Rich Joseph, Le Jonathan, Raad Ragheb, Tejura Tapas, Rastegarpour Ali, Gill Inderbir, Duddalwar Vinay, Oberai Assad
Department of Radiology, University of Southern California, Los Angeles, California, United States of America.
Department of Biology and Bioengineering, California Institute of Technology, Pasadena, California, United States of America.
PLOS Digit Health. 2025 Aug 13;4(8):e0000970. doi: 10.1371/journal.pdig.0000970. eCollection 2025 Aug.
Kidney cancer is among the top 10 most common malignancies in adults, and is commonly evaluated with four-phase computed tomography (CT) imaging. However, the presence of missing or corrupted images remains a significant problem in medical imaging that impairs the detection, diagnosis, and treatment planning of kidney cancer. Deep learning approaches through conditional generative adversarial networks (cGANs) have recently shown technical promise in the task of imputing missing imaging data from these four-phase studies. In this study, we explored the clinical utility of these imputed images. We utilized a cGAN trained on 333 patients, with the task of the cGAN being to impute the image of any phase given the other three phases. We tested the clinical utility on the imputed images of the 37 patients in the test set by manually extracting 21 clinically relevant imaging features and comparing them to their ground truth counterpart. All 13 categorical clinical features had greater than 85% agreement rate between true images and their imputed counterparts. This high accuracy is maintained when stratifying across imaging phases. Imputed images also show good agreement with true images in select radiomic features including mean intensity and enhancement. Imputed images possess the features characteristic of benign or malignant diagnosis at an equivalent rate to true images. In conclusion, imputed images from cGANs have large potential for clinical use due to their ability to retain clinically relevant qualitative and quantitative features.
肾癌是成人中最常见的10种恶性肿瘤之一,通常采用四期计算机断层扫描(CT)成像进行评估。然而,医学影像中存在缺失或损坏的图像仍然是一个重大问题,这会影响肾癌的检测、诊断和治疗规划。通过条件生成对抗网络(cGAN)的深度学习方法最近在从这些四期研究中插补缺失影像数据的任务中显示出技术前景。在本研究中,我们探讨了这些插补图像的临床效用。我们使用了一个在333名患者身上训练的cGAN,其任务是根据其他三个期相插补任何一个期相的图像。我们通过手动提取21个临床相关的影像特征并将其与真实对应特征进行比较,对测试集中37名患者的插补图像的临床效用进行了测试。所有13个分类临床特征在真实图像与其插补对应图像之间的一致率均超过85%。在对影像期相进行分层时,这种高准确率得以保持。插补图像在包括平均强度和强化在内的选定影像组学特征方面也与真实图像显示出良好的一致性。插补图像具有与真实图像同等比例的良性或恶性诊断特征。总之,来自cGAN的插补图像因其能够保留临床相关的定性和定量特征而具有巨大的临床应用潜力。