Tumor segmentation in histopathology images is often complicated by its composition of different histological subtypes and class imbalance. Oversampling subtypes with low prevalence features is not a satisfactory solution since it eventually leads to overfitting. We propose to create synthetic images with semantically-conditioned deep generative networks and to combine subtype-balanced synthetic images with the original dataset to achieve better segmentation performance. We show the suitability of Generative Adversarial Networks (GANs) and especially diffusion models to create realistic images based on subtype-conditioning for the use case of HER2-stained histopathology. Additionally, we show the capability of diffusion models to conditionally inpaint HER2 tumor areas with modified subtypes. Combining the original dataset with the same amount of diffusion-generated images increased the tumor Dice score from 0.833 to 0.854 and almost halved the variance between the HER2 subtype recalls. These results create the basis for more reliable automatic HER2 analysis with lower performance variance between individual HER2 subtypes.

病理学家对患病组织的视觉微观研究一直是一个多世纪以来癌症诊断和预后的基石。最近，深度学习方法在组织图像的分析和分类方面取得了重大进步。但是，关于此类模型在生成组织病理学图像的实用性方面的工作有限。这些合成图像在病理学中有多种应用，包括教育，熟练程度测试，隐私和数据共享的公用事业。最近，引入了扩散概率模型以生成高质量的图像。在这里，我们首次研究了此类模型的潜在用途以及优先的形态加权和颜色归一化，以合成脑癌的高质量组织病理学图像。我们的详细结果表明，与生成对抗网络相比，扩散概率模型能够合成各种组织病理学图像，并且具有较高的性能。

Large annotated datasets are required to train segmentation networks. In medical imaging, it is often difficult, time consuming and expensive to create such datasets, and it may also be difficult to share these datasets with other researchers. Different AI models can today generate very realistic synthetic images, which can potentially be openly shared as they do not belong to specific persons. However, recent work has shown that using synthetic images for training deep networks often leads to worse performance compared to using real images. Here we demonstrate that using synthetic images and annotations from an ensemble of 10 GANs, instead of from a single GAN, increases the Dice score on real test images with 4.7 % to 14.0 % on specific classes.

Recent advances in computer vision have shown promising results in image generation. Diffusion probabilistic models in particular have generated realistic images from textual input, as demonstrated by DALL-E 2, Imagen and Stable Diffusion. However, their use in medicine, where image data typically comprises three-dimensional volumes, has not been systematically evaluated. Synthetic images may play a crucial role in privacy preserving artificial intelligence and can also be used to augment small datasets. Here we show that diffusion probabilistic models can synthesize high quality medical imaging data, which we show for Magnetic Resonance Images (MRI) and Computed Tomography (CT) images. We provide quantitative measurements of their performance through a reader study with two medical experts who rated the quality of the synthesized images in three categories: Realistic image appearance, anatomical correctness and consistency between slices. Furthermore, we demonstrate that synthetic images can be used in a self-supervised pre-training and improve the performance of breast segmentation models when data is scarce (dice score 0.91 vs. 0.95 without vs. with synthetic data).

The success of Deep Learning applications critically depends on the quality and scale of the underlying training data. Generative adversarial networks (GANs) can generate arbitrary large datasets, but diversity and fidelity are limited, which has recently been addressed by denoising diffusion probabilistic models (DDPMs) whose superiority has been demonstrated on natural images. In this study, we propose Medfusion, a conditional latent DDPM for medical images. We compare our DDPM-based model against GAN-based models, which constitute the current state-of-the-art in the medical domain. Medfusion was trained and compared with (i) StyleGan-3 on n=101,442 images from the AIROGS challenge dataset to generate fundoscopies with and without glaucoma, (ii) ProGAN on n=191,027 from the CheXpert dataset to generate radiographs with and without cardiomegaly and (iii) wGAN on n=19,557 images from the CRCMS dataset to generate histopathological images with and without microsatellite stability. In the AIROGS, CRMCS, and CheXpert datasets, Medfusion achieved lower (=better) FID than the GANs (11.63 versus 20.43, 30.03 versus 49.26, and 17.28 versus 84.31). Also, fidelity (precision) and diversity (recall) were higher (=better) for Medfusion in all three datasets. Our study shows that DDPM are a superior alternative to GANs for image synthesis in the medical domain.

深度神经网络在医学图像分析中带来了显着突破。但是，由于其渴望数据的性质，医学成像项目中适度的数据集大小可能会阻碍其全部潜力。生成合成数据提供了一种有希望的替代方案，可以补充培训数据集并进行更大范围的医学图像研究。最近，扩散模型通过产生逼真的合成图像引起了计算机视觉社区的注意。在这项研究中，我们使用潜在扩散模型探索从高分辨率3D脑图像中生成合成图像。我们使用来自英国生物银行数据集的T1W MRI图像（n = 31,740）来训练我们的模型，以了解脑图像的概率分布，该脑图像以协变量为基础，例如年龄，性别和大脑结构量。我们发现我们的模型创建了现实的数据，并且可以使用条件变量有效地控制数据生成。除此之外，我们创建了一个带有100,000次脑图像的合成数据集，并使科学界公开使用。

Curating datasets for object segmentation is a difficult task. With the advent of large-scale pre-trained generative models, conditional image generation has been given a significant boost in result quality and ease of use. In this paper, we present a novel method that enables the generation of general foreground-background segmentation models from simple textual descriptions, without requiring segmentation labels. We leverage and explore pre-trained latent diffusion models, to automatically generate weak segmentation masks for concepts and objects. The masks are then used to fine-tune the diffusion model on an inpainting task, which enables fine-grained removal of the object, while at the same time providing a synthetic foreground and background dataset. We demonstrate that using this method beats previous methods in both discriminative and generative performance and closes the gap with fully supervised training while requiring no pixel-wise object labels. We show results on the task of segmenting four different objects (humans, dogs, cars, birds).

由于形态的相似性，皮肤肿瘤的组织学切片分化为个体亚型可能具有挑战性。最近，基于深度学习的方法证明了它们在这方面支持病理学家的潜力。但是，这些监督算法中的许多都需要大量的注释数据才能进行稳健开发。我们提供了一个公开可用的数据集，该数据集是七个不同的犬皮肤肿瘤的350张全滑图像，其中有13种组织学类别的12,424个多边形注释，包括7种皮肤肿瘤亚型。在评估者间实验中，我们显示了提供的标签的高稠度，尤其是对于肿瘤注释。我们通过训练深层神经网络来进一步验证数据集，以完成组织分割和肿瘤亚型分类的任务。我们的肿瘤尤其是0.7047的类平均Jaccard系数为0.7047，尤其是0.9044。对于分类，我们达到了0.9857的幻灯片级准确性。由于犬皮肤肿瘤对人肿瘤具有各种组织学同源性，因此该数据集的附加值不限于兽医病理学，而是扩展到更一般的应用领域。

Automated synthesis of histology images has several potential applications in computational pathology. However, no existing method can generate realistic tissue images with a bespoke cellular layout or user-defined histology parameters. In this work, we propose a novel framework called SynCLay (Synthesis from Cellular Layouts) that can construct realistic and high-quality histology images from user-defined cellular layouts along with annotated cellular boundaries. Tissue image generation based on bespoke cellular layouts through the proposed framework allows users to generate different histological patterns from arbitrary topological arrangement of different types of cells. SynCLay generated synthetic images can be helpful in studying the role of different types of cells present in the tumor microenvironmet. Additionally, they can assist in balancing the distribution of cellular counts in tissue images for designing accurate cellular composition predictors by minimizing the effects of data imbalance. We train SynCLay in an adversarial manner and integrate a nuclear segmentation and classification model in its training to refine nuclear structures and generate nuclear masks in conjunction with synthetic images. During inference, we combine the model with another parametric model for generating colon images and associated cellular counts as annotations given the grade of differentiation and cell densities of different cells. We assess the generated images quantitatively and report on feedback from trained pathologists who assigned realism scores to a set of images generated by the framework. The average realism score across all pathologists for synthetic images was as high as that for the real images. We also show that augmenting limited real data with the synthetic data generated by our framework can significantly boost prediction performance of the cellular composition prediction task.

扩散模型对图像的生成建模表现出令人印象深刻的性能。在本文中，我们提出了一种基于扩散模型的新型语义分段方法。通过修改培训和采样方案，我们表明扩散模型可以执行医学图像的病变分割。为了生成图像特定的分割，我们在地面真实分割上培训模型，并在采样过程中使用图像作为先前的图像。通过给定的随机抽样过程，我们可以生成分割面罩的分布。此属性允许我们计算分割的像素方面的不确定性地图，并允许增加分段性能的分段内隐式集合。我们评估我们在Brats2020数据集上进行脑肿瘤细分的方法。与最先进的分割模型相比，我们的方法产生了良好的细分结果，另外，有意义地，有意义的不确定性地图。

对从FFPE组织块制备的载玻片上切割的染色组织的光学显微镜检查是组织诊断的金标准。此外，任何病理学家的诊断能力和专业知识都取决于他们在常见和稀有变体形态上的直接经验。最近，深度学习方法已被用来成功显示此类任务的高度准确性。但是，获得专家级注释的图像是一项昂贵且耗时的任务，人为合成的组织学图像可能会非常有益。在这里，我们提出了一种方法，不仅可以生成组织学图像，从而重现普通疾病的诊断形态特征，而且还提供了产生新的和罕见形态的用户能力。我们的方法涉及开发一种生成的对抗网络模型，该模型综合了由类标签约束的病理图像。我们研究了该框架合成现实的前列腺和结肠组织图像的能力，并评估了这些图像在增强机器学习方法的诊断能力以及通过一组经验丰富的解剖病理学家的可用性方面的实用性。我们的框架生成的合成数据在训练深度学习模型中进行了类似于实际数据进行诊断。病理学家无法区分真实图像和合成图像，并显示出相似的前列腺癌分级的观察者间一致性。我们扩展了从结肠活检中显着复杂图像的方法，并表明也可以再现了此类组织中的复杂微环境。最后，我们介绍了用户通过简单的语义标签标记来生成深层组织学图像的能力。

作为生成部件作为自回归模型的向量量化变形式自动化器（VQ-VAE）的集成在图像生成上产生了高质量的结果。但是，自回归模型将严格遵循采样阶段的逐步扫描顺序。这导致现有的VQ系列模型几乎不会逃避缺乏全球信息的陷阱。连续域中的去噪扩散概率模型（DDPM）显示了捕获全局背景的能力，同时产生高质量图像。在离散状态空间中，一些作品已经证明了执行文本生成和低分辨率图像生成的可能性。我们认为，在VQ-VAE的富含内容的离散视觉码本的帮助下，离散扩散模型还可以利用全局上下文产生高保真图像，这补偿了沿像素空间的经典自回归模型的缺陷。同时，离散VAE与扩散模型的集成解决了传统的自回归模型的缺点是超大的，以及在生成图像时需要在采样过程中的过度时间的扩散模型。结果发现所生成的图像的质量严重依赖于离散的视觉码本。广泛的实验表明，所提出的矢量量化离散扩散模型（VQ-DDM）能够实现与低复杂性的顶层方法的相当性能。它还展示了在没有额外培训的图像修复任务方面与自回归模型量化的其他矢量突出的优势。

肿瘤浸润淋巴细胞（TIL）的定量已被证明是乳腺癌患者预后的独立预测因子。通常，病理学家对含有tils的基质区域的比例进行估计，以获得TILS评分。乳腺癌（Tiger）挑战中肿瘤浸润淋巴细胞旨在评估计算机生成的TILS评分的预后意义，以预测作为COX比例风险模型的一部分的存活率。在这一挑战中，作为Tiager团队，我们已经开发了一种算法，以将肿瘤与基质与基质进行第一部分，然后将肿瘤散装区域用于TILS检测。最后，我们使用这些输出来生成每种情况的TILS分数。在初步测试中，我们的方法达到了肿瘤 - 细胞瘤的加权骰子评分为0.791，而淋巴细胞检测的FROC得分为0.572。为了预测生存，我们的模型达到了0.719的C索引。这些结果在老虎挑战的初步测试排行榜中获得了第一名。

在时尚电子商务的快速增长中，时尚文章的远程安装仍然是一个复杂而充满挑战的问题，并且是客户沮丧的主要驱动力。尽管最近在3D虚拟尝试解决方案方面取得了进步，但这种方法仍然限制在非常狭窄的文章（即使是少数文章）中，而且通常只有一种时尚物品。旨在支持客户的其他最先进的方法在网上找到适合他们的方法，主要需要高水平的客户参与度和对隐私敏感的数据（例如身高，体重，年龄，性别，腹部形状等），或者，或者需要穿着紧身衣服的顾客尸体的图像。他们通常还缺乏在大规模上产生合适和塑造视觉指导的能力，仅通过建议订购哪种尺寸，最能与客户的身体属性相匹配，而无需提供有关服装如何合适和外观的任何信息。为了实现飞跃并超越了当前方法的局限性，我们提出了Fitgan，这是一种生成的对抗模型，明确说明了服装的纠缠尺寸和在线时尚的适合特征。以文章的拟合和形状为条件，我们的模型学习了分离的项目表示形式，并生成了逼真的图像，反映了时尚文章的真实拟合和形状。通过大规模的现实世界数据实验，我们演示了我们的方法如何能够合成视觉上现实和各种时尚项目的拟合，并探索其控制数千种在线服装图像的拟合度和形状的能力。

自由格式介绍是在任意二进制掩码指定的区域中向图像中添加新内容的任务。大多数现有方法训练了一定的面具分布，这将其概括能力限制为看不见的掩模类型。此外，通过像素和知觉损失的训练通常会导致对缺失区域的简单质地扩展，而不是语义上有意义的一代。在这项工作中，我们提出重新启动：基于deno的扩散概率模型（DDPM）的内部介入方法，甚至适用于极端掩模。我们采用预定的无条件DDPM作为生成先验。为了调节生成过程，我们仅通过使用给定的图像信息对未掩盖的区域进行采样来改变反向扩散迭代。由于该技术不会修改或调节原始DDPM网络本身，因此该模型可为任何填充形式产生高质量和不同的输出图像。我们使用标准面具和极端口罩验证面部和通用图像的方法。重新粉刷优于最先进的自动回归，而GAN的方法至少在六个面具分布中进行了五个。 github存储库：git.io/repaint

发现神经网络学到的内容仍然是一个挑战。在自我监督的学习中，分类是用于评估表示是多么常见的最常见任务。但是，只依赖于这样的下游任务可以限制我们对给定输入的表示中保留的信息量的理解。在这项工作中，我们展示了使用条件扩散的生成模型（RCDM）来可视化具有自我监督模型学习的表示。我们进一步展示了这种模型的发电质量如何与最先进的生成模型相符，同时忠于用作调节的代表性。通过使用这个新工具来分析自我监督模型，我们可以在视觉上显示i）SSL（骨干）表示并不是真正不变的，以便他们训练的许多数据增强。 ii）SSL投影仪嵌入出现太不变的任务，如分类。 III）SSL表示对其输入IV的小对抗扰动更稳健），具有可用于图像操作的SSL模型的固有结构。

Generating photos satisfying multiple constraints find broad utility in the content creation industry. A key hurdle to accomplishing this task is the need for paired data consisting of all modalities (i.e., constraints) and their corresponding output. Moreover, existing methods need retraining using paired data across all modalities to introduce a new condition. This paper proposes a solution to this problem based on denoising diffusion probabilistic models (DDPMs). Our motivation for choosing diffusion models over other generative models comes from the flexible internal structure of diffusion models. Since each sampling step in the DDPM follows a Gaussian distribution, we show that there exists a closed-form solution for generating an image given various constraints. Our method can unite multiple diffusion models trained on multiple sub-tasks and conquer the combined task through our proposed sampling strategy. We also introduce a novel reliability parameter that allows using different off-the-shelf diffusion models trained across various datasets during sampling time alone to guide it to the desired outcome satisfying multiple constraints. We perform experiments on various standard multimodal tasks to demonstrate the effectiveness of our approach. More details can be found in https://nithin-gk.github.io/projectpages/Multidiff/index.html

为了实现良好的性能和概括性，医疗图像分割模型应在具有足够可变性的大量数据集上进行培训。由于道德和治理限制以及与标签数据相关的成本，经常对科学发展进行扼杀，并经过对有限数据的培训和测试。数据增强通常用于人为地增加数据分布的可变性并提高模型的通用性。最近的作品探索了图像合成的深层生成模型，因为这种方法将使有效的无限数据生成多种多样的数据，从而解决了通用性和数据访问问题。但是，许多提出的解决方案限制了用户对生成内容的控制。在这项工作中，我们提出了Brainspade，该模型将基于合成扩散的标签发生器与语义图像发生器结合在一起。我们的模型可以在有或没有感兴趣的病理的情况下产生完全合成的大脑标签，然后产生任意引导样式的相应MRI图像。实验表明，Brainspade合成数据可用于训练分割模型，其性能与在真实数据中训练的模型相当。

医学图像中的血管分割是诊断血管疾病和治疗计划的重要任务之一。尽管已经对基于学习的细分方法进行了广泛的研究，但在有监督的方法中需要大量的基础真实标签，并且令人困惑的背景结构使神经网络难以以无监督的方式分割血管。为了解决这个问题，在这里，我们介绍了一种新型的扩散对抗表示学习（DARL）模型，该模型利用具有对抗性学习的降解扩散概率模型，并将其应用于血管分割。特别是，对于自我监管的血管分割，Darl使用扩散模块学习背景图像分布，该模块使生成模块有效地提供了容器表示。同样，通过基于提议的可切换在空间自适应的否定规范化的对抗学习，我们的模型估计了合成的假船只图像以及船舶分割掩码，这进一步使模型捕获了辅助血管的语义信息。一旦训练了提出的模型，该模型就会生成一个步骤，并可以应用于冠状动脉血管造影和视网膜图像的一般血管结构分割。各种数据集的实验结果表明，我们的方法在船舶分割中的现有无监督和自我监督方法的表现显着胜过。

The availability of large-scale chest X-ray datasets is a requirement for developing well-performing deep learning-based algorithms in thoracic abnormality detection and classification. However, biometric identifiers in chest radiographs hinder the public sharing of such data for research purposes due to the risk of patient re-identification. To counteract this issue, synthetic data generation offers a solution for anonymizing medical images. This work employs a latent diffusion model to synthesize an anonymous chest X-ray dataset of high-quality class-conditional images. We propose a privacy-enhancing sampling strategy to ensure the non-transference of biometric information during the image generation process. The quality of the generated images and the feasibility of serving as exclusive training data are evaluated on a thoracic abnormality classification task. Compared to a real classifier, we achieve competitive results with a performance gap of only 3.5% in the area under the receiver operating characteristic curve.