Eun Sook Ko

Inye Na, Jonghun Kim, Eun Sook Ko et al.

Motivated by the question, "Can we generate tumors with desired attributes?'' this study leverages radiomics features to explore the feasibility of generating synthetic tumor images. Characterized by its low-dimensional yet biologically meaningful markers, radiomics bridges the gap between complex medical imaging data and actionable clinical insights. We present RadiomicsFill-Mammo, the first of the RadiomicsFill series, an innovative technique that generates realistic mammogram mass images mirroring specific radiomics attributes using masked images and opposite breast images, leveraging a recent stable diffusion model. This approach also allows for the incorporation of essential clinical variables, such as BI-RADS and breast density, alongside radiomics features as conditions for mass generation. Results indicate that RadiomicsFill-Mammo effectively generates diverse and realistic tumor images based on various radiomics conditions. Results also demonstrate a significant improvement in mass detection capabilities, leveraging RadiomicsFill-Mammo as a strategy to generate simulated samples. Furthermore, RadiomicsFill-Mammo not only advances medical imaging research but also opens new avenues for enhancing treatment planning and tumor simulation. Our code is available at https://github.com/nainye/RadiomicsFill.

Jonghun Kim, Inye Na, Eun Sook Ko et al.

Due to privacy concerns, obtaining large datasets is challenging in medical image analysis, especially with 3D modalities like Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Existing generative models, developed to address this issue, often face limitations in output diversity and thus cannot accurately represent 3D medical images. We propose a tumor-generation model that utilizes radiomics features as generative conditions. Radiomics features are high-dimensional handcrafted semantic features that are biologically well-grounded and thus are good candidates for conditioning. Our model employs a GAN-based model to generate tumor masks and a diffusion-based approach to generate tumor texture conditioned on radiomics features. Our method allows the user to generate tumor images according to user-specified radiomics features such as size, shape, and texture at an arbitrary location. This enables the physicians to easily visualize tumor images to better understand tumors according to changing radiomics features. Our approach allows for the removal, manipulation, and repositioning of tumors, generating various tumor types in different scenarios. The model has been tested on tumors in four different organs (kidney, lung, breast, and brain) across CT and MRI. The synthesized images are shown to effectively aid in training for downstream tasks and their authenticity was also evaluated through expert evaluations. Our method has potential usage in treatment planning with diverse synthesized tumors.

Lukas Hirsch, Yu Huang, Shaojun Luo et al.

Purpose: To develop a deep network architecture that would achieve fully automated radiologist-level segmentation of cancers at breast MRI. Materials and Methods: In this retrospective study, 38229 examinations (composed of 64063 individual breast scans from 14475 patients) were performed in female patients (age range, 12-94 years; mean age, 52 years +/- 10 [standard deviation]) who presented between 2002 and 2014 at a single clinical site. A total of 2555 breast cancers were selected that had been segmented on two-dimensional (2D) images by radiologists, as well as 60108 benign breasts that served as examples of noncancerous tissue; all these were used for model training. For testing, an additional 250 breast cancers were segmented independently on 2D images by four radiologists. Authors selected among several three-dimensional (3D) deep convolutional neural network architectures, input modalities, and harmonization methods. The outcome measure was the Dice score for 2D segmentation, which was compared between the network and radiologists by using the Wilcoxon signed rank test and the two one-sided test procedure. Results: The highest-performing network on the training set was a 3D U-Net with dynamic contrast-enhanced MRI as input and with intensity normalized for each examination. In the test set, the median Dice score of this network was 0.77 (interquartile range, 0.26). The performance of the network was equivalent to that of the radiologists (two one-sided test procedures with radiologist performance of 0.69-0.84 as equivalence bounds, P <= .001 for both; n = 250). Conclusion: When trained on a sufficiently large dataset, the developed 3D U-Net performed as well as fellowship-trained radiologists in detailed 2D segmentation of breast cancers at routine clinical MRI.