MICAFlow: Fast and Robust MRI Preprocessing Bridging Research Neuroimaging and Clinical Practice

MICAFlow is a fully automated MRI preprocessing pipeline designed to translate advanced neuroimaging workflows from research into routine clinical practice. The pipeline emphasizes speed, robustness, and ease of use, focusing on structural and diffusion MRI. Key innovations include a Label-Augmented Modality-Agnostic Registration (LAMAReg) technique driven by deep learning segmentations for reliable cross-modal alignment, integration of state-of-the-art distortion corrections, and adherence to reproducible standards (Snakemake workflow, BIDSApp specifications). We describe the design of MICAFlow and evaluate its performance across heterogeneous datasets. First, accessibility: MICAFlow processes a multimodal MRI exam in minutes with clinically accessible hardware and without requiring GPU access, making it feasible for same-day clinical use. Second, registration accuracy: LAMAReg achieves cutting-edge multi-modal registration accuracy, yielding accurate alignment of diffusion MRI, FLAIR, and intra-subject T1-weighted images while remaining generally robust to common artifacts. Third, data reliability: Using identifiability, we show MICAFlow maintains consistent performance across diverse datasets, including subjects with pathology, and is closely comparable to contemporary pipelines. In sum, MICAFlows combination of machine learning and efficient workflows produces research-grade data quality with clinical-grade speed. This work demonstrates that advanced MRI preprocessing can be done fast and robustly, helping close the gap between research neuroimaging and broad clinical application of quantitative MRI techniques. The source code for MICAFlow is available here: https://github.com/MICA-MNI/micaflow, and for LAMAReg here: https://github.com/MICA-MNI/LAMAReg.