CAVM: Conditional Autoregressive Vision Model for Contrast-Enhanced Brain Tumor MRI Synthesis
This work addresses a domain-specific medical imaging challenge for brain tumor analysis, but it appears incremental as it builds on existing deep learning methods for MRI synthesis.
The paper tackles the problem of synthesizing contrast-enhanced brain tumor MRI scans from non-contrast images to avoid expensive and potentially harmful gadolinium-based contrast agents, proposing CAVM which uses an autoregressive strategy to gradually increase contrast dosage and achieves improved synthesis quality, though no concrete numbers are provided.
Contrast-enhanced magnetic resonance imaging (MRI) is pivotal in the pipeline of brain tumor segmentation and analysis. Gadolinium-based contrast agents, as the most commonly used contrast agents, are expensive and may have potential side effects, and it is desired to obtain contrast-enhanced brain tumor MRI scans without the actual use of contrast agents. Deep learning methods have been applied to synthesize virtual contrast-enhanced MRI scans from non-contrast images. However, as this synthesis problem is inherently ill-posed, these methods fall short in producing high-quality results. In this work, we propose Conditional Autoregressive Vision Model (CAVM) for improving the synthesis of contrast-enhanced brain tumor MRI. As the enhancement of image intensity grows with a higher dose of contrast agents, we assume that it is less challenging to synthesize a virtual image with a lower dose, where the difference between the contrast-enhanced and non-contrast images is smaller. Thus, CAVM gradually increases the contrast agent dosage and produces higher-dose images based on previous lower-dose ones until the final desired dose is achieved. Inspired by the resemblance between the gradual dose increase and the Chain-of-Thought approach in natural language processing, CAVM uses an autoregressive strategy with a decomposition tokenizer and a decoder. Specifically, the tokenizer is applied to obtain a more compact image representation for computational efficiency, and it decomposes the image into dose-variant and dose-invariant tokens. Then, a masked self-attention mechanism is developed for autoregression that gradually increases the dose of the virtual image based on the dose-variant tokens. Finally, the updated dose-variant tokens corresponding to the desired dose are decoded together with dose-invariant tokens to produce the final contrast-enhanced MRI.