# BrainAnytime: Anatomy-Aware Cross-Modal Pretraining for Brain Image Analysis with Arbitrary Modality Availability

arXiv: https://arxiv.org/abs/2605.13059 · HTML: https://mlsanity.com/paper/2605.13059/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 8 of its 28 references that are in the map.
- First posted on arXiv 13 May 2026.

## Builds on (most cited first, 8 of 8)

- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Can Spatiotemporal 3D CNNs Retrace the History of 2D CNNs and ImageNet?](https://mlsanity.com/paper/1711.09577/) (2017)
- [Stochastic Beams and Where to Find Them: The Gumbel-Top-k Trick for Sampling Sequences Without Replacement](https://mlsanity.com/paper/1903.06059/) (2019)
- [Flex-MoE: Modeling Arbitrary Modality Combination via the Flexible Mixture-of-Experts](https://mlsanity.com/paper/2410.08245/) (2024)
- [FuseMoE: Mixture-of-Experts Transformers for Fleximodal Fusion](https://mlsanity.com/paper/2402.03226/) (2024)
- [Multi-modal Vision Pre-training for Medical Image Analysis](https://mlsanity.com/paper/2410.10604/) (2024)
- [Brain Foundation Models with Hypergraph Dynamic Adapter for Brain Disease Analysis](https://mlsanity.com/paper/2505.00627/) (2025)
- [MultiMAE for Brain MRIs: Robustness to Missing Inputs Using Multi-Modal Masked Autoencoder](https://mlsanity.com/paper/2509.11442/) (2025)

## Abstract (arXiv)

Clinical diagnostic workups typically follow a modality escalation pathway: after initial clinical evaluation, clinicians begin with routine structural imaging (e.g., MRI), selectively add sequences such as FLAIR or T2 to refine the differential, and reserve molecular imaging (e.g., amyloid-PET) for cases that remain uncertain after standard evaluation. Consequently, patients are observed with heterogeneous and often incomplete modality subsets. However, most current AI models assume fixed data modalities as the model inputs. In this paper, we present BrainAnytime, a unified pretraining framework pretrained on 34,899 3D brain scans from five datasets that support brain image analysis under arbitrary modality availability spanning multi-sequence MRI and amyloid-PET. A single model accepts whatever imaging is available, from a lone T1 scan to a full multimodal workup. Pretraining learns structural-molecular correspondences between MRI and PET via cross-modal distillation (RCMD) and prioritizes disease-vulnerable anatomy via atlas-guided curriculum masking (PACM), all within a shared 3D masked autoencoder (Multi-MAE3D). Across four downstream tasks and five clinically motivated modality settings, BrainAnytime largely outperforms modality-specific models, missing-modality baselines, and large-scale brain MRI pretrained foundation models on most modality settings. Notably, it surpasses the strongest missing-modality baselines with relative improvements of 6.2% and 7.0% in average accuracy on CN vs. AD and CN vs. MCI classification, respectively. Code is available at https://github.com/SDH-Lab/BrainAnytime.