Convolutional Neural Networks (CNNs) can achieve excellent computer-assisted diagnosis performance, relying on sufficient annotated training data. Unfortunately, most medical imaging datasets, often collected from various scanners, are small and fragmented. In this context, as a Data Augmentation (DA) technique, Generative Adversarial Networks (GANs) can synthesize realistic/diverse additional training images to fill the data lack in the real image distribution; researchers have improved classification by augmenting images with noise-to-image (e.g., random noise samples to diverse pathological images) or image-to-image GANs (e.g., a benign image to a malignant one). Yet, no research has reported results combining (i) noise-to-image GANs and image-to-image GANs or (ii) GANs and other deep generative models, for further performance boost. Therefore, to maximize the DA effect with the GAN combinations, we propose a two-step GAN-based DA that generates and refines brain MR images with/without tumors separately: (i) Progressive Growing of GANs (PGGANs), multi-stage noise-to-image GAN for high-resolution image generation, first generates realistic/diverse 256 x 256 images--even a physician cannot accurately distinguish them from real ones via Visual Turing Test; (ii) UNsupervised Image-to-image Translation or SimGAN, image-to-image GAN combining GANs/Variational AutoEncoders or using a GAN loss for DA, further refines the texture/shape of the PGGAN-generated images similarly to the real ones. We thoroughly investigate CNN-based tumor classification results, also considering the influence of pre-training on ImageNet and discarding weird-looking GAN-generated images. The results show that, when combined with classic DA, our two-step GAN-based DA can significantly outperform the classic DA alone, in tumor detection (i.e., boosting sensitivity from 93.63% to 97.53%) and also in other tasks.

Due to the lack of available annotated medical images, accurate computer-assisted diagnosis requires intensive Data Augmentation (DA) techniques, such as geometric/intensity transformations of original images; however, those transformed images intrinsically have a similar distribution to the original ones, leading to limited performance improvement. To fill the data lack in the real image distribution, we synthesize brain contrast-enhanced Magnetic Resonance (MR) images---realistic but completely different from the original ones---using Generative Adversarial Networks (GANs). This study exploits Progressive Growing of GANs (PGGANs), a multi-stage generative training method, to generate original-sized 256 X 256 MR images for Convolutional Neural Network-based brain tumor detection, which is challenging via conventional GANs; difficulties arise due to unstable GAN training with high resolution and a variety of tumors in size, location, shape, and contrast. Our preliminary results show that this novel PGGAN-based DA method can achieve promising performance improvement, when combined with classical DA, in tumor detection and also in other medical imaging tasks.