Translating MRI to PET through Conditional Diffusion Models with Enhanced Pathology Awareness

Positron emission tomography (PET) is a widely recognized technique for diagnosing neurodegenerative diseases, offering critical functional insights. However, its high costs and radiation exposure hinder its widespread use. In contrast, magnetic resonance imaging (MRI) does not involve such limitations. While MRI also detects neurodegenerative changes, it is less sensitive for diagnosis compared to PET. To overcome such limitations, one approach is to generate synthetic PET from MRI. Recent advances in generative models have paved the way for cross-modality medical image translation; however, existing methods largely emphasize structural preservation while neglecting the critical need for pathology awareness. To address this gap, we propose PASTA, a novel image translation framework built on conditional diffusion models with enhanced pathology awareness. PASTA surpasses state-of-the-art methods by preserving both structural and pathological details through its highly interactive dual-arm architecture and multi-modal condition integration. Additionally, we introduce a novel cycle exchange consistency and volumetric generation strategy that significantly enhances PASTA's ability to produce high-quality 3D PET images. Our qualitative and quantitative results demonstrate the high quality and pathology awareness of the synthesized PET scans. For Alzheimer's diagnosis, the performance of these synthesized scans improves over MRI by 4%, almost reaching the performance of actual PET. Our code is available at https://github.com/ai-med/PASTA.

PASTA: Pathology-Aware MRI to PET Cross-Modal Translation with Diffusion Models

Positron emission tomography (PET) is a well-established functional imaging technique for diagnosing brain disorders. However, PET's high costs and radiation exposure limit its widespread use. In contrast, magnetic resonance imaging (MRI) does not have these limitations. Although it also captures neurodegenerative changes, MRI is a less sensitive diagnostic tool than PET. To close this gap, we aim to generate synthetic PET from MRI. Herewith, we introduce PASTA, a novel pathology-aware image translation framework based on conditional diffusion models. Compared to the state-of-the-art methods, PASTA excels in preserving both structural and pathological details in the target modality, which is achieved through its highly interactive dual-arm architecture and multi-modal condition integration. A cycle exchange consistency and volumetric generation strategy elevate PASTA's capability to produce high-quality 3D PET scans. Our qualitative and quantitative results confirm that the synthesized PET scans from PASTA not only reach the best quantitative scores but also preserve the pathology correctly. For Alzheimer's classification, the performance of synthesized scans improves over MRI by 4%, almost reaching the performance of actual PET. Code is available at https://github.com/ai-med/PASTA.

From Barlow Twins to Triplet Training: Differentiating Dementia with Limited Data

Differential diagnosis of dementia is challenging due to overlapping symptoms, with structural magnetic resonance imaging (MRI) being the primary method for diagnosis. Despite the clinical value of computer-aided differential diagnosis, research has been limited, mainly due to the absence of public datasets that contain diverse types of dementia. This leaves researchers with small in-house datasets that are insufficient for training deep neural networks (DNNs). Self-supervised learning shows promise for utilizing unlabeled MRI scans in training, but small batch sizes for volumetric brain scans make its application challenging. To address these issues, we propose Triplet Training for differential diagnosis with limited target data. It consists of three key stages: (i) self-supervised pre-training on unlabeled data with Barlow Twins, (ii) self-distillation on task-related data, and (iii) fine-tuning on the target dataset. Our approach significantly outperforms traditional training strategies, achieving a balanced accuracy of 75.6%. We further provide insights into the training process by visualizing changes in the latent space after each step. Finally, we validate the robustness of Triplet Training in terms of its individual components in a comprehensive ablation study. Our code is available at https://github.com/ai-med/TripletTraining.