Modern medical image translation methods use generative models for tasks such as the conversion of CT images to MRI. Evaluating these methods typically relies on some chosen downstream task in the target domain, such as segmentation. On the other hand, task-agnostic metrics are attractive, such as the network feature-based perceptual metrics (e.g., FID) that are common to image translation in general computer vision. In this paper, we investigate evaluation metrics for medical image translation on two medical image translation tasks (GE breast MRI to Siemens breast MRI and lumbar spine MRI to CT), tested on various state-of-the-art translation methods. We show that perceptual metrics do not generally correlate with segmentation metrics due to them extending poorly to the anatomical constraints of this sub-field, with FID being especially inconsistent. However, we find that the lesser-used pixel-level SWD metric may be useful for subtle intra-modality translation. Our results demonstrate the need for further research into helpful metrics for medical image translation.
Different types of staining highlight different structures in organs, thereby assisting in diagnosis. However, due to the impossibility of repeated staining, we cannot obtain different types of stained slides of the same tissue area. Translating the slide that is easy to obtain (e.g., H&E) to slides of staining types difficult to obtain (e.g., MT, PAS) is a promising way to solve this problem. However, some regions are closely connected to other regions, and to maintain this connection, they often have complex structures and are difficult to translate, which may lead to wrong translations. In this paper, we propose the Attention-Based Varifocal Generative Adversarial Network (AV-GAN), which solves multiple problems in pathologic image translation tasks, such as uneven translation difficulty in different regions, mutual interference of multiple resolution information, and nuclear deformation. Specifically, we develop an Attention-Based Key Region Selection Module, which can attend to regions with higher translation difficulty. We then develop a Varifocal Module to translate these regions at multiple resolutions. Experimental results show that our proposed AV-GAN outperforms existing image translation methods with two virtual kidney tissue staining tasks and improves FID values by 15.9 and 4.16 respectively in the H&E-MT and H&E-PAS tasks.
Cross-modality image segmentation aims to segment the target modalities using a method designed in the source modality. Deep generative models can translate the target modality images into the source modality, thus enabling cross-modality segmentation. However, a vast body of existing cross-modality image translation methods relies on supervised learning. In this work, we aim to address the challenge of zero-shot learning-based image translation tasks (extreme scenarios in the target modality is unseen in the training phase). To leverage generative learning for zero-shot cross-modality image segmentation, we propose a novel unsupervised image translation method. The framework learns to translate the unseen source image to the target modality for image segmentation by leveraging the inherent statistical consistency between different modalities for diffusion guidance. Our framework captures identical cross-modality features in the statistical domain, offering diffusion guidance without relying on direct mappings between the source and target domains. This advantage allows our method to adapt to changing source domains without the need for retraining, making it highly practical when sufficient labeled source domain data is not available. The proposed framework is validated in zero-shot cross-modality image segmentation tasks through empirical comparisons with influential generative models, including adversarial-based and diffusion-based models.
Most image-to-image translation models postulate that a unique correspondence exists between the semantic classes of the source and target domains. However, this assumption does not always hold in real-world scenarios due to divergent distributions, different class sets, and asymmetrical information representation. As conventional GANs attempt to generate images that match the distribution of the target domain, they may hallucinate spurious instances of classes absent from the source domain, thereby diminishing the usefulness and reliability of translated images. CycleGAN-based methods are also known to hide the mismatched information in the generated images to bypass cycle consistency objectives, a process known as steganography. In response to the challenge of non-bijective image translation, we introduce StegoGAN, a novel model that leverages steganography to prevent spurious features in generated images. Our approach enhances the semantic consistency of the translated images without requiring additional postprocessing or supervision. Our experimental evaluations demonstrate that StegoGAN outperforms existing GAN-based models across various non-bijective image-to-image translation tasks, both qualitatively and quantitatively. Our code and pretrained models are accessible at https://github.com/sian-wusidi/StegoGAN.
Given the rise of multimedia content, human translators increasingly focus on culturally adapting not only words but also other modalities such as images to convey the same meaning. While several applications stand to benefit from this, machine translation systems remain confined to dealing with language in speech and text. In this work, we take a first step towards translating images to make them culturally relevant. First, we build three pipelines comprising state-of-the-art generative models to do the task. Next, we build a two-part evaluation dataset: i) concept: comprising 600 images that are cross-culturally coherent, focusing on a single concept per image, and ii) application: comprising 100 images curated from real-world applications. We conduct a multi-faceted human evaluation of translated images to assess for cultural relevance and meaning preservation. We find that as of today, image-editing models fail at this task, but can be improved by leveraging LLMs and retrievers in the loop. Best pipelines can only translate 5% of images for some countries in the easier concept dataset and no translation is successful for some countries in the application dataset, highlighting the challenging nature of the task. Our code and data is released here: https://github.com/simran-khanuja/image-transcreation.
The Frozen Section (FS) technique is a rapid and efficient method, taking only 15-30 minutes to prepare slides for pathologists' evaluation during surgery, enabling immediate decisions on further surgical interventions. However, FS process often introduces artifacts and distortions like folds and ice-crystal effects. In contrast, these artifacts and distortions are absent in the higher-quality formalin-fixed paraffin-embedded (FFPE) slides, which require 2-3 days to prepare. While Generative Adversarial Network (GAN)-based methods have been used to translate FS to FFPE images (F2F), they may leave morphological inaccuracies with remaining FS artifacts or introduce new artifacts, reducing the quality of these translations for clinical assessments. In this study, we benchmark recent generative models, focusing on GANs and Latent Diffusion Models (LDMs), to overcome these limitations. We introduce a novel approach that combines LDMs with Histopathology Pre-Trained Embeddings to enhance restoration of FS images. Our framework leverages LDMs conditioned by both text and pre-trained embeddings to learn meaningful features of FS and FFPE histopathology images. Through diffusion and denoising techniques, our approach not only preserves essential diagnostic attributes like color staining and tissue morphology but also proposes an embedding translation mechanism to better predict the targeted FFPE representation of input FS images. As a result, this work achieves a significant improvement in classification performance, with the Area Under the Curve rising from 81.99% to 94.64%, accompanied by an advantageous CaseFD. This work establishes a new benchmark for FS to FFPE image translation quality, promising enhanced reliability and accuracy in histopathology FS image analysis. Our work is available at https://minhmanho.github.io/f2f_ldm/.
This study investigates the foundational characteristics of image-to-image translation networks, specifically examining their suitability and transferability within the context of routine clinical environments, despite achieving high levels of performance, as indicated by a Structural Similarity Index (SSIM) exceeding 0.95. The evaluation study was conducted using data from 794 patients diagnosed with Prostate cancer. To synthesize MRI from Ultrasound images, we employed five widely recognized image to image translation networks in medical imaging: 2DPix2Pix, 2DCycleGAN, 3DCycleGAN, 3DUNET, and 3DAutoEncoder. For quantitative assessment, we report four prevalent evaluation metrics Mean Absolute Error, Mean Square Error, Structural Similarity Index (SSIM), and Peak Signal to Noise Ratio. Moreover, a complementary analysis employing Radiomic features (RF) via Spearman correlation coefficient was conducted to investigate, for the first time, whether networks achieving high performance, SSIM greater than 0.9, could identify low-level RFs. The RF analysis showed 76 features out of 186 RFs were discovered via just 2DPix2Pix algorithm while half of RFs were lost in the translation process. Finally, a detailed qualitative assessment by five medical doctors indicated a lack of low level feature discovery in image to image translation tasks.
Deep neural networks that achieve remarkable performance in image classification have previously been shown to be easily fooled by tiny transformations such as a one pixel translation of the input image. In order to address this problem, two approaches have been proposed in recent years. The first approach suggests using huge datasets together with data augmentation in the hope that a highly varied training set will teach the network to learn to be invariant. The second approach suggests using architectural modifications based on sampling theory to deal explicitly with image translations. In this paper, we show that these approaches still fall short in robustly handling 'natural' image translations that simulate a subtle change in camera orientation. Our findings reveal that a mere one-pixel translation can result in a significant change in the predicted image representation for approximately 40% of the test images in state-of-the-art models (e.g. open-CLIP trained on LAION-2B or DINO-v2) , while models that are explicitly constructed to be robust to cyclic translations can still be fooled with 1 pixel realistic (non-cyclic) translations 11% of the time. We present Robust Inference by Crop Selection: a simple method that can be proven to achieve any desired level of consistency, although with a modest tradeoff with the model's accuracy. Importantly, we demonstrate how employing this method reduces the ability to fool state-of-the-art models with a 1 pixel translation to less than 5% while suffering from only a 1% drop in classification accuracy. Additionally, we show that our method can be easy adjusted to deal with circular shifts as well. In such case we achieve 100% robustness to integer shifts with state-of-the-art accuracy, and with no need for any further training.
We explore simple methods for adapting a trained multi-task UNet which predicts canopy cover and height to a new geographic setting using remotely sensed data without the need of training a domain-adaptive classifier and extensive fine-tuning. Extending previous research, we followed a selective alignment process to identify similar images in the two geographical domains and then tested an array of data-based unsupervised domain adaptation approaches in a zero-shot setting as well as with a small amount of fine-tuning. We find that the selective aligned data-based image matching methods produce promising results in a zero-shot setting, and even more so with a small amount of fine-tuning. These methods outperform both an untransformed baseline and a popular data-based image-to-image translation model. The best performing methods were pixel distribution adaptation and fourier domain adaptation on the canopy cover and height tasks respectively.
Multi-modal brain images from MRI scans are widely used in clinical diagnosis to provide complementary information from different modalities. However, obtaining fully paired multi-modal images in practice is challenging due to various factors, such as time, cost, and artifacts, resulting in modality-missing brain images. To address this problem, unsupervised multi-modal brain image translation has been extensively studied. Existing methods suffer from the problem of brain tumor deformation during translation, as they fail to focus on the tumor areas when translating the whole images. In this paper, we propose an unsupervised tumor-aware distillation teacher-student network called UTAD-Net, which is capable of perceiving and translating tumor areas precisely. Specifically, our model consists of two parts: a teacher network and a student network. The teacher network learns an end-to-end mapping from source to target modality using unpaired images and corresponding tumor masks first. Then, the translation knowledge is distilled into the student network, enabling it to generate more realistic tumor areas and whole images without masks. Experiments show that our model achieves competitive performance on both quantitative and qualitative evaluations of image quality compared with state-of-the-art methods. Furthermore, we demonstrate the effectiveness of the generated images on downstream segmentation tasks. Our code is available at https://github.com/scut-HC/UTAD-Net.