Generative adversarial models with convolutional neural network (CNN) backbones have recently been established as state-of-the-art in numerous medical image synthesis tasks. However, CNNs are designed to perform local processing with compact filters, and this inductive bias compromises learning of contextual features. Here, we propose a novel generative adversarial approach for medical image synthesis, ResViT, that leverages the contextual sensitivity of vision transformers along with the precision of convolution operators and realism of adversarial learning. ResViT’s generator employs a central bottleneck comprising novel aggregated residual transformer (ART) blocks that synergistically combine residual convolutional and transformer modules. Residual connections in ART blocks promote diversity in captured representations, while a channel compression module distills task-relevant information. A weight sharing strategy is introduced among ART blocks to mitigate computational burden. A unified implementation is introduced to avoid the need to rebuild separate synthesis models for varying source-target modality configurations. Comprehensive demonstrations are performed for synthesizing missing sequences in multi-contrast MRI, and CT images from MRI. Our results indicate superiority of ResViT against competing CNN- and transformer-based methods in terms of qualitative observations and quantitative metrics.

Acquiring images of the same anatomy with multiple different contrasts increases the diversity of diagnostic information available in an MR exam. Yet, scan time limitations may prohibit acquisition of certain contrasts, and some contrasts may be corrupted by noise and artifacts. In such cases, the ability to synthesize unacquired or corrupted contrasts can improve diagnostic utility. For multi-contrast synthesis, current methods learn a nonlinear intensity transformation between the source and target images, either via nonlinear regression or deterministic neural networks. These methods can in turn suffer from the loss of structural details in synthesized images. Here, we propose a new approach for multi-contrast MRI synthesis based on conditional generative adversarial networks. The proposed approach preserves intermediate-to-high frequency details via an adversarial loss; and it offers enhanced synthesis performance via pixel-wise and perceptual losses for registered multi-contrast images and a cycle-consistency loss for unregistered images. Information from neighboring cross-sections are utilized to further improve synthesis quality. Demonstrations on T1- and T2- weighted images from healthy subjects and patients clearly indicate the superior performance of the proposed approach compared to previous state-of-the-art methods. Our synthesis approach can help improve quality and versatility of multicontrast MRI exams without the need for prolonged or repeated examinations.

Imputation of missing images via source-to-target modality translation can improve diversity in medical imaging protocols. A pervasive approach for synthesizing target images involves one-shot mapping through generative adversarial networks (GAN). Yet, GAN models that implicitly characterize the image distribution can suffer from limited sample fidelity. Here, we propose a novel method based on adversarial diffusion modeling, SynDiff, for improved performance in medical image translation. To capture a direct correlate of the image distribution, SynDiff leverages a conditional diffusion process that progressively maps noise and source images onto the target image. For fast and accurate image sampling during inference, large diffusion steps are taken with adversarial projections in the reverse diffusion direction. To enable training on unpaired datasets, a cycle-consistent architecture is devised with coupled diffusive and non-diffusive modules that bilaterally translate between two modalities. Extensive assessments are reported on the utility of SynDiff against competing GAN and diffusion models in multi-contrast MRI and MRI-CT translation. Our demonstrations indicate that SynDiff offers quantitatively and qualitatively superior performance against competing baselines.

Supervised reconstruction models are characteristically trained on matched pairs of undersampled and fully-sampled data to capture an MRI prior, along with supervision regarding the imaging operator to enforce data consistency. To reduce supervision requirements, the recent deep image prior framework instead conjoins untrained MRI priors with the imaging operator during inference. Yet, canonical convolutional architectures are suboptimal in capturing long-range relationships, and priors based on randomly initialized networks may yield suboptimal performance. To address these limitations, here we introduce a novel unsupervised MRI reconstruction method based on zero-Shot Learned Adversarial TransformERs (SLATER). SLATER embodies a deep adversarial network with cross-attention transformers to map noise and latent variables onto coil-combined MR images. During pre-training, this unconditional network learns a high-quality MRI prior in an unsupervised generative modeling task. During inference, a zero-shot reconstruction is then performed by incorporating the imaging operator and optimizing the prior to maximize consistency to undersampled data. Comprehensive experiments on brain MRI datasets clearly demonstrate the superior performance of SLATER against state-of-the-art unsupervised methods.