LiFUSE: Frequency-Spatial Unified Self-Supervised Pretraining for Liver Disease Analysis on Non-contrast CT

Given the growing global burden of liver tumors and diffuse liver diseases, non-contrast computed tomography (NCCT) is increasingly used for opportunistic screening because of its low cost and favorable safety profile. However, downstream tasks such as tumor detection and fine-grained disease diagnosis remain challenging due to NCCT's inherently low tissue contrast, lack of hemodynamic enhancement, and complex anatomical background. These limitations make subtle, heterogeneous, and multifocal hepatic lesions difficult to identify. Although large-scale self-supervised pretraining can learn robust representations from unlabeled NCCT scans, conventional voxel-wise reconstruction does not fully exploit the complementary information available in NCCT. Under weak NCCT contrast, low-level intensity patterns become less informative for pathology recognition, limiting the capture of lesion-specific discriminative features. In this paper, we propose the Liver Frequency-Spatial Unified Self-Supervised Pretraining (LiFUSE). The frequency branch applies random band-stop masking and spectrum reconstruction to encourage the model to capture subtle differences between lesions and surrounding tissues, while the spatial branch performs hybrid-granularity masked volumetric reconstruction to accommodate lesions of diverse sizes and morphologies. Finally, a cross-domain consistency scheme couples the spatial and frequency branches, yielding more discriminative representations for hepatic structures and lesions. Extensive experiments on three clinically relevant tasks across internal cohorts and a public target-domain transfer setting show that LiFUSE consistently outperforms strong baselines. These results suggest that unified frequency-spatial learning can improve liver disease analysis on NCCT, highlighting its potential for large-scale screening.