Perceived Realism of High-Resolution Generative Adversarial Network–derived Synthetic Mammograms

To explore whether generative adversarial networks (GANs) can enable synthesis of realistic medical images that are indiscernible from real images, even by domain experts. In this retrospective study, progressive growing GANs were used to synthesize mammograms at a resolution of 1280 1024 pixels by using images from 90 000 patients (average age, 56 years 9) collected between 2009 and 2019. To evaluate the results, a method to assess distributional alignment for ultra–high-dimensional pixel distributions was used, which was based on moment plots. This method was able to reveal potential sources of misalignment. A total of 117 volunteer participants (55 radiologists and 62 nonradiologists) took part in a study to assess the realism of synthetic images from GANs.