Uncovering Trajectory and Topological Signatures in Multimodal Pediatric Sleep Embeddings

While generative models have shown promise in pediatric sleep analysis, the latent structure of their multimodal embeddings remains poorly understood. This work investigates session-wide diagnostic information contained in the sequences of 30-second pediatric PSG epochs embedded by a multimodal masked autoencoder. We test whether augmenting embeddings with PHATE-derived per-epoch coordinates and whole-night movement descriptors, persistent homology summaries of the embedding cloud, and EHR yields task-relevant signals. Simple linear and MLP models, chosen for interpretability rather than state-of-the-art performance, show that geometric, topological, and clinical features each provide complementary gains. For binary predictions, feature importance is task-dependent, and more expressive late-fusion models generally perform better, with AUPRC improving from 0.26 to 0.34 for desaturation, 0.31 to 0.48 for EEG arousal, 0.09 to 0.22 for hypopnea, and 0.05 to 0.14 for apnea. We also report Brier score and Expected Calibration Error, where the full fusion model yields the best calibration across all four binary tasks. Our study reveals that latent geometry/topology and EHR offer complementary, interpretable signals beyond embeddings, improving calibration and robustness under extreme imbalance.

Distilling Photon-Counting CT into Routine Chest CT through Clinically Validated Degradation Modeling

Photon-counting CT (PCCT) provides superior image quality with higher spatial resolution and lower noise compared to conventional energy-integrating CT (EICT), but its limited clinical availability restricts large-scale research and clinical deployment. To bridge this gap, we propose SUMI, a simulated degradation-to-enhancement method that learns to reverse realistic acquisition artifacts in low-quality EICT by leveraging high-quality PCCT as reference. Our central insight is to explicitly model realistic acquisition degradations, transforming PCCT into clinically plausible lower-quality counterparts and learning to invert this process. The simulated degradations were validated for clinical realism by board-certified radiologists, enabling faithful supervision without requiring paired acquisitions at scale. As outcomes of this technical contribution, we: (1) train a latent diffusion model on 1,046 PCCTs, using an autoencoder first pre-trained on both these PCCTs and 405,379 EICTs from 145 hospitals to extract general CT latent features that we release for reuse in other generative medical imaging tasks; (2) construct a large-scale dataset of over 17,316 publicly available EICTs enhanced to PCCT-like quality, with radiologist-validated voxel-wise annotations of airway trees, arteries, veins, lungs, and lobes; and (3) demonstrate substantial improvements: across external data, SUMI outperforms state-of-the-art image translation methods by 15% in SSIM and 20% in PSNR, improves radiologist-rated clinical utility in reader studies, and enhances downstream top-ranking lesion detection performance, increasing sensitivity by up to 15% and F1 score by up to 10%. Our results suggest that emerging imaging advances can be systematically distilled into routine EICT using limited high-quality scans as reference.