, FLAIR, T2) with tumor regions. CR and DL models were developed using standard methods and evaluated on internal and external cohorts. Sub-analyses assessed models with different feature sets (imaging-only, clinical/molecular-only, combined-features) and patient subsets (S-1: all patients, S-2: with molecular data, S-3: IDH wildtype). Results: The best performance was observed in the full cohort (S-1). In external validation, the combined-feature CR model achieved an AUC of 0.75, slightly, but significantly outperforming clinical-only (0.74) and imaging-only (0.68) models. DL models showed similar trends, though without statistical significance. In S-2 and S-3, combined models did not outperform clinical-only models. Exploratory analysis of CR models for overall survival prediction suggested greater relevance of imaging data: across all subsets, combined-feature models significantly outperformed clinical-only models, though with a modest advantage of 2-4 C-index points. Conclusions: While confirming the predictive value of anatomical MRI sequences for glioblastoma prognosis, this multi-center study found standard CR and DL radiomics approaches offer minimal added value over demographic predictors such as age and gender.