MedSR-Vision: Deep Learning Framework for Multi-Domain Medical Image Super-Resolution

Medical image super-resolution (MedSR) is essential for improving diagnostic precision across diverse imaging modalities such as MRI, CT, X-ray, Ultrasound, and Fundus imaging. Despite rapid advances in deep learning, challenges remain in preserving anatomical accuracy, maintaining perceptual quality, and generalizing across medical domains. This paper presents MedSR-Vision, a novel unified deep learning framework for evaluating and comparing super-resolution models across five modalities: Brain MRI, Chest X-ray, Renal Ultrasound, Nephrolithiasis CT, and Spine MRI, at magnification scales of $\times2$, $\times3$, and $\times4$. Three representative models namely SRCNN, SwinIR, and Real-ESRGAN are benchmarked using multiple quantitative metrics encompassing fidelity, perceptual realism, and sharpness. Experimental analysis demonstrates that Real-ESRGAN achieves superior perceptual quality and edge recovery at higher scales, SwinIR excels in preserving structural and diagnostic features, and SRCNN provides efficient and stable performance at lower magnifications. The results establish domain-specific insights and practical guidelines for model selection in clinical imaging workflows, offering a standardized evaluation framework for future medical image super-resolution research and deployment.

Compact Latent Manifold Translation: A Parameter-Efficient Foundation Model for Cross-Modal and Cross-Frequency Physiological Signal Synthesis

The analysis of physiological time series, such as electrocardiograms (ECG) and photoplethysmograms (PPG), is persistently hindered by modality and frequency gaps stemming from heterogeneous recording devices. Existing foundation models typically rely on continuous latent spaces, which frequently suffer from severe modality entanglement, lack high-fidelity cross-frequency generative capacity, and impose high computational costs that prohibit edge-device deployment. In this paper, we propose Compact Latent Manifold Translation (CLMT), a highly parameter-efficient (0.09B) unified framework that bridges these gaps through a novel two-stage discrete translation paradigm. First, we introduce a Universal Tokenizer utilizing Hierarchical Residual Vector Quantization (RVQ) to decouple heterogeneous signals into isolated, well-structured discrete latent manifolds, effectively preventing inter-modality interference. Second, a Context-Prompted Latent Translator maps these discrete tokens across modalities by integrating static physiological priors, reframing complex signal synthesis as a pure latent sequence translation task. Extensive evaluations demonstrate that our 0.09B model significantly outperforms massive baselines. In cross-modal PPG-to-ECG synthesis, it resolves temporal phase drift and dramatically improves the clinical R-peak detection F1-score from 0.37 (baseline) to 0.83. Furthermore, in extreme cross-frequency super-resolution (25Hz to 100Hz), it successfully recovers high-frequency diagnostic landmarks, achieving an unprecedented Pearson correlation of 0.9956. By learning a universal discrete language for biological signals with a fraction of the computational footprint, our approach sets a new trajectory for edge-deployable, multi-modal medical foundation models.

Domain-Specific Latent Representations Improve the Fidelity of Diffusion-Based Medical Image Super-Resolution

Latent diffusion models for medical image super-resolution universally inherit variational autoencoders designed for natural photographs. We show that this default choice, not the diffusion architecture, is the dominant constraint on reconstruction quality. In a controlled experiment holding all other pipeline components fixed, replacing the generic Stable Diffusion VAE with MedVAE, a domain-specific autoencoder pretrained on more than 1.6 million medical images, yields +2.91 to +3.29 dB PSNR improvement across knee MRI, brain MRI, and chest X-ray (n = 1,820; Cohen's d = 1.37 to 1.86, all p < 10^{-20}, Wilcoxon signed-rank). Wavelet decomposition localises the advantage to the finest spatial frequency bands encoding anatomically relevant fine structure. Ablations across inference schedules, prediction targets, and generative architectures confirm the gap is stable within plus or minus 0.15 dB, while hallucination rates remain comparable between methods (Cohen's h < 0.02 across all datasets), establishing that reconstruction fidelity and generative hallucination are governed by independent pipeline components. These results provide a practical screening criterion: autoencoder reconstruction quality, measurable without diffusion training, predicts downstream SR performance (R^2 = 0.67), suggesting that domain-specific VAE selection should precede diffusion architecture search. Code and trained model weights are publicly available at https://github.com/sebasmos/latent-sr.

Structure-Adaptive Sparse Diffusion in Voxel Space for 3D Medical Image Enhancement

Three-dimensional (3D) medical image enhancement, including denoising and super-resolution, is critical for clinical diagnosis in CT, PET, and MRI. Although diffusion models have shown remarkable success in 2D medical imaging, scaling them to high-resolution 3D volumes remains computationally prohibitive due to lengthy diffusion trajectories over high-dimensional volumetric data. We observe that in conditional enhancement, strong anatomical priors in the degraded input render dense noise schedules largely redundant. Leveraging this insight, we propose a sparse voxel-space diffusion framework that trains and samples on a compact set of uniformly subsampled timesteps. The network predicts clean data directly on the data manifold, supervised in velocity space for stable gradient scaling. A lightweight Structure-aware Trajectory Modulation (STM) module recalibrates time embeddings at each network block based on local anatomical content, enabling structure-adaptive denoising over the shared sparse schedule. Operating directly in voxel space, our framework preserves fine anatomical detail without lossy compression while achieving up to $10\times$ training acceleration. Experiments on four datasets spanning CT, PET, and MRI demonstrate state-of-the-art performance on both denoising and super-resolution tasks. Our code is publicly available at: https://github.com/mirthAI/sparse-3d-diffusion.

VoDaSuRe: A Large-Scale Dataset Revealing Domain Shift in Volumetric Super-Resolution

Recent advances in volumetric super-resolution (SR) have demonstrated strong performance in medical and scientific imaging, with transformer- and CNN-based approaches achieving impressive results even at extreme scaling factors. In this work, we show that much of this performance stems from training on downsampled data rather than real low-resolution scans. This reliance on downsampling is partly driven by the scarcity of paired high- and low-resolution 3D datasets. To address this, we introduce VoDaSuRe, a large-scale volumetric dataset containing paired high- and low-resolution scans. When training models on VoDaSuRe, we reveal a significant discrepancy: SR models trained on downsampled data produce substantially sharper predictions than those trained on real low-resolution scans, which smooth fine structures. Conversely, applying models trained on downsampled data to real scans preserves more structure but is inaccurate. Our findings suggest that current SR methods are overstated - when applied to real data, they do not recover structures lost in low-resolution scans and instead predict a smoothed average. We argue that progress in deep learning-based volumetric SR requires datasets with paired real scans of high complexity, such as VoDaSuRe. Our dataset and code are publicly available through: https://augusthoeg.github.io/VoDaSuRe/

OmniFM: Toward Modality-Robust and Task-Agnostic Federated Learning for Heterogeneous Medical Imaging

Federated learning (FL) has become a promising paradigm for collaborative medical image analysis, yet existing frameworks remain tightly coupled to task-specific backbones and are fragile under heterogeneous imaging modalities. Such constraints hinder real-world deployment, where institutions vary widely in modality distributions and must support diverse downstream tasks. To address this limitation, we propose OmniFM, a modality- and task-agnostic FL framework that unifies training across classification, segmentation, super-resolution, visual question answering, and multimodal fusion without re-engineering the optimization pipeline. OmniFM builds on a key frequency-domain insight: low-frequency spectral components exhibit strong cross-modality consistency and encode modality-invariant anatomical structures. Accordingly, OmniFM integrates (i) Global Spectral Knowledge Retrieval to inject global frequency priors, (ii) Embedding-wise Cross-Attention Fusion to align representations, and (iii) Prefix-Suffix Spectral Prompting to jointly condition global and personalized cues, together regularized by a Spectral-Proximal Alignment objective that stabilizes aggregation. Experiments on real-world datasets show that OmniFM consistently surpasses state-of-the-art FL baselines across intra- and cross-modality heterogeneity, achieving superior results under both fine-tuning and training-from-scratch setups.

sFRC for assessing hallucinations in medical image restoration

Deep learning (DL) methods are currently being explored to restore images from sparse-view-, limited-data-, and undersampled-based acquisitions in medical applications. Although outputs from DL may appear visually appealing based on likability/subjective criteria (such as less noise, smooth features), they may also suffer from hallucinations. This issue is further exacerbated by a lack of easy-to-use techniques and robust metrics for the identification of hallucinations in DL outputs. In this work, we propose performing Fourier Ring Correlation (FRC) analysis over small patches and concomitantly (s)canning across DL outputs and their reference counterparts to detect hallucinations (termed as sFRC). We describe the rationale behind sFRC and provide its mathematical formulation. The parameters essential to sFRC may be set using predefined hallucinated features annotated by subject matter experts or using imaging theory-based hallucination maps. We use sFRC to detect hallucinations for three undersampled medical imaging problems: CT super-resolution, CT sparse view, and MRI subsampled restoration. In the testing phase, we demonstrate sFRC's effectiveness in detecting hallucinated features for the CT problem and sFRC's agreement with imaging theory-based outputs on hallucinated feature maps for the MR problem. Finally, we quantify the hallucination rates of DL methods on in-distribution versus out-of-distribution data and under increasing subsampling rates to characterize the robustness of DL methods. Beyond DL-based methods, sFRC's effectiveness in detecting hallucinations for a conventional regularization-based restoration method and a state-of-the-art unrolled method is also shown.

Scale-Cascaded Diffusion Models for Super-Resolution in Medical Imaging

Diffusion models have been increasingly used as strong generative priors for solving inverse problems such as super-resolution in medical imaging. However, these approaches typically utilize a diffusion prior trained at a single scale, ignoring the hierarchical scale structure of image data. In this work, we propose to decompose images into Laplacian pyramid scales and train separate diffusion priors for each frequency band. We then develop an algorithm to perform super-resolution that utilizes these priors to progressively refine reconstructions across different scales. Evaluated on brain, knee, and prostate MRI data, our approach both improves perceptual quality over baselines and reduces inference time through smaller coarse-scale networks. Our framework unifies multiscale reconstruction and diffusion priors for medical image super-resolution.

TriFusion-SR: Joint Tri-Modal Medical Image Fusion and SR

Multimodal medical image fusion facilitates comprehensive diagnosis by aggregating complementary structural and functional information, but its effectiveness is limited by resolution degradation and modality discrepancies. Existing approaches typically perform image fusion and super-resolution (SR) in separate stages, leading to artifacts and degraded perceptual quality. These limitations are further amplified in tri-modal settings that combine anatomical modalities (e.g., MRI, CT) with functional scans (e.g., PET, SPECT) due to pronounced frequency domain imbalances. We propose TriFusionSR, a wavelet-guided conditional diffusion framework for joint tri-modal fusion and SR. The framework explicitly decomposes multimodal features into frequency bands using the 2D Discrete Wavelet Transform, enabling frequency-aware crossmodal interaction. We further introduce a Rectified Wavelet Features (RWF) strategy for latent coefficient calibration, followed by an Adaptive Spatial-Frequency Fusion (ASFF) module with gated channel-spatial attention to enable structure-driven multimodal refinement. Extensive experiments demonstrate state-of-the-art performance, achieving 4.8-12.4% PSNR improvement and substantial reductions in RMSE and LPIPS across multiple upsampling scales.

Distributional Deep Learning for Super-Resolution of 4D Flow MRI under Domain Shift

Super-resolution is widely used in medical imaging to enhance low-quality data, reducing scan time and improving abnormality detection. Conventional super-resolution approaches typically rely on paired datasets of downsampled and original high resolution images, training models to reconstruct high resolution images from their artificially degraded counterparts. However, in real-world clinical settings, low resolution data often arise from acquisition mechanisms that differ significantly from simple downsampling. As a result, these inputs may lie outside the domain of the training data, leading to poor model generalization due to domain shift. To address this limitation, we propose a distributional deep learning framework that improves model robustness and domain generalization. We develop this approch for enhancing the resolution of 4D Flow MRI (4DF). This is a novel imaging modality that captures hemodynamic flow velocity and clinically relevant metrics such as vessel wall stress. These metrics are critical for assessing aneurysm rupture risk. Our model is initially trained on high resolution computational fluid dynamics (CFD) simulations and their downsampled counterparts. It is then fine-tuned on a small, harmonized dataset of paired 4D Flow MRI and CFD samples. We derive the theoretical properties of our distributional estimators and demonstrate that our framework significantly outperforms traditional deep learning approaches through real data applications. This highlights the effectiveness of distributional learning in addressing domain shift and improving super-resolution performance in clinically realistic scenarios.