Common Feature Learning for Brain Tumor MRI Synthesis by Context-aware Generative Adversarial Network

Generative AI for synthetic data across multiple medical modalities: A systematic review of recent developments and challenges

This paper presents a comprehensive systematic review of generative models (GANs, VAEs, DMs, and LLMs) used to synthesize various medical data types, including imaging (dermoscopic, mammographic, ultrasound, CT, MRI, and X-ray), text, time-series, and tabular data (EHR). Unlike previous narrowly focused reviews, our study encompasses a broad array of medical data modalities and explores various generative models. Our aim is to offer insights into their current and future applications in medical research, particularly in the context of synthesis applications, generation techniques, and evaluation methods, as well as providing a GitHub repository as a dynamic resource for ongoing collaboration and innovation. Our search strategy queries databases such as Scopus, PubMed, and ArXiv, focusing on recent works from January 2021 to November 2023, excluding reviews and perspectives. This period emphasizes recent advancements beyond GANs, which have been extensively covered in previous reviews. The survey also emphasizes the aspect of conditional generation, which is not focused on in similar work. Key contributions include a broad, multi-modality scope that identifies cross-modality insights and opportunities unavailable in single-modality surveys. While core generative techniques are transferable, we find that synthesis methods often lack sufficient integration of patient-specific context, clinical knowledge, and modality-specific requirements tailored to the unique characteristics of medical data. Conditional models leveraging textual conditioning and multimodal synthesis remain underexplored but offer promising directions for innovation. Our findings are structured around three themes: (1) Synthesis applications, highlighting clinically valid synthesis applications and significant gaps in using synthetic data beyond augmentation, such as for validation and evaluation; (2) Generation techniques, identifying gaps in personalization and cross-modality innovation; and (3) Evaluation methods, revealing the absence of standardized benchmarks, the need for large-scale validation, and the importance of privacy-aware, clinically relevant evaluation frameworks. These findings emphasize the need for benchmarking and comparative studies to promote openness and collaboration.

Enhanced MRI-based brain tumour classification with a novel Pix2pix generative adversarial network augmentation framework

The scarcity of medical imaging datasets and privacy concerns pose significant challenges in artificial intelligence-based disease prediction. This poses major concerns to patient confidentiality as there are now tools capable of extracting patient information by merely analysing patient's imaging data. To address this, we propose the use of synthetic data generated by generative adversarial networks as a solution. Our study pioneers the utilisation of a novel Pix2Pix generative adversarial network model, specifically the 'image-to-image translation with conditional adversarial networks,' to generate synthetic datasets for brain tumour classification. We focus on classifying four tumour types: glioma, meningioma, pituitary and healthy. We introduce a novel conditional deep convolutional neural network architecture, developed from convolutional neural network architectures, to process the pre-processed generated synthetic datasets and the original datasets obtained from the Kaggle repository. Our evaluation metrics demonstrate the conditional deep convolutional neural network model's high performance with synthetic images, achieving an accuracy of 86%. Comparative analysis with state-of-the-art models such as Residual Network50, Visual Geometry Group 16, Visual Geometry Group 19 and InceptionV3 highlights the superior performance of our conditional deep convolutional neural network model in brain tumour detection, diagnosis and classification. Our findings underscore the efficacy of our novel Pix2Pix generative adversarial network augmentation technique in creating synthetic datasets for accurate brain tumour classification, offering a promising avenue for improved disease prediction and treatment planning.

Radiogenomics: bridging the gap between imaging and genomics for precision oncology

Genomics allows the tracing of origin and evolution of cancer at molecular scale and underpin modern cancer diagnosis and treatment systems. Yet, molecular biomarker-guided clinical decision-making encounters major challenges in the realm of individualized medicine, consisting of the invasiveness of procedures and the sampling errors due to high tumor heterogeneity. By contrast, medical imaging enables noninvasive and global characterization of tumors at a low cost. In recent years, radiomics has overcomes the limitations of human visual evaluation by high-throughput quantitative analysis, enabling the comprehensive utilization of the vast amount of information underlying radiological images. The cross-scale integration of radiomics and genomics (hereafter radiogenomics) has the enormous potential to enhance cancer decoding and act as a catalyst for digital precision medicine. Herein, we provide a comprehensive overview of the current framework and potential clinical applications of radiogenomics in patient care. We also highlight recent research advances to illustrate how radiogenomics can address common clinical problems in solid tumors such as breast cancer, lung cancer, and glioma. Finally, we analyze existing literature to outline challenges and propose solutions, while also identifying future research pathways. We believe that the perspectives shared in this survey will provide a valuable guide for researchers in the realm of radiogenomics aiming to advance precision oncology.

Multi-Task Collaborative Pre-Training and Adaptive Token Selection: A Unified Framework for Brain Representation Learning

Structural magnetic resonance imaging (sMRI) reveals the structural organization of the brain. Learning general brain representations from sMRI is an enduring topic in neuroscience. Previous deep learning models neglect that the brain, as the core of cognition, is distinct from other organs whose primary attribute is anatomy. Capturing the high-level representation associated with inter-individual cognitive variability is key to appropriately represent the brain. Given that this cognition-related information is subtle, mixed, and distributed in the brain structure, sMRI-based models need to both capture fine-grained details and understand how they relate to the overall global structure. Additionally, it is also necessary to explicitly express the cognitive information that implicitly embedded in local-global image features. Therefore, we propose MCPATS, a brain representation learning framework that combines Multi-task Collaborative Pre-training (MCP) and Adaptive Token Selection (ATS). First, we develop MCP, including mask-reconstruction to understand global context, distort-restoration to capture fine-grained local details, adversarial learning to integrate features at different granularities, and age-prediction, using age as a surrogate for cognition to explicitly encode cognition-related information from local-global image features. This co-training allows progressive learning of implicit and explicit cognition-related representations. Then, we develop ATS based on mutual attention for downstream use of the learned representation. During fine-tuning, the ATS highlights discriminative features and reduces the impact of irrelevant information. MCPATS was validated on three different public datasets for brain disease diagnosis, outperforming competing methods and achieving accurate diagnosis. Further, we performed detailed analysis to confirm that the MCPATS-learned representation captures cognition-related information.

A Comparative Analysis of the Novel Conditional Deep Convolutional Neural Network Model, Using Conditional Deep Convolutional Generative Adversarial Network-Generated Synthetic and Augmented Brain Tumor Datasets for Image Classification

Disease prediction is greatly challenged by the scarcity of datasets and privacy concerns associated with real medical data. An approach that stands out to circumvent this hurdle is the use of synthetic data generated using Generative Adversarial Networks (GANs). GANs can increase data volume while generating synthetic datasets that have no direct link to personal information. This study pioneers the use of GANs to create synthetic datasets and datasets augmented using traditional augmentation techniques for our binary classification task. The primary aim of this research was to evaluate the performance of our novel Conditional Deep Convolutional Neural Network (C-DCNN) model in classifying brain tumors by leveraging these augmented and synthetic datasets. We utilized advanced GAN models, including Conditional Deep Convolutional Generative Adversarial Network (DCGAN), to produce synthetic data that retained essential characteristics of the original datasets while ensuring privacy protection. Our C-DCNN model was trained on both augmented and synthetic datasets, and its performance was benchmarked against state-of-the-art models such as ResNet50, VGG16, VGG19, and InceptionV3. The evaluation metrics demonstrated that our C-DCNN model achieved accuracy, precision, recall, and F1 scores of 99% on both synthetic and augmented images, outperforming the comparative models. The findings of this study highlight the potential of using GAN-generated synthetic data in enhancing the training of machine learning models for medical image classification, particularly in scenarios with limited data available. This approach not only improves model accuracy but also addresses privacy concerns, making it a viable solution for real-world clinical applications in disease prediction and diagnosis.

sTBI-GAN: An adversarial learning approach for data synthesis on traumatic brain segmentation

Automatic brain segmentation of magnetic resonance images (MRIs) from severe traumatic brain injury (sTBI) patients is critical for brain abnormality assessments and brain network analysis. Construction of sTBI brain segmentation model requires manually annotated MR scans of sTBI patients, which becomes a challenging problem as it is quite impractical to implement sufficient annotations for sTBI images with large deformations and lesion erosion. Data augmentation techniques can be applied to alleviate the issue of limited training samples. However, conventional data augmentation strategies such as spatial and intensity transformation are unable to synthesize the deformation and lesions in traumatic brains, which limits the performance of the subsequent segmentation task. To address these issues, we propose a novel medical image inpainting model named sTBI-GAN to synthesize labeled sTBI MR scans by adversarial inpainting. The main strength of our sTBI-GAN method is that it can generate sTBI images and corresponding labels simultaneously, which has not been achieved in previous inpainting methods for medical images. We first generate the inpainted image under the guidance of edge information following a coarse-to-fine manner, and then the synthesized MR image is used as the prior for label inpainting. Furthermore, we introduce a registration-based template augmentation pipeline to increase the diversity of the synthesized image pairs and enhance the capacity of data augmentation. Experimental results show that the proposed sTBI-GAN method can synthesize high-quality labeled sTBI images, which greatly improves the 2D and 3D traumatic brain segmentation performance compared with the alternatives. Code is available at .

MTFN: multi-temporal feature fusing network with co-attention for DCE-MRI synthesis

BACKGROUND

Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) plays an important role in the diagnosis and treatment of breast cancer. However, obtaining complete eight temporal images of DCE-MRI requires a long scanning time, which causes patients' discomfort in the scanning process. Therefore, to reduce the time, the multi temporal feature fusing neural network with Co-attention (MTFN) is proposed to generate the eighth temporal images of DCE-MRI, which enables the acquisition of DCE-MRI images without scanning. In order to reduce the time, multi-temporal feature fusion cooperative attention mechanism neural network (MTFN) is proposed to generate the eighth temporal images of DCE-MRI, which enables DCE-MRI image acquisition without scanning.

METHODS

In this paper, we propose multi temporal feature fusing neural network with Co-attention (MTFN) for DCE-MRI Synthesis, in which the Co-attention module can fully fuse the features of the first and third temporal image to obtain the hybrid features. The Co-attention explore long-range dependencies, not just relationships between pixels. Therefore, the hybrid features are more helpful to generate the eighth temporal images.

RESULTS

We conduct experiments on the private breast DCE-MRI dataset from hospitals and the multi modal Brain Tumor Segmentation Challenge2018 dataset (BraTs2018). Compared with existing methods, the experimental results of our method show the improvement and our method can generate more realistic images. In the meanwhile, we also use synthetic images to classify the molecular typing of breast cancer that the accuracy on the original eighth time-series images and the generated images are 89.53% and 92.46%, which have been improved by about 3%, and the classification results verify the practicability of the synthetic images.

CONCLUSIONS

The results of subjective evaluation and objective image quality evaluation indicators show the effectiveness of our method, which can obtain comprehensive and useful information. The improvement of classification accuracy proves that the images generated by our method are practical.

TransRender: a transformer-based boundary rendering segmentation network for stroke lesions

Vision transformer architectures attract widespread interest due to their robust representation capabilities of global features. Transformer-based methods as the encoder achieve superior performance compared to convolutional neural networks and other popular networks in many segmentation tasks for medical images. Due to the complex structure of the brain and the approximate grayscale of healthy tissue and lesions, lesion segmentation suffers from over-smooth boundaries or inaccurate segmentation. Existing methods, including the transformer, utilize stacked convolutional layers as the decoder to uniformly treat each pixel as a grid, which is convenient for feature computation. However, they often neglect the high-frequency features of the boundary and focus excessively on the region features. We propose an effective method for lesion boundary rendering called TransRender, which adaptively selects a series of important points to compute the boundary features in a point-based rendering way. The transformer-based method is selected to capture global information during the encoding stage. Several renders efficiently map the encoded features of different levels to the original spatial resolution by combining global and local features. Furthermore, the point-based function is employed to supervise the render module generating points, so that TransRender can continuously refine the uncertainty region. We conducted substantial experiments on different stroke lesion segmentation datasets to prove the efficiency of TransRender. Several evaluation metrics illustrate that our method can automatically segment the stroke lesion with relatively high accuracy and low calculation complexity.

Joint learning-based feature reconstruction and enhanced network for incomplete multi-modal brain tumor segmentation

Multimodal Magnetic Resonance Imaging (MRI) can provide valuable complementary information and substantially enhance the performance of brain tumor segmentation. However, it is common for certain modalities to be absent or missing during clinical diagnosis, which can significantly impair segmentation techniques that rely on complete modalities. Current advanced methods attempt to address this challenge by developing shared feature representations via modal fusion to handle different missing modality situations. Considering the importance of missing modality information in multimodal segmentation, this paper utilize a feature reconstruction method to recover the missing information, and proposes a joint learning-based feature reconstruction and enhancement method for incomplete modality brain tumor segmentation. The method leverages an information learning mechanism to transfer information from the complete modality to a single modality, enabling it to obtain complete brain tumor information, even without the support of other modalities. Additionally, the method incorporates a module for reconstructing missing modality features, which recovers fused features of the absent modality through utilizing the abundant potential information obtained from the available modalities. Furthermore, the feature enhancement mechanism improves shared feature representation by utilizing the information obtained from the missing modalities that have been reconstructed. These processes enable the method to obtain more comprehensive information regarding brain tumors in various missing modality circumstances, thereby enhancing the model's robustness. The performance of the proposed model was evaluated on BraTS datasets and compared with other deep learning algorithms using Dice similarity scores. On the BraTS2018 dataset, the proposed algorithm achieved a Dice similarity score of 86.28%, 77.02%, and 59.64% for whole tumors, tumor cores, and enhanced tumors, respectively. These results demonstrate the superiority of our framework over state-of-the-art methods in missing modalities situations.

Emerging role of artificial intelligence in diagnosis, classification and clinical management of glioma

Glioma represents a dominant primary intracranial malignancy in the central nervous system. Artificial intelligence that mainly includes machine learning, and deep learning computational approaches, presents a unique opportunity to enhance clinical management of glioma through improving tumor segmentation, diagnosis, differentiation, grading, treatment, prediction of clinical outcomes (prognosis, and recurrence), molecular features, clinical classification, characterization of the tumor microenvironment, and drug discovery. A growing body of recent studies apply artificial intelligence-based models to disparate data sources of glioma, covering imaging modalities, digital pathology, high-throughput multi-omics data (especially emerging single-cell RNA sequencing and spatial transcriptome), etc. While these early findings are promising, future studies are required to normalize artificial intelligence-based models to improve the generalizability and interpretability of the results. Despite prominent issues, targeted clinical application of artificial intelligence approaches in glioma will facilitate the development of precision medicine of this field. If these challenges can be overcome, artificial intelligence has the potential to profoundly change the way patients with or at risk of glioma are provided with more rational care.

Breast tumor localization and segmentation using machine learning techniques: Overview of datasets, findings, and methods

The Global Cancer Statistics 2020 reported breast cancer (BC) as the most common diagnosis of cancer type. Therefore, early detection of such type of cancer would reduce the risk of death from it. Breast imaging techniques are one of the most frequently used techniques to detect the position of cancerous cells or suspicious lesions. Computer-aided diagnosis (CAD) is a particular generation of computer systems that assist experts in detecting medical image abnormalities. In the last decades, CAD has applied deep learning (DL) and machine learning approaches to perform complex medical tasks in the computer vision area and improve the ability to make decisions for doctors and radiologists. The most popular and widely used technique of image processing in CAD systems is segmentation which consists of extracting the region of interest (ROI) through various techniques. This research provides a detailed description of the main categories of segmentation procedures which are classified into three classes: supervised, unsupervised, and DL. The main aim of this work is to provide an overview of each of these techniques and discuss their pros and cons. This will help researchers better understand these techniques and assist them in choosing the appropriate method for a given use case.