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.
MR-only radiotherapy treatment planning requires accurate MR-to-CT synthesis. Current deep learning methods for MR-to-CT synthesis depend on pairwise aligned MR and CT training images of the same patient. However, misalignment between paired images could lead to errors in synthesized CT images. To overcome this, we propose to train a generative adversarial network (GAN) with unpaired MR and CT images. A GAN consisting of two synthesis convolutional neural networks (CNNs) and two discriminator CNNs was trained with cycle consistency to transform 2D brain MR image slices into 2D brain CT image slices and vice versa. Brain MR and CT images of 24 patients were analyzed. A quantitative evaluation showed that the model was able to synthesize CT images that closely approximate reference CT images, and was able to outperform a GAN model trained with paired MR and CT images. Computed tomography (CT) is critical for various clinical applications, e.g., radiotherapy treatment planning and also PET attenuation correction. However, CT exposes radiation during acquisition, which may cause side effects to patients. Compared to CT, magnetic resonance imaging (MRI) is much safer and does not involve any radiations. Therefore, recently, researchers are greatly motivated to estimate CT image from its corresponding MR image of the same subject for the case of radiotherapy planning. In this paper, we propose a data-driven approach to address this challenging problem. Specifically, we train a fully convolutional network to generate CT given an MR image. To better model the nonlinear relationship from MRI to CT and to produce more realistic images, we propose to use the adversarial training strategy and an image gradient difference loss function. We further apply AutoContext Model to implement a context-aware generative adversarial network. Experimental results show that our method is accurate and robust for predicting CT images from MRI images, and also outperforms three state-of-the-art methods under comparison.  Computationally synthesized blood vessels can be used for training and evaluation of medical image analysis applications. We propose a deep generative model to synthesize blood vessel geometries, with an application to coronary arteries in cardiac CT angiography (CCTA). In the proposed method, a Wasserstein generative adversarial network (GAN) consisting of a generator and a discriminator network is trained. While the generator tries to synthesize realistic blood vessel geometries, the discriminator tries to distinguish synthesized geometries from those of real blood vessels. Both real and synthesized blood vessel geometries are parametrized as 1D signals based on the central vessel axis. The generator can optionally be provided with an attribute vector to synthesize vessels with particular characteristics. The GAN was optimized using a reference database with parametrizations of 4,412 real coronary artery geometries extracted from CCTA scans. After training, plausible coronary artery geometries could be synthesized based on random vectors sampled from a latent space. A qualitative analysis showed strong similarities between real and synthesized coronary arteries. A detailed analysis of the latent space showed that the diversity present in coronary artery anatomy was accurately captured by the generator. Results show that Wasserstein generative adversarial networks can be used to synthesize blood vessel geometries. 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 .