Daniel Rückert

Fryderyk Kögl, Anna Reithmeir, Vasiliki Sideri-Lampretsa et al.

General vision encoders like DINOv2 and SAM have recently transformed computer vision. Even though they are trained on natural images, such encoder models have excelled in medical imaging, e.g., in classification, segmentation, and registration. However, no in-depth comparison of different state-of-the-art general vision encoders for medical registration is available. In this work, we investigate how well general vision encoder features can be used in the dissimilarity metrics for medical image registration. We explore two encoders that were trained on natural images as well as one that was fine-tuned on medical data. We apply the features within the well-established B-spline FFD registration framework. In extensive experiments on cardiac cine MRI data, we find that using features as additional guidance for conventional metrics improves the registration quality. The code is available at github.com/compai-lab/2024-miccai-koegl.

Felix Meissen, Svenja Breuer, Moritz Knolle et al.

Background: With the ever-increasing amount of medical imaging data, the demand for algorithms to assist clinicians has amplified. Unsupervised anomaly detection (UAD) models promise to aid in the crucial first step of disease detection. While previous studies have thoroughly explored fairness in supervised models in healthcare, for UAD, this has so far been unexplored. Methods: In this study, we evaluated how dataset composition regarding subgroups manifests in disparate performance of UAD models along multiple protected variables on three large-scale publicly available chest X-ray datasets. Our experiments were validated using two state-of-the-art UAD models for medical images. Finally, we introduced a novel subgroup-AUROC (sAUROC) metric, which aids in quantifying fairness in machine learning. Findings: Our experiments revealed empirical "fairness laws" (similar to "scaling laws" for Transformers) for training-dataset composition: Linear relationships between anomaly detection performance within a subpopulation and its representation in the training data. Our study further revealed performance disparities, even in the case of balanced training data, and compound effects that exacerbate the drop in performance for subjects associated with multiple adversely affected groups. Interpretation: Our study quantified the disparate performance of UAD models against certain demographic subgroups. Importantly, we showed that this unfairness cannot be mitigated by balanced representation alone. Instead, the representation of some subgroups seems harder to learn by UAD models than that of others. The empirical fairness laws discovered in our study make disparate performance in UAD models easier to estimate and aid in determining the most desirable dataset composition.

Valentin Biller, Niklas Bubeck, Lucas Zimmer et al.

Glioblastoma exhibits diverse, infiltrative, and patient-specific growth patterns that are only partially visible on routine MRI, making it difficult to reliably assess true tumor extent and personalize treatment planning and follow-up. We present a biophysically-conditioned generative framework that synthesizes biologically realistic 3D brain MRI volumes from estimated, spatially continuous tumor-concentration fields. Our approach combines a generative model with tumor-infiltration maps that can be propagated through time using a biophysical growth model, enabling fine-grained control over tumor shape and growth while preserving patient anatomy. This enables us to synthesize consistent tumor growth trajectories directly in the space of real patients, providing interpretable, controllable estimation of tumor infiltration and progression beyond what is explicitly observed in imaging. We evaluate the framework on longitudinal glioblastoma cases and demonstrate that it can generate temporally coherent sequences with realistic changes in tumor appearance and surrounding tissue response. These results suggest that integrating mechanistic tumor growth priors with modern generative modeling can provide a practical tool for patient-specific progression visualization and for generating controlled synthetic data to support downstream neuro-oncology workflows. In longitudinal extrapolation, we achieve a consistent 75% Dice overlap with the biophysical model while maintaining a constant PSNR of 25 in the surrounding tissue. Our code is available at: https://github.com/valentin-biller/lgm.git

Veronika Spieker, Hannah Eichhorn, Jonathan K. Stelter et al.

Neural implicit k-space representations have shown promising results for dynamic MRI at high temporal resolutions. Yet, their exclusive training in k-space limits the application of common image regularization methods to improve the final reconstruction. In this work, we introduce the concept of parallel imaging-inspired self-consistency (PISCO), which we incorporate as novel self-supervised k-space regularization enforcing a consistent neighborhood relationship. At no additional data cost, the proposed regularization significantly improves neural implicit k-space reconstructions on simulated data. Abdominal in-vivo reconstructions using PISCO result in enhanced spatio-temporal image quality compared to state-of-the-art methods. Code is available at https://github.com/vjspi/PISCO-NIK.

Valentin Biller, Lucas Zimmer, Can Erdur et al.

Magnetic resonance imaging (MRI) inpainting supports numerous clinical and research applications. We introduce the first generative model that conditions on voxel-level, continuous tumor concentrations to synthesize high-fidelity brain tumor MRIs. For the BraTS 2025 Inpainting Challenge, we adapt this architecture to the complementary task of healthy tissue restoration by setting the tumor concentrations to zero. Our latent diffusion model conditioned on both tissue segmentations and the tumor concentrations generates 3D spatially coherent and anatomically consistent images for both tumor synthesis and healthy tissue inpainting. For healthy inpainting, we achieve a PSNR of 18.5, and for tumor inpainting, we achieve 17.4. Our code is available at: https://github.com/valentin-biller/ldm.git

Alexander Selivanov, Philip Müller, Özgün Turgut et al.

An electrocardiogram (ECG) is a widely used, cost-effective tool for detecting electrical abnormalities in the heart. However, it cannot directly measure functional parameters, such as ventricular volumes and ejection fraction, which are crucial for assessing cardiac function. Cardiac magnetic resonance (CMR) is the gold standard for these measurements, providing detailed structural and functional insights, but is expensive and less accessible. To bridge this gap, we propose PTACL (Patient and Temporal Alignment Contrastive Learning), a multimodal contrastive learning framework that enhances ECG representations by integrating spatio-temporal information from CMR. PTACL uses global patient-level contrastive loss and local temporal-level contrastive loss. The global loss aligns patient-level representations by pulling ECG and CMR embeddings from the same patient closer together, while pushing apart embeddings from different patients. Local loss enforces fine-grained temporal alignment within each patient by contrasting encoded ECG segments with corresponding encoded CMR frames. This approach enriches ECG representations with diagnostic information beyond electrical activity and transfers more insights between modalities than global alignment alone, all without introducing new learnable weights. We evaluate PTACL on paired ECG-CMR data from 27,951 subjects in the UK Biobank. Compared to baseline approaches, PTACL achieves better performance in two clinically relevant tasks: (1) retrieving patients with similar cardiac phenotypes and (2) predicting CMR-derived cardiac function parameters, such as ventricular volumes and ejection fraction. Our results highlight the potential of PTACL to enhance non-invasive cardiac diagnostics using ECG. The code is available at: https://github.com/alsalivan/ecgcmr

Jonas Weidner, Yeray Martin-Ruisanchez, Daniel Rückert et al.

Neural surrogate models for computational fluid dynamics (CFD) are typically trained as forward operators that map explicit problem specifications, such as geometry and boundary conditions, to solution fields. This ties the model to the conditioning variables seen during training and limits reuse under boundary-condition shifts or local geometry changes. We propose to reformulate steady CFD inference as an inpainting problem: instead of training on explicit boundary conditions, we learn a self-supervised prior over velocity fields and impose boundary constraints only during inference by fixing known regions such as inlet, outlet or unchanged regions from previous simulations. To scale this idea to large 3D meshes, we introduce a local neighbourhood tokeniser that represents high-resolution velocity fields as compact spatial latent tokens and train latent flow-matching and masked-autoencoder models on these tokens. On intracranial aneurysm hemodynamics, our method reconstructs full velocity fields from sparse boundary context, outperforms supervised neural surrogates under boundary-condition and dataset shift and enables local geometry editing by reusing unchanged simulation context. These results suggest that viewing CFD inference as context-conditioned inpainting can turn neural surrogates from task-specific predictors into reusable flow priors.

Ivan Iliash, Simeon Allmendinger, Felix Meissen et al.

Generative AI, in general, and synthetic visual data generation, in specific, hold much promise for benefiting surgical training by providing photorealism to simulation environments. Current training methods primarily rely on reading materials and observing live surgeries, which can be time-consuming and impractical. In this work, we take a significant step towards improving the training process. Specifically, we use diffusion models in combination with a zero-shot video diffusion method to interactively generate realistic laparoscopic images and videos by specifying a surgical action through text and guiding the generation with tool positions through segmentation masks. We demonstrate the performance of our approach using the publicly available Cholec dataset family and evaluate the fidelity and factual correctness of our generated images using a surgical action recognition model as well as the pixel-wise F1-score for the spatial control of tool generation. We achieve an FID of 38.097 and an F1-score of 0.71.

Johannes Kaiser, Alexander Ziller, Eleni Triantafillou et al.

Individual Differential Privacy (iDP) promises users control over their privacy, but this promise can be broken in practice. We reveal a previously overlooked vulnerability in sampling-based iDP mechanisms: while conforming to the iDP guarantees, an individual's privacy risk is not solely governed by their own privacy budget, but critically depends on the privacy choices of all other data contributors. This creates a mismatch between the promise of individual privacy control and the reality of a system where risk is collectively determined. We demonstrate empirically that certain distributions of privacy preferences can unintentionally inflate the privacy risk of individuals, even when their formal guarantees are met. Moreover, this excess risk provides an exploitable attack vector. A central adversary or a set of colluding adversaries can deliberately choose privacy budgets to amplify vulnerabilities of targeted individuals. Most importantly, this attack operates entirely within the guarantees of DP, hiding this excess vulnerability. Our empirical evaluation demonstrates successful attacks against 62% of targeted individuals, substantially increasing their membership inference susceptibility. To mitigate this, we propose $(\varepsilon_i,δ_i,\overlineΔ)$-iDP a privacy contract that uses $Δ$-divergences to provide users with a hard upper bound on their excess vulnerability, while offering flexibility to mechanism design. Our findings expose a fundamental challenge to the current paradigm, demanding a re-evaluation of how iDP systems are designed, audited, communicated, and deployed to make excess risks transparent and controllable.