AutoIQ: An Ensemble Framework for Automatic Assessment of Geometric Distortion in Prostate Diffusion-Weighted Imaging

Geometric distortion in prostate diffusion-weighted imaging (DWI) can impair lesion localization and reduce the reliability of MRI-based clinical assessment. We propose AutoIQ, an ensemble machine learning framework for automatic quantification and classification of DWI geometric distortion severity. A total of 140 retrospective prostate biparametric MRI examinations were analyzed, including 33 scans with severe distortion requiring repeat acquisition and 107 scans with acceptable distortion based on expert radiologist assessment. AutoIQ combines two complementary distortion quantification strategies: a segmentation-based method measuring prostate boundary mismatch between T2-weighted imaging (T2WI) and DWI, and a registration-based method estimating deformation magnitude after DWI-to-T2WI alignment. The resulting distortion scores were used to train individual classifiers and a logistic-regression ensemble model. Both computational methods significantly differentiated severe from acceptable distortion cases (p < 0.001). On an independent test set, the ensemble model achieved an accuracy of 0.95, F1-score of 0.93, and AUC of 0.98, outperforming individual models. These results suggest that AutoIQ can provide automated, quantitative quality assessment for prostate DWI and may help identify scans that require repeat acquisition.

Let Distortion Guide Restoration (DGR): A physics-informed learning framework for Prostate Diffusion MRI

We present Distortion-Guided Restoration (DGR), a physics-informed hybrid CNN-diffusion framework for acquisition-free correction of severe susceptibility-induced distortions in prostate single-shot EPI diffusion-weighted imaging (DWI). DGR is trained to invert a realistic forward distortion model using large-scale paired distorted and undistorted data synthesized from distortion-free prostate DWI and co-registered T2-weighted images from 410 multi-institutional studies, together with 11 measured B0 field maps from metal-implant cases incorporated into a forward simulator to generate low-b DWI (b = 50 s per mm squared), high-b DWI (b = 1400 s per mm squared), and ADC distortions. The network couples a CNN-based geometric correction module with conditional diffusion refinement under T2-weighted anatomical guidance. On a held-out synthetic validation set (n = 34) using ground-truth simulated distortion fields, DGR achieved higher PSNR and lower NMSE than FSL TOPUP and FUGUE. In 34 real clinical studies with severe distortion, including hip prostheses and marked rectal distension, DGR improved geometric fidelity and increased radiologist-rated image quality and diagnostic confidence. Overall, learning the inverse of a physically simulated forward process provides a practical alternative to acquisition-dependent distortion-correction pipelines for prostate DWI.