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 .
GANs have been also used in medical imaging for data augmentation. @cite_17 and @cite_9 use pix2pix to generate retinal images from the vessel segmentation mask. Synthetic training samples (such as skin lesions @cite_11 , liver lesions @cite_5 and lung nodules @cite_1 ) are generated by GAN to increase the size of the training dataset or as educational purposes for radiologists. GANs are also being used to help segmentation networks to work well across different modalities, e.g CycleGAN proposed by @cite_18 to segment brain images in both CT and MRI @cite_23 . @cite_6 use DCGAN to synthesize X-ray chest scans with under-represented diseases and to classify lung diseases. The motivation of the work from is most similar to ours but instead of generating images from scratch, ScarGAN simulates diseases on scans of healthy patients.
@cite_18 @cite_9 @cite_1 @cite_17 @cite_6 @cite_23 @cite_5 @cite_11
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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. Data availability plays a critical role for the performance of deep learning systems. This challenge is especially acute within the medical image domain, particularly when pathologies are involved, due to two factors: 1) limited number of cases, and 2) large variations in location, scale, and appearance. In this work, we investigate whether augmenting a dataset with artificially generated lung nodules can improve the robustness of the progressive holistically nested network (P-HNN) model for pathological lung segmentation of CT scans. To achieve this goal, we develop a 3D generative adversarial network (GAN) that effectively learns lung nodule property distributions in 3D space. In order to embed the nodules within their background context, we condition the GAN based on a volume of interest whose central part containing the nodule has been erased. To further improve realism and blending with the background, we propose a novel multi-mask reconstruction loss. We train our method on over 1000 nodules from the LIDC dataset. Qualitative results demonstrate the effectiveness of our method compared to the state-of-art. We then use our GAN to generate simulated training images where nodules lie on the lung border, which are cases where the published P-HNN model struggles. Qualitative and quantitative results demonstrate that armed with these simulated images, the P-HNN model learns to better segment lung regions under these challenging situations. As a result, our system provides a promising means to help overcome the data paucity that commonly afflicts medical imaging. 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. Abstract Deep learning methods, and in particular convolutional neural networks (CNNs), have led to an enormous breakthrough in a wide range of computer vision tasks, primarily by using large-scale annotated datasets. However, obtaining such datasets in the medical domain remains a challenge. In this paper, we present methods for generating synthetic medical images using recently presented deep learning Generative Adversarial Networks (GANs). Furthermore, we show that generated medical images can be used for synthetic data augmentation, and improve the performance of CNN for medical image classification. Our novel method is demonstrated on a limited dataset of computed tomography (CT) images of 182 liver lesions (53 cysts, 64 metastases and 65 hemangiomas). We first exploit GAN architectures for synthesizing high quality liver lesion ROIs. Then we present a novel scheme for liver lesion classification using CNN. Finally, we train the CNN using classic data augmentation and our synthetic data augmentation and compare performance. In addition, we explore the quality of our synthesized examples using visualization and expert assessment. The classification performance using only classic data augmentation yielded 78.6 sensitivity and 88.4 specificity. By adding the synthetic data augmentation the results increased to 85.7 sensitivity and 92.4 specificity. We believe that this approach to synthetic data augmentation can generalize to other medical classification applications and thus support radiologists’ efforts to improve diagnosis.