用强化学习做脑部MRI异常检测，少标注也能准。

To develop a domain-agnostic, semi-supervised anomaly detection framework that integrates deep reinforcement learning (DRL) to address challenges such as large-scale data, overfitting, and class imbalance, focusing on brain MRI volumes. This retrospective study used publicly available brain MRI datasets collected between 2005 and 2021. The IXI dataset provided 581 T1-weighted and 578 T2-weighted MRI volumes (from healthy subjects) for training, while the BraTS 2021 dataset provided 251 volumes for validation and 1000 for testing (unhealthy subjects with Glioblastomas). Preprocessing included normalization, skull-stripping, and co-registering to a uniform voxel size. Experiments were conducted on both T1- and T2-weighted modalities. Additional experiments and ablation analyses were also carried out on the industrial datasets. The proposed method integrates DRL with feature representations to handle label scarcity, large-scale data and overfitting. Statistical analysis was based on several detection and segmentation metrics including AUROC and Dice score. The proposed method achieved an AUROC of 88.7% (pixel-level) and 96.7% (image-level) on brain MRI datasets, outperforming State-of-The-Art (SOTA) methods. On industrial surface datasets, the model also showed competitive performance (AUROC = 99.8% pixel-level, 99.3% image-level) on MVTec AD dataset, indicating strong cross-domain generalization. Studies on anomaly sample size showed a monotonic increase in AUROC as more anomalies were seen, without evidence of overfitting or additional computational cost. The domain-agnostic semi-supervised approach using DRL shows significant promise for MRI anomaly detection, achieving strong performance on both medical and industrial datasets. Its robustness, generalizability and efficiency highlight its potential for real-world clinical applications.