Large-Scale Pretraining for Improving Deep Learning-Based Geometric Distortion Correction of Diffusion-Weighted Imaging

Diffusion-weighted imaging (DWI) is widely used in clinical settings but remains vulnerable to geometric distortion. Conventional correction methods often require additional acquisitions or vendor-specific solutions, limiting their feasibility in high-throughput, resource-constrained settings. This study investigates whether large-scale pretraining strategies can improve deep learning-based distortion correction for single-phase-encoding DWI. We formulate the task as image reconstruction, and compare a non-pretrained baseline against a self-supervised and a generative pretrained model, evaluated using both quantitative image-similarity metrics and qualitative expert assessment. The best-performing model was further tested for transferability on data collected in an LMIC setting with acquisition shift. Pretrained models outperformed the non-pretrained baseline, with cWDM achieving the strongest results across both quantitative and qualitative evaluation. However, application to LMIC data revealed transferability challenges, including contrast alteration and over-reliance on T1-weighted anatomical structure. Registering images to a common standard space improved predictions, suggesting that harmonized preprocessing may enhance cross-domain deployment.