Background and Objective. Research in the cross-modal medical image translation domain has been very productive over the past few years in tackling the scarce availability of large curated multimodality datasets with the promising performance of GAN-based architectures. However, only a few of these studies assessed task-based related performance of these synthetic data, especially for the training of deep models. Method. We design and compare different GAN-based frameworks for generating synthetic brain [18F]fluorodeoxyglucose (FDG) PET images from T1 weighted MRI data. We first perform standard qualitative and quantitative visual quality evaluation. Then, we explore further impact of using these fake PET data in the training of a deep unsupervised anomaly detection (UAD) model designed to detect subtle epilepsy lesions in T1 MRI and FDG PET images. We introduce novel diagnostic task-oriented quality metrics of the synthetic FDG PET data tailored to our unsupervised detection task, then use these fake data to train a use case UAD model combining a deep representation learning based on siamese autoencoders with a OC-SVM density support estimation model. This model is trained on normal subjects only and allows the detection of any variation from the pattern of the normal population. We compare the detection performance of models trained on 35 paired real MR T1 of normal subjects paired either on 35 true PET images or on 35 synthetic PET images generated from the best performing generative models. Performance analysis is conducted on 17 exams of epilepsy patients undergoing surgery. Results. The best performing GAN-based models allow generating realistic fake PET images of control subject with SSIM and PSNR values around 0.9 and 23.8, respectively and in distribution (ID) with regard to the true control dataset. The best UAD model trained on these synthetic normative PET data allows reaching 74% sensitivity. Conclusion. Our results confirm that GAN-based models are the best suited for MR T1 to FDG PET translation, outperforming transformer or diffusion models. We also demonstrate the diagnostic value of these synthetic data for the training of UAD models and evaluation on clinical exams of epilepsy patients. Our code and the normative image dataset are available.

Unsupervised Anomaly Detection (UAD) is a key data mining problem owing to its wide real-world applications. Due to the complete absence of supervision signals, UAD methods rely on implicit assumptions about anomalous patterns (e.g., scattered/sparsely/densely clustered) to detect anomalies. However, real-world data are complex and vary significantly across different domains. No single assumption can describe such complexity and be valid in all scenarios. This is also confirmed by recent research that shows no UAD method is omnipotent. Based on above observations, instead of searching for a magic universal winner assumption, we seek to design a general UAD Booster (UADB) that empowers any UAD models with adaptability to different data. This is a challenging task given the heterogeneous model structures and assumptions adopted by existing UAD methods. To achieve this, we dive deep into the UAD problem and find that compared to normal data, anomalies (i) lack clear structure/pattern in feature space, thus (ii) harder to learn by model without a suitable assumption, and finally, leads to (iii) high variance between different learners. In light of these findings, we propose to (i) distill the knowledge of the source UAD model to an imitation learner (booster) that holds no data assumption, then (ii) exploit the variance between them to perform automatic correction, and thus (iii) improve the booster over the original UAD model. We use a neural network as the booster for its strong expressive power as a universal approximator and ability to perform flexible post-hoc tuning. Note that UADB is a model-agnostic framework that can enhance heterogeneous UAD models in a unified way. Extensive experiments on over 80 tabular datasets demonstrate the effectiveness of UADB.

Due to scarcity of anomaly situations in the early manufacturing stage, an unsupervised anomaly detection (UAD) approach is widely adopted which only uses normal samples for training. This approach is based on the assumption that the trained UAD model will accurately reconstruct normal patterns but struggles with unseen anomalous patterns. To enhance the UAD performance, reconstruction-by-inpainting based methods have recently been investigated, especially on the masking strategy of suspected defective regions. However, there are still issues to overcome: 1) time-consuming inference due to multiple masking, 2) output inconsistency by random masking strategy, and 3) inaccurate reconstruction of normal patterns when the masked area is large. Motivated by this, we propose a novel reconstruction-by-inpainting method, dubbed Excision And Recovery (EAR), that features single deterministic masking based on the ImageNet pre-trained DINO-ViT and visual obfuscation for hint-providing. Experimental results on the MVTec AD dataset show that deterministic masking by pre-trained attention effectively cuts out suspected defective regions and resolve the aforementioned issues 1 and 2. Also, hint-providing by mosaicing proves to enhance the UAD performance than emptying those regions by binary masking, thereby overcomes issue 3. Our approach achieves a high UAD performance without any change of the neural network structure. Thus, we suggest that EAR be adopted in various manufacturing industries as a practically deployable solution.

Background: With the ever-increasing amount of medical imaging data, the demand for algorithms to assist clinicians has amplified. Unsupervised anomaly detection (UAD) models promise to aid in the crucial first step of disease detection. While previous studies have thoroughly explored fairness in supervised models in healthcare, for UAD, this has so far been unexplored. Methods: In this study, we evaluated how dataset composition regarding subgroups manifests in disparate performance of UAD models along multiple protected variables on three large-scale publicly available chest X-ray datasets. Our experiments were validated using two state-of-the-art UAD models for medical images. Finally, we introduced a novel subgroup-AUROC (sAUROC) metric, which aids in quantifying fairness in machine learning. Findings: Our experiments revealed empirical "fairness laws" (similar to "scaling laws" for Transformers) for training-dataset composition: Linear relationships between anomaly detection performance within a subpopulation and its representation in the training data. Our study further revealed performance disparities, even in the case of balanced training data, and compound effects that exacerbate the drop in performance for subjects associated with multiple adversely affected groups. Interpretation: Our study quantified the disparate performance of UAD models against certain demographic subgroups. Importantly, we showed that this unfairness cannot be mitigated by balanced representation alone. Instead, the representation of some subgroups seems harder to learn by UAD models than that of others. The empirical fairness laws discovered in our study make disparate performance in UAD models easier to estimate and aid in determining the most desirable dataset composition.

Robust and accurate detection and segmentation of heterogenous tumors appearing in different anatomical organs with supervised methods require large-scale labeled datasets covering all possible types of diseases. Due to the unavailability of such rich datasets and the high cost of annotations, unsupervised anomaly detection (UAD) methods have been developed aiming to detect the pathologies as deviation from the normality by utilizing the unlabeled healthy image data. However, developed UAD models are often trained with an incomplete distribution of healthy anatomies and have difficulties in preserving anatomical constraints. This work intends to, first, propose a robust inpainting model to learn the details of healthy anatomies and reconstruct high-resolution images by preserving anatomical constraints. Second, we propose an autoinpainting pipeline to automatically detect tumors, replace their appearance with the learned healthy anatomies, and based on that segment the tumoral volumes in a purely unsupervised fashion. Three imaging datasets, including PET, CT, and PET-CT scans of lung tumors and head and neck tumors, are studied as benchmarks for evaluation. Experimental results demonstrate the significant superiority of the proposed method over a wide range of state-of-the-art UAD methods. Moreover, the unsupervised method we propose produces comparable results to a robust supervised segmentation method when applied to multimodal images.

Anomaly detection remains a challenging task in neuroimaging when little to no supervision is available and when lesions can be very small or with subtle contrast. Patch-based representation learning has shown powerful representation capacities when applied to industrial or medical imaging and outlier detection methods have been applied successfully to these images. In this work, we propose an unsupervised anomaly detection (UAD) method based on a latent space constructed by a siamese patch-based auto-encoder and perform the outlier detection with a One-Class SVM training paradigm tailored to the lesion detection task in multi-modality neuroimaging. We evaluate performances of this model on a public database, the White Matter Hyperintensities (WMH) challenge and show in par performance with the two best performing state-of-the-art methods reported so far.

Neural network-based anomaly detection remains challenging in clinical applications with little or no supervised information and subtle anomalies such as hardly visible brain lesions. Among unsupervised methods, patch-based auto-encoders with their efficient representation power provided by their latent space, have shown good results for visible lesion detection. However, the commonly used reconstruction error criterion may limit their performance when facing less obvious lesions. In this work, we design two alternative detection criteria. They are derived from multivariate analysis and can more directly capture information from latent space representations. Their performance compares favorably with two additional supervised learning methods, on a difficult de novo Parkinson Disease (PD) classification task.