IVMar 30
MRI-to-CT synthesis using drifting modelsQing Lyu, Jianxu Wang, Jeremy Hudson et al.
Accurate MRI-to-CT synthesis could enable MR-only pelvic workflows by providing CT-like images with bone details while avoiding additional ionizing radiation. In this work, we investigate recently proposed drifting models for synthesizing pelvis CT images from MRI and benchmark them against convolutional neural networks (UNet, VAE), a generative adversarial network (WGAN-GP), a physics-inspired probabilistic model (PPFM), and diffusion-based methods (FastDDPM, DDIM, DDPM). Experiments are performed on two complementary datasets: Gold Atlas Male Pelvis and the SynthRAD2023 pelvis subset. Image fidelity and structural consistency are evaluated with SSIM, PSNR, and RMSE, complemented by qualitative assessment of anatomically critical regions such as cortical bone and pelvic soft-tissue interfaces. Across both datasets, the proposed drifting model achieves high SSIM and PSNR and low RMSE, surpassing strong diffusion baselines and conventional CNN-, VAE-, GAN-, and PPFM-based methods. Visual inspection shows sharper cortical bone edges, improved depiction of sacral and femoral head geometry, and reduced artifacts or over-smoothing, particularly at bone-air-soft tissue boundaries. Moreover, the drifting model attains these gains with one-step inference and inference times on the order of milliseconds, yielding a more favorable accuracy-efficiency trade-off than iterative diffusion sampling while remaining competitive in image quality. These findings suggest that drifting models are a promising direction for fast, high-quality pelvic synthetic CT generation from MRI and warrant further investigation for downstream applications such as MRI-only radiotherapy planning and PET/MR attenuation correction.
IVDec 17, 2025
MCR-VQGAN: A Scalable and Cost-Effective Tau PET Synthesis Approach for Alzheimer's Disease ImagingJin Young Kim, Jeremy Hudson, Jeongchul Kim et al.
Tau positron emission tomography (PET) is a critical diagnostic modality for Alzheimer's disease (AD) because it visualizes and quantifies neurofibrillary tangles, a hallmark of AD pathology. However, its widespread clinical adoption is hindered by significant challenges, such as radiation exposure, limited availability, high clinical workload, and substantial financial costs. To overcome these limitations, we propose Multi-scale CBAM Residual Vector Quantized Generative Adversarial Network (MCR-VQGAN) to synthesize high-fidelity tau PET images from structural T1-weighted MRI scans. MCR-VQGAN improves standard VQGAN by integrating three key architectural enhancements: multi-scale convolutions, ResNet blocks, and Convolutional Block Attention Modules (CBAM). Using 222 paired structural T1-weighted MRI and tau PET scans from Alzheimer's Disease Neuroimaging Initiative (ADNI), we trained and compared MCR-VQGAN with cGAN, WGAN-GP, CycleGAN, and VQGAN. Our proposed model achieved superior image synthesis performance across all metrics: MSE of 0.0056 +/- 0.0061, PSNR of 24.39 +/- 4.49 dB, and SSIM of 0.9000 +/- 0.0453. To assess the clinical utility of the synthetic images, we trained and evaluated a CNN-based AD classifier. The classifier achieved comparable accuracy when tested on real (63.64%) and synthetic (65.91%) images. This result indicates that our synthesis process successfully preserves diagnostically relevant features without significant information loss. Our results demonstrate that MCR-VQGAN can offer a reliable and scalable surrogate for conventional tau PET imaging, potentially improving the accessibility and scalability of tau imaging biomarkers for AD research and clinical workflows.
LGApr 30
PROMISE-AD: Progression-aware Multi-horizon Survival Estimation for Alzheimer's Disease Progression and Dynamic TrackingQing Lyu, Jeremy Hudson, Mohammad Kawas et al.
Individualized Alzheimer's disease (AD) progression prediction requires models that use irregular visits, account for censoring, avoid diagnostic leakage, and provide calibrated horizon risks. We propose PROgression-aware MultI-horizon Survival Estimation for Alzheimer's Disease (PROMISE-AD), a leakage-safe survival framework for predicting conversion from cognitively normal (CN) to mild cognitive impairment (MCI) and from MCI to AD dementia using ADNI/TADPOLE tabular histories. PROMISE-AD converts pre-index visits into tokens with standardized measurements, missingness masks, longitudinal changes, time-normalized slopes, visit timing, and non-diagnostic categorical attributes. A temporal Transformer fuses global, attention-pooled, and latest-visit representations to estimate a progression score and latent discrete-time mixture hazards. Training combines survival likelihood, horizon-specific focal risk loss, progression ranking, hazard smoothness, and mixture-balance regularization, followed by validation-set isotonic calibration for 1-, 2-, 3-, and 5-year risks. In held-out testing across three seeds, PROMISE-AD achieved an integrated Brier score (IBS) of 0.085 $\pm$ 0.012, C-index of 0.808 $\pm$ 0.015, and mean time-dependent AUC of 0.840 $\pm$ 0.081 for CN-to-MCI conversion, yielding the lowest IBS among compared methods. For MCI-to-AD conversion, PROMISE-AD achieved the highest C-index (0.894 $\pm$ 0.018) and near-ceiling 5-year discrimination (AUROC 0.997 $\pm$ 0.003; AUPRC 0.999 $\pm$ 0.001), although some baselines had lower IBS. Ablations and interpretability supported longitudinal change features, fused temporal representations, mixture hazards, cognitive and functional measures, APOE4 status, and recent conversion-proximal visits. These findings suggest that progression-aware survival modeling can provide interpretable multi-horizon AD conversion risk estimates.