Clare Allen

YuCheng Tang, Wen Yan, Alexander Ng et al.

Single-shot echo-planar prostate diffusion-weighted imaging (DWI) is frequently complicated by geometric distortions, which impact the ability to derive reliable diagnoses from such images. Developing automated correction methods is challenged by the absence of paired distorted and undistorted clinical scans. In this paper, we first propose a novel weakly-supervised image quality transfer (IQT) framework from undistorted to distorted images that utilizes image quality assessment (IQA) signals to supervise the transfer process. Unlike traditional methods that require expensive, voxel-wise paired data or resort to developing unpaired algorithms, our approach utilizes image-level quality labels (here, distorted vs. undistorted) to establish latent quality prototypes within a pre-trained feature space. Recognizing that simulating realistic distortions is more reliable than direct unpaired correction, we describe a weakly-supervised prototype flow matching algorithm to explicitly regularize generative trajectories towards distorted prototypes, producing realistic susceptibility artifacts that mimic clinical degradations. By synthesizing these realistic pairs, we enable a second IQT model to be trained in the forward direction for distortion correction. Experimental results demonstrate that our generated images successfully mimic the diagnostic interference of real-world artifacts, which leads to more capable distortion correction IQT models. In addition to qualitative comparisons, we also conduct exhaustive quantitative evaluations that compare our approach with existing unpaired approaches (e.g., CycleGAN, UNIT-DDPM, and OT-FM) - as either forward or reverse alternatives - by assessing clinical downstream task performance in PI-RADS and Gleason score classification, using both in-distribution and external data sets.

Yuheng Tang, Alexander Ng, Wen Yan et al.

Clinical prostate multi-parametric MRI relies heavily on high-quality diffusion-weighted imaging (DWI), yet reading DWI is frequently compromised by geometric distortion, often caused by rectal air. Assessing quality via the PI-QUAL scoring system is an emerging clinical standard, but it is subjective, time-consuming and suffers from a class imbalance where low-quality cases are diverse and relatively scarce. Using the PRIME clinical trial as an example, there are $6\%$ images with PI-QUAL scores lower than 4, $87\%$ of DWI issues are due to distortion. Many of the other clinical quality issues are under-represented. To address this common dual-scarcity of annotated clinical data, we propose a few-shot biparametric prototypical network for automated image quality assessment (IQA). Our framework utilizes a dual-branch 3D ResNet to fuse T2-weighted and DWI features, providing anatomical context to distinguish true morphology from distortion. To handle real-world heterogeneity, we introduce feature-wise linear modulation (FiLM) and a gradient reversal layer (GRL) to align feature distributions conditioned on varying b-values while suppressing acquisition-related biases. We demonstrate that a model meta-trained solely on comparatively objective, readily obtainable distortion labels can effectively adapt to predicting complex, multi-factorial clinical quality scores such as PI-QUAL using only five representative samples. Experimental results on two datasets show that our method significantly outperforms few-shot learning baselines for this challenging IQA task, offering a practically feasible and data-efficient solution for standardizing prostate MRI quality control in clinical workflows.

Yucheng Tang, Pawel Rajwa, Alexander Ng et al.

Foundation models in medical imaging have shown promising label efficiency, achieving high performance on downstream tasks using only a fraction of the annotated data otherwise required. In this study, we evaluate this potential in the context of prostate multiparametric MRI using ProFound, a recently developed domain-specific vision foundation model pretrained on large-scale prostate MRI datasets. We investigate the impact of variable image quality on the label-efficient finetuning, by quantifying the generalisability of the finetuned models. We conduct a comprehensive set of experiments by systematically varying the ratios of high- and low-quality images in the finetuning and evaluation sets. Our findings indicate that image quality distribution and its finetune-and-test mismatch significantly affect model performance. In particular: a) Varying the ratio of high- to low-quality images between finetuning and test sets leads to notable differences in downstream performance; and b) The presence of sufficient high-quality images in the finetuning set is critical for maintaining strong performance, whilst the importance of matched finetuning and testing distribution varies between different downstream tasks, such as automated radiology reporting and prostate cancer detection. Importantly, experimental results also show that, although finetuning requires significantly less labeled data compared to training from scratch when the quality ratio is consistent, this label efficiency is not independent of the image quality distribution. For example, we show cases that, without sufficient high-quality images in finetuning, finetuned models may fail to outperform those without pretraining.