Infarcted brain tissue resulting from acute stroke readily shows up as hyperintense regions within diffusion-weighted magnetic resonance imaging (DWI). It has also been proposed that computed tomography perfusion (CTP) could alternatively be used to triage stroke patients, given improvements in speed and availability, as well as reduced cost. However, CTP has a lower signal to noise ratio compared to MR. In this work, we investigate whether a conditional mapping can be learned by a generative adversarial network to map CTP inputs to generated MR DWI that more clearly delineates hyperintense regions due to ischemic stroke. We detail the architectures of the generator and discriminator and describe the training process used to perform image-to-image translation from multi-modal CT perfusion maps to diffusion weighted MR outputs. We evaluate the results both qualitatively by visual comparison of generated MR to ground truth, as well as quantitatively by training fully convolutional neural networks that make use of generated MR data inputs to perform ischemic stroke lesion segmentation. Segmentation networks trained using generated CT-to-MR inputs result in at least some improvement on all metrics used for evaluation, compared with networks that only use CT perfusion input.
The high cost of acquiring ground truth labels means that many medical imaging datasets are either not large enough or exhibit large class imbalances between healthy and pathological cases. Generative models and GANs attempt to circumvent this problem by generating synthesized data that can be used to augment datasets during model training. Consequently, GANs are increasingly being utilized within medical image synthesis and analysis @cite_8 @cite_19 @cite_17 @cite_20 . We make use of the pix2pix framework @cite_15 as it is able to learn both the image translation map and an appropriate loss function for training. The framework has been used effectively in several tasks, such as to simulate myocardial scar tissue in cardiovascular MR scans @cite_17 . Here, GANs were used to augment healthy MR scans with realistic-looking scar tissue. Using two GANs, @cite_17 were able to both generate the scar tissue and refine intensity values using a domain-specific heuristic. The generation of scar tissue was effective in training and led to realistic results -- experienced physicians mistook the generated images as being real.
@cite_8 @cite_19 @cite_15 @cite_20 @cite_17
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Medical images with specific pathologies are scarce, but a large amount of data is usually required for a deep convolutional neural network (DCNN) to achieve good accuracy. We consider the problem of segmenting the left ventricular (LV) myocardium on late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) scans of which only some of the scans have scar tissue. We propose ScarGAN to simulate scar tissue on healthy myocardium using chained generative adversarial networks (GAN). Our novel approach factorizes the simulation process into 3 steps: 1) a mask generator to simulate the shape of the scar tissue; 2) a domain-specific heuristic to produce the initial simulated scar tissue from the simulated shape; 3) a refining generator to add details to the simulated scar tissue. Unlike other approaches that generate samples from scratch, we simulate scar tissue on normal scans resulting in highly realistic samples. We show that experienced radiologists are unable to distinguish between real and simulated scar tissue. Training a U-Net with additional scans with scar tissue simulated by ScarGAN increases the percentage of scar pixels correctly included in LV myocardium prediction from 75.9 to 80.5 . Generative Adversarial Networks (GANs) have been successfully used to synthesize realistically looking images of faces, scenery and even medical images. Unfortunately, they usually require large training datasets, which are often scarce in the medical field, and to the best of our knowledge GANs have been only applied for medical image synthesis at fairly low resolution. However, many state-of-the-art machine learning models operate on high resolution data as such data carries indispensable, valuable information. In this work, we try to generate realistically looking high resolution images of skin lesions with GANs, using only a small training dataset of 2000 samples. The nature of the data allows us to do a direct comparison between the image statistics of the generated samples and the real dataset. We both quantitatively and qualitatively compare state-of-the-art GAN architectures such as DCGAN and LAPGAN against a modification of the latter for the task of image generation at a resolution of 256x256px. Our investigation shows that we can approximate the real data distribution with all of the models, but we notice major differences when visually rating sample realism, diversity and artifacts. In a set of use-case experiments on skin lesion classification, we further show that we can successfully tackle the problem of heavy class imbalance with the help of synthesized high resolution melanoma samples. We propose a new recurrent generative adversarial architecture named RNN-GAN to mitigate imbalance data problem in medical image semantic segmentation where the number of pixels belongs to the desired object are significantly lower than those belonging to the background. A model trained with imbalanced data tends to bias towards healthy data which is not desired in clinical applications and predicted outputs by these networks have high precision and low recall. To mitigate imbalanced training data impact, we train RNN-GAN with proposed complementary segmentation mask, in addition, ordinary segmentation masks. The RNN-GAN consists of two components: a generator and a discriminator. The generator is trained on the sequence of medical images to learn corresponding segmentation label map plus proposed complementary label both at a pixel level, while the discriminator is trained to distinguish a segmentation image coming from the ground truth or from the generator network. Both generator and discriminator substituted with bidirectional LSTM units to enhance temporal consistency and get inter and intra-slice representation of the features. We show evidence that the proposed framework is applicable to different types of medical images of varied sizes. In our experiments on ACDC-2017, HVSMR-2016, and LiTS-2017 benchmarks we find consistently improved results, demonstrating the efficacy of our approach. Medical datasets are often highly imbalanced, over representing common medical problems, and sparsely representing rare problems. We propose simulation of pathology in images to overcome the above limitations. Using chest Xrays as a model medical image, we implement a generative adversarial network (GAN) to create artificial images based upon a modest sized labeled dataset. We employ a combination of real and artificial images to train a deep convolutional neural network (DCNN) to detect pathology across five classes of disease. We furthermore demonstrate that augmenting the original imbalanced dataset with GAN generated images improves performance of chest pathology classification using the proposed DCNN in comparison to the same DCNN trained with the original dataset alone. This improved performance is largely attributed to balancing of the dataset using GAN generated images, where image classes that are lacking in example images are preferentially augmented.