Comparative clinical evaluation of "memory-efficient" synthetic 3d generative adversarial networks (gan) head-to-head to state of art: results on computed tomography of the chest

Generative Adversarial Networks (GANs) are increasingly used to generate synthetic medical images, addressing the critical shortage of annotated data for training Artificial Intelligence systems. This study introduces CRF-GAN, a novel memory-efficient GAN architecture that enhances structural consistency in 3D medical image synthesis. Integrating Conditional Random Fields within a two-step generation process allows CRF-GAN improving spatial coherence while maintaining high-resolution image quality. The model's performance is evaluated against the state-of-the-art hierarchical (HA)-GAN model. Materials and Methods: We evaluate the performance of CRF-GAN against the HA-GAN model. The comparison between the two models was made through a quantitative evaluation, using FID and MMD metrics, and a qualitative evaluation, through a two-alternative forced choice (2AFC) test completed by a pool of 12 resident radiologists, to assess the realism of the generated images. Results: CRF-GAN outperformed HA-GAN with lower FID and MMD scores, indicating better image fidelity. The 2AFC test showed a significant preference for images generated by CRF-Gan over those generated by HA-GAN. Additionally, CRF-GAN demonstrated 9.34% lower memory usage and achieved up to 14.6% faster training speeds, offering substantial computational savings. Discussion: CRF-GAN model successfully generates high-resolution 3D medical images with non-inferior quality to conventional models, while being more memory-efficient and faster. The key objective was not only to lower the computational cost but also to reallocate the freed-up resources towards the creation of higher-resolution 3D imaging, which is still a critical factor limiting their direct clinical applicability. Moreover, unlike many previous studies, we combined qualitative and quantitative assessments to obtain a more holistic feedback on the model's performance.