Synthetic Generation and Latent Projection Denoising of Rim Lesions in Multiple Sclerosis

Quantitative susceptibility maps from magnetic resonance images can provide both prognostic and diagnostic information in multiple sclerosis, a neurodegenerative disease characterized by the formation of lesions in white matter brain tissue. In particular, susceptibility maps provide adequate contrast to distinguish between "rim" lesions, surrounded by deposited paramagnetic iron, and "non-rim" lesion types. These paramagnetic rim lesions (PRLs) are an emerging biomarker in multiple sclerosis. Much effort has been devoted to both detection and segmentation of such lesions to monitor longitudinal change. As paramagnetic rim lesions are rare, addressing this problem requires confronting the class imbalance between rim and non-rim lesions. We produce synthetic quantitative susceptibility maps of paramagnetic rim lesions and show that inclusion of such synthetic data improves classifier performance and provide a multi-channel extension to generate accompanying contrasts and probabilistic segmentation maps. We exploit the projection capability of our trained generative network to demonstrate a novel denoising approach that allows us to train on ambiguous rim cases and substantially increase the minority class. We show that both synthetic lesion synthesis and our proposed rim lesion label denoising method best approximate the unseen rim lesion distribution and improve detection in a clinically interpretable manner. We release our code and generated data at https://github.com/agr78/PRLx-GAN upon publication.

Maximum Spherical Mean Value (mSMV) Filtering for Whole Brain Quantitative Susceptibility Mapping

To develop a tissue field filtering algorithm, called maximum Spherical Mean Value (mSMV), for reducing shadow artifacts in quantitative susceptibility mapping (QSM) of the brain without requiring brain tissue erosion. Residual background field is a major source of shadow artifacts in QSM. The mSMV algorithm filters large field values near the border, where the maximum value of the harmonic background field is located. The effectiveness of mSMV for artifact removal was evaluated by comparing with existing QSM algorithms in a simulated numerical brain, 11 healthy volunteers, by assessing image quality in routine clinical patient study $(n=43)$, and by measuring lesion susceptibility values in multiple sclerosis patients $(n=50)$, a total of $n=93$ patients. Numerical simulation showed that mSMV reduces shadow artifacts and improves QSM accuracy. Better shadow reduction, as demonstrated by lower QSM variation in the gray matter and higher QSM image quality score, was also observed in healthy subjects and in patients with hemorrhages, stroke and multiple sclerosis. The mSMV algorithm allows reconstruction of QSMs that are equivalent to those obtained using SMV-filtered dipole inversion without eroding the volume of interest.