A Domain Adaptation Model for Carotid Ultrasound: Image Harmonization, Noise Reduction, and Impact on Cardiovascular Risk Markers

Deep learning has been used extensively for medical image analysis applications, assuming the training and test data adhere to the same probability distributions. However, a common challenge arises when dealing with medical images generated by different systems or even the same system with varying parameter settings. Such images often contain diverse textures and noise patterns, violating the assumption. Consequently, models trained on data from one machine or setting usually struggle to perform effectively on data from another. To address this issue in ultrasound images, we proposed a Generative Adversarial Network (GAN) based model in this paper. We formulated image harmonization and denoising tasks as an image-to-image translation task, wherein we modified the texture pattern and reduced noise in Carotid ultrasound images while keeping the image content (the anatomy) unchanged. The performance was evaluated using feature distribution and pixel-space similarity metrics. In addition, blood-to-tissue contrast and influence on computed risk markers (Gray scale median, GSM) were evaluated. The results showed that domain adaptation was achieved in both tasks (histogram correlation 0.920 and 0.844), as compared to no adaptation (0.890 and 0.707), and that the anatomy of the images was retained (structure similarity index measure of the arterial wall 0.71 and 0.80). In addition, the image noise level (contrast) did not change in the image harmonization task (-34.1 vs 35.2 dB) but was improved in the noise reduction task (-23.5 vs -46.7 dB). The model outperformed the CycleGAN in both tasks. Finally, the risk marker GSM increased by 7.6 (p<0.001) in task 1 but not in task 2. We conclude that domain translation models are powerful tools for ultrasound image improvement while retaining the underlying anatomy but that downstream calculations of risk markers may be affected.

Leveraging GANs for data scarcity of COVID-19: Beyond the hype

Artificial Intelligence (AI)-based models can help in diagnosing COVID-19 from lung CT scans and X-ray images; however, these models require large amounts of data for training and validation. Many researchers studied Generative Adversarial Networks (GANs) for producing synthetic lung CT scans and X-Ray images to improve the performance of AI-based models. It is not well explored how good GAN-based methods performed to generate reliable synthetic data. This work analyzes 43 published studies that reported GANs for synthetic data generation. Many of these studies suffered data bias, lack of reproducibility, and lack of feedback from the radiologists or other domain experts. A common issue in these studies is the unavailability of the source code, hindering reproducibility. The included studies reported rescaling of the input images to train the existing GANs architecture without providing clinical insights on how the rescaling was motivated. Finally, even though GAN-based methods have the potential for data augmentation and improving the training of AI-based models, these methods fall short in terms of their use in clinical practice. This paper highlights research hotspots in countering the data scarcity problem, identifies various issues as well as potentials, and provides recommendations to guide future research. These recommendations might be useful to improve acceptability for the GAN-based approaches for data augmentation as GANs for data augmentation are increasingly becoming popular in the AI and medical imaging research community.

R2U++: A Multiscale Recurrent Residual U-Net with Dense Skip Connections for Medical Image Segmentation

U-Net is a widely adopted neural network in the domain of medical image segmentation. Despite its quick embracement by the medical imaging community, its performance suffers on complicated datasets. The problem can be ascribed to its simple feature extracting blocks: encoder/decoder, and the semantic gap between encoder and decoder. Variants of U-Net (such as R2U-Net) have been proposed to address the problem of simple feature extracting blocks by making the network deeper, but it does not deal with the semantic gap problem. On the other hand, another variant UNET++ deals with the semantic gap problem by introducing dense skip connections but has simple feature extraction blocks. To overcome these issues, we propose a new U-Net based medical image segmentation architecture R2U++. In the proposed architecture, the adapted changes from vanilla U-Net are: (1) the plain convolutional backbone is replaced by a deeper recurrent residual convolution block. The increased field of view with these blocks aids in extracting crucial features for segmentation which is proven by improvement in the overall performance of the network. (2) The semantic gap between encoder and decoder is reduced by dense skip pathways. These pathways accumulate features coming from multiple scales and apply concatenation accordingly. The modified architecture has embedded multi-depth models, and an ensemble of outputs taken from varying depths improves the performance on foreground objects appearing at various scales in the images. The performance of R2U++ is evaluated on four distinct medical imaging modalities: electron microscopy (EM), X-rays, fundus, and computed tomography (CT). The average gain achieved in IoU score is 1.5+-0.37% and in dice score is 0.9+-0.33% over UNET++, whereas, 4.21+-2.72 in IoU and 3.47+-1.89 in dice score over R2U-Net across different medical imaging segmentation datasets.