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_0: Semantic segmentation constitutes an integral part of medical image analyses for which breakthroughs in the field of deep learning were of high relevance. The large number of trainable parameters of deep neural networks however renders them inherently data hungry, a characteristic that heavily challenges the medical imaging community. Though interestingly, with the de facto standard training of fully convolutional networks (FCNs) for semantic segmentation being agnostic towards the structure' of the predicted label maps, valuable complementary information about the global quality of the segmentation lies idle. In order to tap into this potential, we propose utilizing an adversarial network which discriminates between expert and generated annotations in order to train FCNs for semantic segmentation. Because the adversary constitutes a learned parametrization of what makes a good segmentation at a global level, we hypothesize that the method holds particular advantages for segmentation tasks on complex structured, small datasets. This holds true in our experiments: We learn to segment aggressive prostate cancer utilizing MRI images of 152 patients and show that the proposed scheme is superior over the de facto standard in terms of the detection sensitivity and the dice-score for aggressive prostate cancer. The achieved relative gains are shown to be particularly pronounced in the small dataset limit.
@cite_40: Automatic liver segmentation in 3D medical images is essential in many clinical applications, such as pathological diagnosis of hepatic diseases, surgical planning, and postoperative assessment. However, it is still a very challenging task due to the complex background, fuzzy boundary, and various appearance of liver. In this paper, we propose an automatic and efficient algorithm to segment liver from 3D CT volumes. A deep image-to-image network (DI2IN) is first deployed to generate the liver segmentation, employing a convolutional encoder-decoder architecture combined with multi-level feature concatenation and deep supervision. Then an adversarial network is utilized during training process to discriminate the output of DI2IN from ground truth, which further boosts the performance of DI2IN. The proposed method is trained on an annotated dataset of 1000 CT volumes with various different scanning protocols (e.g., contrast and non-contrast, various resolution and position) and large variations in populations (e.g., ages and pathology). Our approach outperforms the state-of-the-art solutions in terms of segmentation accuracy and computing efficiency.
@cite_9: Adversarial training has been shown to produce state of the art results for generative image modeling. In this paper we propose an adversarial training approach to train semantic segmentation models. We train a convolutional semantic segmentation network along with an adversarial network that discriminates segmentation maps coming either from the ground truth or from the segmentation network. The motivation for our approach is that it can detect and correct higher-order inconsistencies between ground truth segmentation maps and the ones produced by the segmentation net. Our experiments show that our adversarial training approach leads to improved accuracy on the Stanford Background and PASCAL VOC 2012 datasets.
@cite_22: Inspired by classic Generative Adversarial Networks (GANs), we propose a novel end-to-end adversarial neural network, called SegAN, for the task of medical image segmentation. Since image segmentation requires dense, pixel-level labeling, the single scalar real fake output of a classic GAN’s discriminator may be ineffective in producing stable and sufficient gradient feedback to the networks. Instead, we use a fully convolutional neural network as the segmentor to generate segmentation label maps, and propose a novel adversarial critic network with a multi-scale L1 loss function to force the critic and segmentor to learn both global and local features that capture long- and short-range spatial relationships between pixels. In our SegAN framework, the segmentor and critic networks are trained in an alternating fashion in a min-max game: The critic is trained by maximizing a multi-scale loss function, while the segmentor is trained with only gradients passed along by the critic, with the aim to minimize the multi-scale loss function. We show that such a SegAN framework is more effective and stable for the segmentation task, and it leads to better performance than the state-of-the-art U-net segmentation method. We tested our SegAN method using datasets from the MICCAI BRATS brain tumor segmentation challenge. Extensive experimental results demonstrate the effectiveness of the proposed SegAN with multi-scale loss: on BRATS 2013 SegAN gives performance comparable to the state-of-the-art for whole tumor and tumor core segmentation while achieves better precision and sensitivity for Gd-enhance tumor core segmentation; on BRATS 2015 SegAN achieves better performance than the state-of-the-art in both dice score and precision.
Apart from synthesizing data, several studies @cite_0 @cite_9 @cite_40 @cite_22 use adversarial learning as an extra supervision on the segmentation or detection networks. The adversarial loss plays a role of constraining the prediction to be close to the distribution of groundtruth. However, such strategy is a refinement process, so it is less likely to remedy the cost of data insufficiency.