# Rectified flow-based prediction of post-treatment brain MRI from pre-radiotherapy priors for patients with glioma

arXiv: https://arxiv.org/abs/2603.08385 · HTML: https://mlsanity.com/paper/2603.08385/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Placed in Medical imaging and segmentation, one of 14 directions in Diffusion models.
- Builds on 16 of its 51 references that are in the map.
- First posted on arXiv 9 Mar 2026.

## Placed in

- Diffusion models / [Medical imaging and segmentation](https://mlsanity.com/diffusion/medical-imaging-and-segmentation/)

## Builds on (most cited first, 16 of 16)

- [Denoising Diffusion Implicit Models](https://mlsanity.com/paper/2010.02502/) (2020)
- [Improved Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2102.09672/) (2021)
- [Flow Straight and Fast: Learning to Generate and Transfer Data with Rectified Flow](https://mlsanity.com/paper/2209.03003/) (2022)
- [DPM-Solver: A Fast ODE Solver for Diffusion Probabilistic Model Sampling in Around 10 Steps](https://mlsanity.com/paper/2206.00927/) (2022)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Imagic: Text-Based Real Image Editing with Diffusion Models](https://mlsanity.com/paper/2210.09276/) (2022)
- [VoxelMorph: A Learning Framework for Deformable Medical Image Registration](https://mlsanity.com/paper/1809.05231/) (2018)
- [fastMRI: An Open Dataset and Benchmarks for Accelerated MRI](https://mlsanity.com/paper/1811.08839/) (2018)
- [Brain Imaging Generation with Latent Diffusion Models](https://mlsanity.com/paper/2209.07162/) (2022)
- [SynthSeg: Segmentation of brain MRI scans of any contrast and resolution without retraining](https://mlsanity.com/paper/2107.09559/) (2021)
- [SynthMorph: learning contrast-invariant registration without acquired images](https://mlsanity.com/paper/2004.10282/) (2020)
- [Learning Conditional Deformable Templates with Convolutional Networks](https://mlsanity.com/paper/1908.02738/) (2019)
- [Robust machine learning segmentation for large-scale analysis of heterogeneous clinical brain MRI datasets](https://mlsanity.com/paper/2209.02032/) (2022)
- [Deep learning-based synthetic-CT generation in radiotherapy and PET: a review](https://mlsanity.com/paper/2102.02734/) (2021)
- [Treatment-aware Diffusion Probabilistic Model for Longitudinal MRI Generation and Diffuse Glioma Growth Prediction](https://mlsanity.com/paper/2309.05406/) (2023)
- [Comprehensive Multimodal Deep Learning Survival Prediction Enabled by a Transformer Architecture: A Multicenter Study in Glioblastoma](https://mlsanity.com/paper/2405.12963/) (2024)

## Built on by (most cited first, 1 of 1)

- [3D-GlioPREDICT: 3D Latent Diffusion for Post-Radiotherapy Brain MRI Prediction in Patients with Glioma](https://mlsanity.com/paper/2606.05113/) (2026)

## Abstract (arXiv)

Brain tumors result in 20 years of lost life on average. Standard therapies induce complex structural changes in the brain that are monitored through MRI. Recent developments in artificial intelligence (AI) enable conditional multimodal image generation from clinical data. In this study, we investigate AI-driven generation of follow-up MRI in patients with intracranial tumors through conditional image generation. This approach enables realistic modeling of post-radiotherapy changes, allowing for treatment optimization. The public SAILOR dataset of 25 patients was used to create a 2D rectified flow model conditioned on axial slices of pre-treatment MRI and RT dose maps. Cross-attention conditioning was used to incorporate temporal and chemotherapy data. The resulting images were validated with structural similarity index measure (SSIM), peak signal-to-noise ratio (PSNR), Dice scores and Jacobian determinants. The resulting model generates realistic follow-up MRI for any time point, while integrating treatment information. Comparing real versus predicted images, SSIM is 0.88, and PSNR is 22.82. Tissue segmentations from real versus predicted MRI result in a mean Dice-Sorensen coefficient (DSC) of 0.91. The rectified flow (RF) model enables up to 250x faster inference than Denoising Diffusion Probabilistic Models (DDPM). The proposed model generates realistic follow-up MRI in real-time, preserving both semantic and visual fidelity as confirmed by image quality metrics and tissue segmentations. Conditional generation allows counterfactual simulations by varying treatment parameters, producing predicted morphological changes. This capability has potential to support adaptive treatment dose planning and personalized outcome prediction for patients with intracranial tumors. Code will be available upon peer-reviewed publication at: https://github.com/SelenaIHuisman/RF-GlioPREDICT
