T-CACE: A Time-Conditioned Autoregressive Contrast Enhancement Multi-Task Framework for Contrast-Free Liver MRI Synthesis, Segmentation, and Diagnosis

Magnetic resonance imaging (MRI) is a leading modality for the diagnosis of liver cancer, significantly improving the classification of the lesion and patient outcomes. However, traditional MRI faces challenges including risks from contrast agent (CA) administration, time-consuming manual assessment, and limited annotated datasets. To address these limitations, we propose a Time-Conditioned Autoregressive Contrast Enhancement (T-CACE) framework for synthesizing multi-phase contrast-enhanced MRI (CEMRI) directly from non-contrast MRI (NCMRI). T-CACE introduces three core innovations: a conditional token encoding (CTE) mechanism that unifies anatomical priors and temporal phase information into latent representations; and a dynamic time-aware attention mask (DTAM) that adaptively modulates inter-phase information flow using a Gaussian-decayed attention mechanism, ensuring smooth and physiologically plausible transitions across phases. Furthermore, a constraint for temporal classification consistency (TCC) aligns the lesion classification output with the evolution of the physiological signal, further enhancing diagnostic reliability. Extensive experiments on two independent liver MRI datasets demonstrate that T-CACE outperforms state-of-the-art methods in image synthesis, segmentation, and lesion classification. This framework offers a clinically relevant and efficient alternative to traditional contrast-enhanced imaging, improving safety, diagnostic efficiency, and reliability for the assessment of liver lesion. The implementation of T-CACE is publicly available at: https://github.com/xiaojiao929/T-CACE.

United adversarial learning for liver tumor segmentation and detection of multi-modality non-contrast MRI

Simultaneous segmentation and detection of liver tumors (hemangioma and hepatocellular carcinoma (HCC)) by using multi-modality non-contrast magnetic resonance imaging (NCMRI) are crucial for the clinical diagnosis. However, it is still a challenging task due to: (1) the HCC information on NCMRI is invisible or insufficient makes extraction of liver tumors feature difficult; (2) diverse imaging characteristics in multi-modality NCMRI causes feature fusion and selection difficult; (3) no specific information between hemangioma and HCC on NCMRI cause liver tumors detection difficult. In this study, we propose a united adversarial learning framework (UAL) for simultaneous liver tumors segmentation and detection using multi-modality NCMRI. The UAL first utilizes a multi-view aware encoder to extract multi-modality NCMRI information for liver tumor segmentation and detection. In this encoder, a novel edge dissimilarity feature pyramid module is designed to facilitate the complementary multi-modality feature extraction. Second, the newly designed fusion and selection channel is used to fuse the multi-modality feature and make the decision of the feature selection. Then, the proposed mechanism of coordinate sharing with padding integrates the multi-task of segmentation and detection so that it enables multi-task to perform united adversarial learning in one discriminator. Lastly, an innovative multi-phase radiomics guided discriminator exploits the clear and specific tumor information to improve the multi-task performance via the adversarial learning strategy. The UAL is validated in corresponding multi-modality NCMRI (i.e. T1FS pre-contrast MRI, T2FS MRI, and DWI) and three phases contrast-enhanced MRI of 255 clinical subjects. The experiments show that UAL has great potential in the clinical diagnosis of liver tumors.