medical imaging engineers

Abstract: Dementia is a major and growing global health burden, with Alzheimer's disease (AD) accounting for most cases. Timely and accurate diagnosis is central to managing this burden and increasingly depends on integrating complementary clinical and imaging information. Multimodal deep learning can combine these modalities for AD diagnosis, but how its explanations behave across modalities, fusion strategies, and cohorts remains unclear. We developed an explainable multimodal framework pairing a 3D CNN encoder for T1-weighted MRI with a feedforward network for harmonized clinical and demographic data, comparing varied model setups on three-way and pairwise diagnostic tasks using 6,479 internal records from the ADNI and 1,703 independent records from the OASIS-3. On ADNI, the tabular-only model achieved the highest three-class AUC-ROC of 0.879 and best discriminated cognitively normal (CN) versus mild cognitive impairment (MCI; 0.903), while cross-attention performed best for MCI versus AD (0.861); CN versus AD was highly discriminative overall. On OASIS-3, the vision-only model performed best (three-class AUC-ROC 0.910); CN versus MCI remained difficult, and no fusion strategy consistently outperformed single modalities across tasks and cohorts. SHAP and Integrated Gradients identified the MMSE as the dominant tabular feature in both cohorts, with global feature rankings agreeing strongly in ADNI ($ρ=0.94$) and OASIS-3 ($ρ=0.96$); CAM-based explanations, however, changed with model configuration and cohort. These findings show that multimodal performance and explanations are task, modality, fusion, and cohort-dependent: a dominant cognitive signal persisted across cohorts, but feature contributions and CAM explanations did not, underscoring the need to evaluate explainability under cohort shift rather than as a stable, intrinsic property.

Abstract: We present a framework for tracking topological features directly within continuous implicit models. Such models, including implicit neural representations (INRs) and multivariate functional approximations (MFAs), are increasingly adopted to represent scientific data without the resolution constraints of discrete grids. They offer compact, smooth, and differentiable representations of complex fields, enabling new opportunities for high-performance data storage, reconstruction, and analysis. Given a continuous implicit model, our method tracks the evolution of critical points by querying the model and its derivatives, thereby eliminating the need to resample onto a grid. This approach enables faithful feature tracking while avoiding discretization-induced artifacts such as aliasing. We demonstrate the generality of our framework across a range of implicit representations, including analytic functions, MFAs, and INRs, and show that it produces smooth, coherent critical point trajectories. By enabling feature tracking directly on continuous representations, our method supports a new class of feature-driven visualization workflows centered on implicit models.

Abstract: While accelerators for AI have seen great commercial success, it is challenging to replicate that success for other specialized domains due to a number of factors. We make the case that barriers for new accelerators can be lowered by starting with a baseline AI accelerator, and adding minimal logic to support new operators demanded by new specialized domains. This leads to a versatile chip that can be manufactured at high volume and deployed for a range of popular applications. We refer to this as the AI+X approach. This paper explores its potential for the emerging domain of Computational Pathology, which involves analysis of large whole-slide tissue images with a multi-stage pipeline. The pipeline requires support for a number of different kernels and operators - early stages perform segmentation and feature extraction, followed by graph creation with k nearest neighbor (kNN) algorithms, and finally inference with an iterative graph convolutional network (GCN) that alternates between Aggregation and Combination. We show that these stages execute inefficiently on a range of baseline CPU, GPU, AI, and GCN accelerators. That inefficiency is addressed with a combination of software re-structuring and small modifications to a baseline systolic AI accelerator. Many of the above kernels can be mapped to a systolic accelerator by offering a flexible datapath between processing elements and register access mechanisms. We add support for feature aggregation, load balanced execution, Euclidean distance calculation, binning, and counter aggregation. This additional flexibility and logic grows the area of a baseline AI chiplet by 1.1x, but by avoiding the memory wall and offering high parallelism, the proposed accelerator BEACON yields over an order of magnitude higher throughput for Computational Pathology than baseline CPU and GPU platforms.

Abstract: Multi-modal medical image segmentation leverages complementary diagnostic information, yet fusion can underperform single-modality baselines when spatially aligned inputs differ in quality. Here, "corruption" primarily denotes resolution-induced degradation rather than misalignment or complete modality absence, while synthetic noise is evaluated only as an auxiliary setting. We identify a critical optimization-inference inconsistency: degraded modalities can receive weak training updates yet substantially affect predictions, indicating active interference with fusion. We attribute this failure to resampling-induced feature corruption and optimization bias, where noisy features propagate through skip connections and encourage unreliable modality selection. We therefore propose CoReFuse-Med, a Corruption-aware Rebalanced Fusion framework that suppresses corruption during feature transmission and rebalances modality contributions during high-level fusion. Experiments on EPVS, BraTS, and WMH, including multiple Z-axis slice-retention ratios and an auxiliary noise test, demonstrate improved accuracy and robustness under modality-quality discrepancies. Our code is available at https://github.com/lrever/CoReFuse.

Abstract: Model pruning is widely used to compress deep neural networks, reducing memory and computational requirements with minimal impact on aggregate performance. However, its effect on model behavior remains poorly understood, particularly for long-tailed medical datasets where rare but clinically important conditions are underrepresented. Furthermore, it remains unclear whether pruned models preserve reliable explanations of their predictions. To address this gap, we present a systematic study of long-tail forgetting and explanation reliability under model pruning. Across two long-tailed medical imaging datasets, two CNN architectures, four pruning methods, and sparsity levels up to 95\%, we evaluate predictive performance, explanation stability, and explanation faithfulness. Our results show that predictive performance exhibits a strong frequency-dependent trend, with lower-frequency classes generally experiencing earlier and larger degradation than higher-frequency classes. In contrast, explanation stability and faithfulness are influenced primarily by the pruning strategy, with gradient-informed methods preserving explanation reliability more effectively under aggressive compression. Qualitative and mechanistic analyses further indicate that explanation degradation is primarily associated with the collapse of class-discriminative gradients rather than the disappearance of feature activations. These findings suggest that model compression should be evaluated beyond aggregate performance. Incorporating class-aware and explanation-aware evaluation reveals failure modes that would otherwise remain hidden, while moderate sparsity levels provide a practical balance between compression, predictive performance, and explanation reliability.

Abstract: Most automated brain parcellation tools are developed and validated on T1-weighted (T1w) MRI. Yet, some clinical workflows for which parcellation is relevant only use contrast-enhanced T1w (T1ce) MRI, on which T1w-trained models are less accurate. We present a unified network that parcellates both pre- and post-contrast agent T1w MRI reliably, trained on a combination of the two with conditioning that spatially modulates its response differently for each. Feature-wise Linear Modulation (FiLM) is a known approach for input-based modulation in networks. It applies a per-channel scale and shift uniformly across the input. However, the appearance change between pre- and post-contrast varies locally across the brain, making FiLM suboptimal for our use case. In this work, we introduce Spatial FiLM (SpFiLM), a conditioning layer whose modulation varies spatially, assembling a voxel-wise scale and shift from image-derived spatial patterns. Using a cohort of 134 patients with paired T1w and T1ce MRI parcellated into 106 classes, the addition of SpFiLM layers in a UNet increased the mean Dice on the test set of 25 patients from 80.2% to 84.1%, a 4.9% relative improvement. Adding SpFiLM layers led to the best performance on both pre- and post-contrast MRI, even when controlling for network parameter counts.