Synthesized medical images have several important applications, e.g., as an intermedium in cross-modality image registration and as supplementary training samples to boost the generalization capability of a classifier. Especially, synthesized computed tomography (CT) data can provide X-ray attenuation map for radiation therapy planning. In this work, we propose a generic cross-modality synthesis approach with the following targets: 1) synthesizing realistic looking 3D images using unpaired training data, 2) ensuring consistent anatomical structures, which could be changed by geometric distortion in cross-modality synthesis and 3) improving volume segmentation by using synthetic data for modalities with limited training samples. We show that these goals can be achieved with an end-to-end 3D convolutional neural network (CNN) composed of mutually-beneficial generators and segmentors for image synthesis and segmentation tasks. The generators are trained with an adversarial loss, a cycle-consistency loss, and also a shape-consistency loss, which is supervised by segmentors, to reduce the geometric distortion. From the segmentation view, the segmentors are boosted by synthetic data from generators in an online manner. Generators and segmentors prompt each other alternatively in an end-to-end training fashion. With extensive experiments on a dataset including a total of 4,496 CT and magnetic resonance imaging (MRI) cardiovascular volumes, we show both tasks are beneficial to each other and coupling these two tasks results in better performance than solving them exclusively.
@cite_28: Synthesizing images of the eye fundus is a challenging task that has been previously approached by formulating complex models of the anatomy of the eye. New images can then be generated by sampling a suitable parameter space. In this work, we propose a method that learns to synthesize eye fundus images directly from data. For that, we pair true eye fundus images with their respective vessel trees, by means of a vessel segmentation technique. These pairs are then used to learn a mapping from a binary vessel tree to a new retinal image. For this purpose, we use a recent image-to-image translation technique, based on the idea of adversarial learning. Experimental results show that the original and the generated images are visually different in terms of their global appearance, in spite of sharing the same vessel tree. Additionally, a quantitative quality analysis of the synthetic retinal images confirms that the produced images retain a high proportion of the true image set quality.
@cite_21: A lack of generalizability is one key limitation of deep learning based segmentation. Typically, one manually labels new training images when segmenting organs in different imaging modalities or segmenting abnormal organs from distinct disease cohorts. The manual efforts can be alleviated if one is able to reuse manual labels from one modality (e.g., MRI) to train a segmentation network for a new modality (e.g., CT). Previously, two stage methods have been proposed to use cycle generative adversarial networks (CycleGAN) to synthesize training images for a target modality. Then, these efforts trained a segmentation network independently using synthetic images. However, these two independent stages did not use the complementary information between synthesis and segmentation. Herein, we proposed a novel end-to-end synthesis and segmentation network (EssNet) to achieve the unpaired MRI to CT image synthesis and CT splenomegaly segmentation simultaneously without using manual labels on CT. The end-to-end EssNet achieved significantly higher median Dice similarity coefficient (0.9188) than the two stages strategy (0.8801), and even higher than canonical multi-atlas segmentation (0.9125) and ResNet method (0.9107), which used the CT manual labels.
@cite_3: Significant advances have been made towards building accurate automatic segmentation systems for a variety of biomedical applications using machine learning. However, the performance of these systems often degrades when they are applied on new data that differ from the training data, for example, due to variations in imaging protocols. Manually annotating new data for each test domain is not a feasible solution. In this work we investigate unsupervised domain adaptation using adversarial neural networks to train a segmentation method which is more robust to differences in the input data, and which does not require any annotations on the test domain. Specifically, we derive domain-invariant features by learning to counter an adversarial network, which attempts to classify the domain of the input data by observing the activations of the segmentation network. Furthermore, we propose a multi-connected domain discriminator for improved adversarial training. Our system is evaluated using two MR databases of subjects with traumatic brain injuries, acquired using different scanners and imaging protocols. Using our unsupervised approach, we obtain segmentation accuracies which are close to the upper bound of supervised domain adaptation.
@cite_6: Availability of multi-modal magnetic resonance imaging (MRI) databases opens up the opportunity to synthesize different MRI contrasts without actually acquiring the images. In theory such synthetic images have the potential to reduce the amount of acquisitions to perform certain analyses. However, to what extent they can substitute real acquisitions in the respective analyses is an open question. In this study, we used a synthesis method based on patch matching to test whether synthetic images can be useful in segmentation and inter-modality cross-subject registration of brain MRI. Thirty-nine T1 scans with 36 manually labeled structures of interest were used in the registration and segmentation of eight proton density (PD) scans, for which ground truth T1 data were also available. The results show that synthesized T1 contrast can considerably enhance the quality of non-linear registration compared with using the original PD data, and it is only marginally worse than using the original T1 scans. In segmentation, the relative improvement with respect to using the PD is smaller, but still statistically significant.
@cite_2: With recent progress in graphics, it has become more tractable to train models on synthetic images, potentially avoiding the need for expensive annotations. However, learning from synthetic images may not achieve the desired performance due to a gap between synthetic and real image distributions. To reduce this gap, we propose Simulated+Unsupervised (S+U) learning, where the task is to learn a model to improve the realism of a simulators output using unlabeled real data, while preserving the annotation information from the simulator. We develop a method for S+U learning that uses an adversarial network similar to Generative Adversarial Networks (GANs), but with synthetic images as inputs instead of random vectors. We make several key modifications to the standard GAN algorithm to preserve annotations, avoid artifacts, and stabilize training: (i) a self-regularization term, (ii) a local adversarial loss, and (iii) updating the discriminator using a history of refined images. We show that this enables generation of highly realistic images, which we demonstrate both qualitatively and with a user study. We quantitatively evaluate the generated images by training models for gaze estimation and hand pose estimation. We show a significant improvement over using synthetic images, and achieve state-of-the-art results on the MPIIGaze dataset without any labeled real data.
Synthesizing medical data to overcome insufficient labeled data attracted wide interests recently @cite_2 @cite_6 @cite_21 . Due to the diversity of medical modalities, learning an unsupervised translation between modalities is a promising direction @cite_28 . @cite_3 demonstrates the benefits on brain (MRI and CT) images, by using synthetic data as augmented training data to help lesion segmentation.