Forecasting Intrathecal Tracer Enhancement from Pre-Contrast Brain MRI: Direct Regression versus Flow Matching

📅 2026-09-17
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研究通过直接回归与流匹配方法预测脑MRI中造影剂增强情况,以减少多次扫描需求。直接回归法在预测准确性及成本上优于流匹配法。
📝 Abstract
Intrathecal contrast-enhanced MRI tracks how a cerebrospinal-fluid tracer spreads through the brain, but requires repeated scans over 24--48\,h. Forecasting enhancement from a pre-contrast scan could one day help select patients for intrathecal drug treatment and plan their dose. We ask how much of the enhancement at a given time can be predicted from the pre-contrast scan and the elapsed time alone. Training on 104 patients, we compared direct image-to-image regression (I2I) with conditional flow matching (CFM) using the same 3D U-Net and protocol, and tested on 23 held-out patients and 51 external patients with normal pressure hydrocephalus. All models were measured against simply copying the pre-contrast scan. I2I removed about 60\% of this copying error internally and 25\% externally, outperformed CFM on both test sets (mean absolute error 0.036 vs.\ 0.058 and 0.056 vs.\ 0.063), and predicted each volume in a single forward pass, whereas CFM ran its network ten times. CFM uncertainty located errors but was poorly calibrated. Much of tracer enhancement is thus predictable from anatomy and timing, and direct regression is the more accurate and cheaper choice at this data scale.
Problem

Research questions and friction points this paper is trying to address.

Intrathecal Tracer Enhancement
Pre-Contrast MRI
Forecasting
Innovation

Methods, ideas, or system contributions that make the work stand out.

direct image-to-image regression
conditional flow matching
3D U-Net
tracer enhancement prediction
cerebrospinal-fluid tracer
Q
Qinghui Liu
Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway
J
Jon André Ottesen
Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway
T
Thu Nguyen
Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway
G
Geir Ringstad
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; K.G. Jebsen Centre for Brain Fluid Research, University of Oslo, Oslo, Norway; Department of Geriatrics and Internal Medicine, Sørlandet Hospital, Arendal, Norway; Department of Radiology, Oslo University Hospital, Oslo, Norway
I
Ingrid Mossige
Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; K.G. Jebsen Centre for Brain Fluid Research, University of Oslo, Oslo, Norway
S
Siri Fløgstad Svensson
Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway; K.G. Jebsen Centre for Brain Fluid Research, University of Oslo, Oslo, Norway
A
Atle Bjørnerud
Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway; Departments of Physics and Psychology, University of Oslo, Oslo, Norway
P
Per Kristian Eide
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; K.G. Jebsen Centre for Brain Fluid Research, University of Oslo, Oslo, Norway; Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
K
Kyrre Eeg Emblem
Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; K.G. Jebsen Centre for Brain Fluid Research, University of Oslo, Oslo, Norway