NnFoundation models improve 3D radiology AI across many tasks
nnFoundation: 3D Foundation Models for Radiology
Computer Vision and Pattern Recognition
Summary
Radiology AI tools often work well only for specific tasks and struggle with new types of medical images. The authors created nnFoundation, a set of large-scale 3D models trained on millions of CT, MRI, and PET scans to work better across many radiology tasks like finding, segmenting, and describing images. They show that different model types excel at different tasks, and combining them improves accuracy and flexibility. Their models perform better than older methods, even when data or computing resources are limited.
What this means in practice
- •For radiology ai developers: Use nnFoundation models to improve performance and data efficiency across 3D radiology tasks including segmentation, detection, and report generation.
- •For medical image analysis teams: Integrate nnFoundation models into existing radiology workflows to handle diverse imaging data from different institutions with improved robustness under domain shifts.
Authors
Constantin Ulrich Harsy, Tassilo Wald, Karol Gotkowski, Yannick Kirchhoff, Marcel Knopp, Maximilian Rokuss, Elisa Stegmeier, Philipp Schader, Dasha Trofimova, Raphael Stock, Kim-Celine Kahl, Stephen Schaumann, Selen Erkan, David Zimmerer, Stefan Denner, Moritz Langenberg, Sebastian Ziegler, Katharina Eckstein, Maximilian Fischer, Jonathan Suprijadi, Bálint Kovács, Benjamin Hamm, Anand Deshpande, Dimitrios Bounias, Nico Disch, Shuhan Xiao, Jessica Kächele, Jan Sellner, Rajesh Baidya, Jeremias Traub, Lars Krämer, Maximilian Zenk, Tim Rädsch, Stefan Dvoretskii, Robin Peretzke, Jonathan Deissler, Alexandra Ertl, Partha Ghosh, Kris Dreher, Stefan Dinkelacker, Annika Reinke, Evangelia Christodoulou, Numan Saeed, Yoland Savriama, Santiago Estrada, David Kügler, Laura Alexandra Daza Barragan, Cristina Isabel Gonzalez Osorio, Jan Peeken, Michael Baumgartner, Marvin Teichmann, Guillaume Chabin, Matthias Kirchler, Valentin Koch, for the ALFA study, Markus Hohenhaus, Dimitri Koslov, Nina Decker, Mohammad Yaqub, Arnd Heuser, Martin Reuter, Julia A. Schnabel, Tobias Heimann, Florin Ghesu, Paul Brachmann, Claus P. Heußel, Alexander Radbruch, Gianluca Brugnara, Aditya Rastogi, Martha Foltyn-Dumitru, Heinz-Peter Schlemmer, Ignaz Reicht, Julius C. Holzschuh, Michael Bach, Bram Stieltjes, Kai Schlamp, Lena Maier-Hein, Marco Nolden, Ralf Floca, Paul F. Jäger, Philipp Vollmuth, Fabian Isensee, Klaus H. Maier-Hein
Abstract
Radiological artificial intelligence has advanced rapidly, yet most systems remain narrowly task-specific, data-intensive, and fragile under domain shift. Foundation models promise more transferable and data-efficient solutions, but existing approaches are limited in scale, evaluated narrowly, and often assume that a single pretrained model can support diverse downstream tasks. Here we present nnFoundation, complementary convolutional and transformer-based 3D radiological foundation models. Developed within the Human Radiome Project (THRP), nnFoundation is trained on 2.1 million CT, MRI, and PET image volumes from 125 institutional and public datasets. We evaluate them across 108 tasks spanning segmentation, detection, classification, report generation, and image retrieval, including evaluations under domain shift, by external partners and in low-data and low-compute regimes. Across all task types, our convolution- and transformer-based nnFoundation models consistently outperform both prior 3D foundation models and training from scratch, establishing state-of-the-art performance for radiological imaging. However, performance follows a consistent task-dependent structure: the convolutional nnFoundation model dominates spatially localized tasks, whereas the transformer-based nnFoundation model excels in tasks requiring global semantic reasoning and in frozen-feature settings. Dynamically aligning the foundation model topology with the dataset characteristics post-hoc further improves transfer across heterogeneous 3D settings. These results show that transferable 3D radiological performance is governed not by a single universal model, but by the interplay of scalable pretraining, complementary architectures, and dataset-aware adaptation. We release nnFoundation models integrated into nnU-Net and nnDetection, enabling immediate application across established radiology workflows.