Currently, medical image domain translation operations show a high demand from researchers and clinicians. Amongst other capabilities, this task allows the generation of new medical images with sufficiently high image quality, making them clinically relevant. Deep Learning (DL) architectures, most specifically deep generative models, are widely used to generate and translate images from one domain to another. The proposed framework relies on an adversarial Denoising Diffusion Model (DDM) to synthesize echocardiography images and perform domain translation. Contrary to Generative Adversarial Networks (GANs), DDMs are able to generate high quality image samples with a large diversity. If a DDM is combined with a GAN, this ability to generate new data is completed at an even faster sampling time. In this work we trained an adversarial DDM combined with a GAN to learn the reverse denoising process, relying on a guide image, making sure relevant anatomical structures of each echocardiography image were kept and represented on the generated image samples. For several domain translation operations, the results verified that such generative model was able to synthesize high quality image samples: MSE: 11.50 +/- 3.69, PSNR (dB): 30.48 +/- 0.09, SSIM: 0.47 +/- 0.03. The proposed method showed high generalization ability, introducing a framework to create echocardiography images suitable to be used for clinical research purposes.

In this paper, we propose the Adversarial Denoising Diffusion Model (ADDM). The ADDM is based on the Denoising Diffusion Probabilistic Model (DDPM) but complementarily trained by adversarial learning. The proposed adversarial learning is achieved by classifying model-based denoised samples and samples to which random Gaussian noise is added to a specific sampling step. With the addition of explicit adversarial learning on data samples, ADDM can learn the semantic characteristics of the data more robustly during training, which achieves a similar data sampling performance with much fewer sampling steps than DDPM. We apply ADDM to anomaly detection in unsupervised MRI images. Experimental results show that the proposed ADDM outperformed existing generative model-based unsupervised anomaly detection methods. In particular, compared to other DDPM-based anomaly detection methods, the proposed ADDM shows better performance with the same number of sampling steps and similar performance with 50% fewer sampling steps.