TRACE-Seg3D: Counterfactual Context Auditing For Robust 3D Glioma Segmentation Under Institutional Shift

Medical image segmentation models can achieve strong benchmark performance while remaining sensitive to scanner, protocol, and institutional variation. These context shifts alter image appearance without changing the underlying lesion, allowing models to exploit nuisance cues that Dice and HD95 fail to expose. We present TRACE-Seg3D, a counterfactual context auditing framework for robust 3D medical image segmentation. TRACE-Seg3D preserves lesion-relevant evidence and systematically varies imaging context to quantify prediction stability under controlled context shifts. The framework pairs each segmentation with audit evidence for context sensitivity and anatomical plausibility, enabling case-level reliability assessment beyond overlap-based evaluation. Experiments on BraTS and UTSW glioma segmentation benchmarks demonstrate competitive in-distribution and cross-domain performance. TRACE-Seg3D also exposes context-sensitive failure modes missed by conventional metrics. These results establish counterfactual context auditing as a practical route toward transparent and reliable 3D medical image segmentation under distribution shift. Our code is available at https://github.com/danleneurocom/Counterfactual-Representation-Network.

Bayesian Networks with Latent Time Embedding for Stage-Aware Causal Modeling of Alzheimer's Disease Progression

Alzheimer's disease (AD) progression is often described through the amyloid-tau-neurodegeneration, or AT(N), cascade. However, most longitudinal models represent this cascade either as a fixed sequence of biomarkers or as a black-box forecasting task. This makes it difficult to determine when biologically guided biomarker relationships influence future regional pathology. In this study, we introduce Bayesian Networks with Latent Time Embedding (BN-LTE), a Bayesian structural framework for stage-aware modeling of AD progression. BN-LTE estimates disease pseudotime from baseline biomarker profiles and constrains directed dependencies according to biologically plausible AT(N) ordering. Posterior spline-varying structural equations are then used to link initial multimodal measurements with future annualized regional tau-PET change. Across repeated subject-disjoint evaluations using ADNI data, BN-LTE shows strong spatial reconstruction of tau progression compared with the included forecasting baselines. Beyond spatial reconstruction, BN-LTE recovers posterior stage-varying AT(N)-constrained effects and identifies a mid-pseudotime window of amyloid sensitivity. This window is supported by model-implied g-formula contrasts, root-adjusted AIPW, mechanism-sensitive ablations, and robustness analyses across spline and prior specifications. Overall, these findings position BN-LTE as a Bayesian structural framework for forecasting tau progression while examining stage-dependent AT(N)-cascade mechanisms in observational longitudinal neuroimaging data. Our code is available at https://github.com/danleneurocom/BN-LTE.

BrainMAP: Multimodal Graph Learning For Efficient Brain Disease Localization

Recent years have seen a surge in research focused on leveraging graph learning techniques to detect neurodegenerative diseases. However, existing graph-based approaches typically lack the ability to localize and extract the specific brain regions driving neurodegenerative pathology within the full connectome. Additionally, recent works on multimodal brain graph models often suffer from high computational complexity, limiting their practical use in resource-constrained devices. In this study, we present BrainMAP, a novel multimodal graph learning framework designed for precise and computationally efficient identification of brain regions affected by neurodegenerative diseases. First, BrainMAP utilizes an atlas-driven filtering approach guided by the AAL atlas to pinpoint and extract critical brain subgraphs. Unlike recent state-of-the-art methods, which model the entire brain network, BrainMAP achieves more than 50% reduction in computational overhead by concentrating on disease-relevant subgraphs. Second, we employ an advanced multimodal fusion process comprising cross-node attention to align functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) data, coupled with an adaptive gating mechanism to blend and integrate these modalities dynamically. Experimental results demonstrate that BrainMAP outperforms state-of-the-art methods in computational efficiency, without compromising predictive accuracy.