Modality-AGnostic Image Cascade (MAGIC) for Multi-Modality Cardiac Substructure Segmentation

Cardiac substructures are essential in thoracic radiation therapy planning to minimize risk of radiation-induced heart disease. Deep learning (DL) offers efficient methods to reduce contouring burden but lacks generalizability across different modalities and overlapping structures. This work introduces and validates a Modality-AGnostic Image Cascade (MAGIC) for comprehensive and multi-modal cardiac substructure segmentation. MAGIC is implemented through replicated encoding and decoding branches of an nnU-Net-based, U-shaped backbone conserving the function of a single model. Twenty cardiac substructures (heart, chambers, great vessels (GVs), valves, coronary arteries (CAs), and conduction nodes) from simulation CT (Sim-CT), low-field MR-Linac, and cardiac CT angiography (CCTA) modalities were manually delineated and used to train (n=76), validate (n=15), and test (n=30) MAGIC. Twelve comparison models (four segmentation subgroups across three modalities) were equivalently trained. All methods were compared for training efficiency and against reference contours using the Dice Similarity Coefficient (DSC) and two-tailed Wilcoxon Signed-Rank test (threshold, p<0.05). Average DSC scores were 0.75(0.16) for Sim-CT, 0.68(0.21) for MR-Linac, and 0.80(0.16) for CCTA. MAGIC outperforms the comparison in 57% of cases, with limited statistical differences. MAGIC offers an effective and accurate segmentation solution that is lightweight and capable of segmenting multiple modalities and overlapping structures in a single model. MAGIC further enables clinical implementation by simplifying the computational requirements and offering unparalleled flexibility for clinical settings.

Deterministic Medical Image Translation via High-fidelity Brownian Bridges

Recent studies have shown that diffusion models produce superior synthetic images when compared to Generative Adversarial Networks (GANs). However, their outputs are often non-deterministic and lack high fidelity to the ground truth due to the inherent randomness. In this paper, we propose a novel High-fidelity Brownian bridge model (HiFi-BBrg) for deterministic medical image translations. Our model comprises two distinct yet mutually beneficial mappings: a generation mapping and a reconstruction mapping. The Brownian bridge training process is guided by the fidelity loss and adversarial training in the reconstruction mapping. This ensures that translated images can be accurately reversed to their original forms, thereby achieving consistent translations with high fidelity to the ground truth. Our extensive experiments on multiple datasets show HiFi-BBrg outperforms state-of-the-art methods in multi-modal image translation and multi-image super-resolution.

Modality-Agnostic Learning for Medical Image Segmentation Using Multi-modality Self-distillation

Medical image segmentation of tumors and organs at risk is a time-consuming yet critical process in the clinic that utilizes multi-modality imaging (e.g, different acquisitions, data types, and sequences) to increase segmentation precision. In this paper, we propose a novel framework, Modality-Agnostic learning through Multi-modality Self-dist-illation (MAG-MS), to investigate the impact of input modalities on medical image segmentation. MAG-MS distills knowledge from the fusion of multiple modalities and applies it to enhance representation learning for individual modalities. Thus, it provides a versatile and efficient approach to handle limited modalities during testing. Our extensive experiments on benchmark datasets demonstrate the high efficiency of MAG-MS and its superior segmentation performance than current state-of-the-art methods. Furthermore, using MAG-MS, we provide valuable insight and guidance on selecting input modalities for medical image segmentation tasks.