Orientation-Aware Diffusion Super-Resolution for 3T-Like Fetal MRI from Routine 1.5T Scans.

Fetal MRI plays a central role in assessing early brain development. While 3T scanners offer higher SNR and improved cortical detail, their increased sensitivity to motion, susceptibility artifacts, and B 1 inhomogeneity limits wide adoption for routine fetal imaging. Consequently, most clinical examinations are performed at 1.5T, where greater motion tolerance comes at the cost of lower SNR, reduced gray-white matter contrast, and partial-volume blurring - factors that undermine downstream morphometric analysis. Bridging this quality gap without sacrificing motion robustness of 1.5T would enable 3T-like morphometric reliability in routine clinical acquisitions. We propose an orientation-aware diffusion super-resolution framework that synthesizes 3T-like fetal brain contrast from routine 1.5T scans. The model combines a Swin-UNet backbone with gated FiLM-based orientation embeddings and a residual error-shifting diffusion mechanism. Training leverages the FaBiAN phantom to generate controllable high-/low-resolution pairs with monotonic intensity remapping, geometric perturbations, and simulated signal voids, thereby ensuring generalization to clinical data. Our model produces markedly sharper gyri and mitigates partial-volume effects in both synthesized and clinical data. When evaluated using Fetal-SynthSeg following NeSVoR reconstruction, the framework consistently improves tissue segmentation accuracy over state-of-the-art restoration baselines, yielding more reliable morphometric estimates for fetal brain analysis.