From Redaction to Restoration: Deep Learning for Medical Image Anonymization and Reconstruction

Removing patient-specific information from medical images is crucial to enable sharing and open science without compromising patient identities. However, many methods currently used for deidentification have negative effects on downstream image analysis tasks because of removal of relevant but non-identifiable information. This work presents an end-to-end deep learning framework for transforming raw clinical image volumes into de-identified, analysis-ready datasets without compromising downstream utility. The methodology developed and tested in this work first detects and redacts regions likely to contain protected health information (PHI), such as burned-in text and metadata, and then uses a generative deep learning model to inpaint the redacted areas with anatomically and imaging plausible content. The proposed pipeline leverages a lightweight hybrid architecture, combining CRNN-based redaction with a latent-diffusion inpainting restoration module (Stable Diffusion 2). We evaluate the approach using both privacy-oriented metrics, which quantify residual PHI and success of redaction, and image-quality and task-based metrics, which assess the fidelity of restored volumes for representative deep learning applications. Our results suggest that the proposed method yields de-identified medical images that are visually coherent, maintaining fidelity for downstream models, while substantially reducing the risk of patient re-identification. By automating anonymization and image reconstruction within a single workflow, and dissemination of large-scale medical imaging collections, thereby lowering a key barrier to data sharing and multi-institutional collaboration in medical imaging AI.

MACAW: A Causal Generative Model for Medical Imaging

Although deep learning techniques show promising results for many neuroimaging tasks in research settings, they have not yet found widespread use in clinical scenarios. One of the reasons for this problem is that many machine learning models only identify correlations between the input images and the outputs of interest, which can lead to many practical problems, such as encoding of uninformative biases and reduced explainability. Thus, recent research is exploring if integrating a priori causal knowledge into deep learning models is a potential avenue to identify these problems. This work introduces a new causal generative architecture named Masked Causal Flow (MACAW) for neuroimaging applications. Within this context, three main contributions are described. First, a novel approach that integrates complex causal structures into normalizing flows is proposed. Second, counterfactual prediction is performed to identify the changes in effect variables associated with a cause variable. Finally, an explicit Bayesian inference for classification is derived and implemented, providing an inherent uncertainty estimation. The feasibility of the proposed method was first evaluated using synthetic data and then using MRI brain data from more than 23000 participants of the UK biobank study. The evaluation results show that the proposed method can (1) accurately encode causal reasoning and generate counterfactuals highlighting the structural changes in the brain known to be associated with aging, (2) accurately predict a subject's age from a single 2D MRI slice, and (3) generate new samples assuming other values for subject-specific indicators such as age, sex, and body mass index. The code for a toy dataset is available at the following link: https://github.com/vibujithan/macaw-2D.git.