NCCT-CECT image synthesizers and their application to pulmonary vessel segmentation

Background and objectives: Non-contrast CT (NCCT) and contrast-enhanced CT (CECT) are important diag-nostic tools with distinct features and applications for chest diseases. We developed two synthesizers for the mutual synthesis of NCCT and CECT and evaluated their applications.Methods: Two synthesizers (S1 and S2) were proposed based on a generative adversarial network. S1 generated synthetic CECT (SynCECT) from NCCT and S2 generated synthetic NCCT (SynNCCT) from CECT. A new training procedure for synthesizers was proposed. Initially, the synthesizers were pretrained using self-supervised learning (SSL) and dual-energy CT (DECT) and then fine-tuned using the registered NCCT and CECT images. Pulmonary vessel segmentation from NCCT was used as an example to demonstrate the effectiveness of the synthesizers. Two strategies (ST1 and ST2) were proposed for pulmonary vessel segmentation. In ST1, CECT images were used to train a segmentation model (Model-CECT), NCCT im-ages were converted to SynCECT through S1, and SynCECT was input to Model-CECT for testing. In ST2, CECT data were converted to SynNCCT through S2. SynNCCT and CECT-based annotations were used to train an additional model (Model-NCCT), and NCCT was input to Model-NCCT for testing. Three datasets, D1 (40 paired CTs), D2 (14 NCCTs and 14 CECTs), and D3 (49 paired DECTs), were used to evaluate the synthesizers and strategies.Results: For S1, the mean absolute error (MAE), mean squared error (MSE), peak signal-to-noise ratio (PSNR), and structural similarity index (SSIM) were 14.60 +/- 2.19, 1644 +/- 890, 34.34 +/- 1.91, and 0.94 +/- 0.02, respectively. For S2, they were 12.52 +/- 2.59, 1460 +/- 922, 35.08 +/- 2.35, and 0.95 +/- 0.02, respectively. Our synthesizers outperformed the counterparts of CycleGAN, Pix2Pix, and Pix2PixHD. The results of ablation studies on SSL pretraining, DECT pretraining, and fine-tuning showed that performance worsened (for example, for S1, MAE increased to 16.53 +/- 3.10, 17.98 +/- 3.10, and 20.57 +/- 3.75, respectively). Model-NCCT and Model-CECT achieved dice similarity coefficients (DSC) of 0.77 and 0.86 on D1 and 0.77 and 0.72 on D2, respectively.Conclusions: The proposed synthesizers realized mutual and high-quality synthesis between NCCT and CECT images; the training procedures, including SSL pretraining, DECT pretraining, and fine-tuning, were critical to their effectiveness. The results demonstrated the usefulness of synthesizers for pulmonary ves -sel segmentation from NCCT images.(c) 2023 Elsevier B.V. All rights reserved.

Automated summary

In this study, two synthesizers were developed to achieve mutual synthesis between non-contrast CT (NCCT) and contrast-enhanced CT (CECT) using generative adversarial networks. The results demonstrated the effectiveness of the synthesizers in high-quality synthesis of NCCT and CECT images, with the training process being crucial to their performance.