ScarGAN: Chained Generative Adversarial Networks to Simulate Pathological Tissue on Cardiovascular MR Scans

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%.Comment: 12 pages, 5 figures. To appear in MICCAI DLMIA 201

'A net for everyone': fully personalized and unsupervised neural networks trained with longitudinal data from a single patient

With the rise in importance of personalized medicine, we trained personalized neural networks to detect tumor progression in longitudinal datasets. The model was evaluated on two datasets with a total of 64 scans from 32 patients diagnosed with glioblastoma multiforme (GBM). Contrast-enhanced T1w sequences of brain magnetic resonance imaging (MRI) images were used in this study. For each patient, we trained their own neural network using just two images from different timepoints. Our approach uses a Wasserstein-GAN (generative adversarial network), an unsupervised network architecture, to map the differences between the two images. Using this map, the change in tumor volume can be evaluated. Due to the combination of data augmentation and the network architecture, co-registration of the two images is not needed. Furthermore, we do not rely on any additional training data, (manual) annotations or pre-training neural networks. The model received an AUC-score of 0.87 for tumor change. We also introduced a modified RANO criteria, for which an accuracy of 66% can be achieved. We show that using data from just one patient can be used to train deep neural networks to monitor tumor change

Enhanced Magnetic Resonance Image Synthesis with Contrast-Aware Generative Adversarial Networks

A Magnetic Resonance Imaging (MRI) exam typically consists of the acquisition of multiple MR pulse sequences, which are required for a reliable diagnosis. Each sequence can be parameterized through multiple acquisition parameters affecting MR image contrast, signal-to-noise ratio, resolution, or scan time. With the rise of generative deep learning models, approaches for the synthesis of MR images are developed to either synthesize additional MR contrasts, generate synthetic data, or augment existing data for AI training. However, current generative approaches for the synthesis of MR images are only trained on images with a specific set of acquisition parameter values, limiting the clinical value of these methods as various sets of acquisition parameter settings are used in clinical practice. Therefore, we trained a generative adversarial network (GAN) to generate synthetic MR knee images conditioned on various acquisition parameters (repetition time, echo time, image orientation). This approach enables us to synthesize MR images with adjustable image contrast. In a visual Turing test, two experts mislabeled 40.5% of real and synthetic MR images, demonstrating that the image quality of the generated synthetic and real MR images is comparable. This work can support radiologists and technologists during the parameterization of MR sequences by previewing the yielded MR contrast, can serve as a valuable tool for radiology training, and can be used for customized data generation to support AI training