Developing reliable healthcare AI models requires training with representative and diverse data. In imbalanced datasets, model performance tends to plateau on the more prevalent classes while remaining low on less common cases. To overcome this limitation, we propose DiffUltra, the first generative AI technique capable of synthesizing realistic Lung Ultrasound (LUS) images with extensive lesion variability. Specifically, we condition the generative AI by the introduced Lesion-anatomy Bank, which captures the lesion's structural and positional properties from real patient data to guide the image synthesis.We demonstrate that DiffUltra improves consolidation detection by 5.6% in AP compared to the models trained solely on real patient data. More importantly, DiffUltra increases data diversity and prevalence of rare cases, leading to a 25% AP improvement in detecting rare instances such as large lung consolidations, which make up only 10% of the dataset.

Bone marrow lesions (BMLs) are critical indicators of knee osteoarthritis (OA). Since they often appear as small, irregular structures with indistinguishable edges in knee magnetic resonance images (MRIs), effective detection of BMLs in MRI is vital for OA diagnosis and treatment. This paper proposes a semi-supervised local anomaly detection method using mask inpainting models for identification of BMLs in high-resolution knee MRI, effectively integrating a 3D femur bone segmentation model, a large mask inpainting model, and a series of post-processing techniques. The method was evaluated using MRIs at various resolutions from a subset of the public Osteoarthritis Initiative database. Dice score, Intersection over Union (IoU), and pixel-level sensitivity, specificity, and accuracy showed an advantage over the multiresolution knowledge distillation method-a state-of-the-art global anomaly detection method. Especially, segmentation performance is enhanced on higher-resolution images, achieving an over two times performance increase on the Dice score and the IoU score at a 448x448 resolution level. We also demonstrate that with increasing size of the BML region, both the Dice and IoU scores improve as the proportion of distinguishable boundary decreases. The identified BML masks can serve as markers for downstream tasks such as segmentation and classification. The proposed method has shown a potential in improving BML detection, laying a foundation for further advances in imaging-based OA research.

Unsupervised anomaly detection is a popular approach for the analysis of neuroimaging data as it allows to identify a wide variety of anomalies from unlabelled data. It relies on building a subject-specific model of healthy appearance to which a subject's image can be compared to detect anomalies. In the literature, it is common for anomaly detection to rely on analysing the residual image between the subject's image and its pseudo-healthy reconstruction. This approach however has limitations partly due to the pseudo-healthy reconstructions being imperfect and to the lack of natural thresholding mechanism. Our proposed method, inspired by Z-scores, leverages the healthy population variability to overcome these limitations. Our experiments conducted on FDG PET scans from the ADNI database demonstrate the effectiveness of our approach in accurately identifying Alzheimer's disease related anomalies.

Tumor segmentation in PET-CT images is challenging due to the dual nature of the acquired information: low metabolic information in CT and low spatial resolution in PET. U-Net architecture is the most common and widely recognized approach when developing a fully automatic image segmentation method in the medical field. We proposed a two-step approach, aiming to refine and improve the segmentation performances of tumoral lesions in PET-CT. The first step generates a prior tumor appearance map from the PET-CT volumes, regarded as prior tumor information. The second step, consisting of a standard U-Net, receives the prior tumor appearance map and PET-CT images to generate the lesion mask. We evaluated the method on the 1014 cases available for the AutoPET 2022 challenge, and the results showed an average Dice score of 0.701 on the positive cases.

Pseudo healthy synthesis, i.e. the creation of a subject-specific `healthy' image from a pathological one, could be helpful in tasks such as anomaly detection, understanding changes induced by pathology and disease or even as data augmentation. We treat this task as a factor decomposition problem: we aim to separate what appears to be healthy and where disease is (as a map). The two factors are then recombined (by a network) to reconstruct the input disease image. We train our models in an adversarial way using either paired or unpaired settings, where we pair disease images and maps (as segmentation masks) when available. We quantitatively evaluate the quality of pseudo healthy images. We show in a series of experiments, performed in ISLES and BraTS datasets, that our method is better than conditional GAN and CycleGAN, highlighting challenges in using adversarial methods in the image translation task of pseudo healthy image generation.