D2SA: Dual-Stage Distribution and Slice Adaptation for Efficient Test-Time Adaptation in MRI Reconstruction

Variations in Magnetic resonance imaging (MRI) scanners and acquisition protocols cause distribution shifts that degrade reconstruction performance on unseen data. Test-time adaptation (TTA) offers a promising solution to address this discrepancies. However, previous single-shot TTA approaches are inefficient due to repeated training and suboptimal distributional models. Self-supervised learning methods may risk over-smoothing in scarce data scenarios. To address these challenges, we propose a novel Dual-Stage Distribution and Slice Adaptation (D2SA) via MRI implicit neural representation (MR-INR) to improve MRI reconstruction performance and efficiency, which features two stages. In the first stage, an MR-INR branch performs patient-wise distribution adaptation by learning shared representations across slices and modelling patient-specific shifts with mean and variance adjustments. In the second stage, single-slice adaptation refines the output from frozen convolutional layers with a learnable anisotropic diffusion module, preventing over-smoothing and reducing computation. Experiments across five MRI distribution shifts demonstrate that our method can integrate well with various self-supervised learning (SSL) framework, improving performance and accelerating convergence under diverse conditions.