Analysis of noninvasive microvascular blood flow can improve the diagnosis, prognosis, and management of many medical conditions, including cardiovascular, peripheral vascular, and sickle cell disease. This paper introduces SAM2Flow, an interactive optical flow estimation model to analyze long Oblique Back-illumination Microscopy (OBM) videos of *in vivo* microvascular flow. Inspired by the Segment Anything Model (SAM2), SAM2Flow enables users to specify regions of interest through user prompts for focused flow estimation. SAM2Flow also incorporates a dual memory attention mechanism, comprising both motion and context memory, to achieve efficient and stable flow estimations over extended video sequences. According to our experiments, SAM2Flow achieves SOTA accuracy in foreground optical flow estimation on both microvascular flow and public datasets, with a fast inference speed of over $20$ fps on $512\times512$ inputs. Based on the temporally robust flow estimation, SAM2Flow demonstrated superior performance in downstream physiological applications compared to existing models. The code and dataset will be published with this paper.

A major challenge in applying deep learning to medical imaging is the paucity of annotated data. This study explores the use of synthetic images for data augmentation to address the challenge of limited annotated data in colonoscopy lesion classification. We demonstrate that synthetic colonoscopy images generated by Generative Adversarial Network (GAN) inversion can be used as training data to improve polyp classification performance by deep learning models. We invert pairs of images with the same label to a semantically rich and disentangled latent space and manipulate latent representations to produce new synthetic images. These synthetic images maintain the same label as the input pairs. We perform image modality translation (style transfer) between white light and narrow-band imaging (NBI). We also generate realistic synthetic lesion images by interpolating between original training images to increase the variety of lesion shapes in the training dataset. Our experiments show that GAN inversion can produce multiple colonoscopy data augmentations that improve the downstream polyp classification performance by 2.7% in F1-score and 4.9% in sensitivity over other methods, including state-of-the-art data augmentation. Testing on unseen out-of-domain data also showcased an improvement of 2.9% in F1-score and 2.7% in sensitivity. This approach outperforms other colonoscopy data augmentation techniques and does not require re-training multiple generative models. It also effectively uses information from diverse public datasets, even those not specifically designed for the targeted downstream task, resulting in strong domain generalizability. Project code and model: https://github.com/DurrLab/GAN-Inversion.

Although wireless capsule endoscopy is the preferred modality for diagnosis and assessment of small bowel diseases, the poor camera resolution is a substantial limitation for both subjective and automated diagnostics. Enhanced-resolution endoscopy has shown to improve adenoma detection rate for conventional endoscopy and is likely to do the same for capsule endoscopy. In this work, we propose and quantitatively validate a novel framework to learn a mapping from low-to-high-resolution endoscopic images. We combine conditional adversarial networks with a spatial attention block to improve the resolution by up to factors of 8× , 10× , 12× , respectively. Quantitative and qualitative studies demonstrate the superiority of EndoL2H over state-of-the-art deep super-resolution methods Deep Back-Projection Networks (DBPN), Deep Residual Channel Attention Networks (RCAN) and Super Resolution Generative Adversarial Network (SRGAN). Mean Opinion Score (MOS) tests were performed by 30 gastroenterologists qualitatively assess and confirm the clinical relevance of the approach. EndoL2H is generally applicable to any endoscopic capsule system and has the potential to improve diagnosis and better harness computational approaches for polyp detection and characterization. Our code and trained models are available at https://github.com/CapsuleEndoscope/EndoL2H.

We present a deep learning framework for wide-field, content-aware estimation of absorption and scattering coefficients of tissues, called Generative Adversarial Network Prediction of Optical Properties (GANPOP). Spatial frequency domain imaging is used to obtain ground-truth optical properties at 660 nm from in vivo human hands and feet, freshly resected human esophagectomy samples, and homogeneous tissue phantoms. Images of objects with either flat-field or structured illumination are paired with registered optical property maps and are used to train conditional generative adversarial networks that estimate optical properties from a single input image. We benchmark this approach by comparing GANPOP to a single-snapshot optical property (SSOP) technique, using a normalized mean absolute error (NMAE) metric. In human gastrointestinal specimens, GANPOP with a single structured-light input image estimates the reduced scattering and absorption coefficients with 60% higher accuracy than SSOP while GANPOP with a single flat-field illumination image achieves similar accuracy to SSOP. When applied to both in vivo and ex vivo swine tissues, a GANPOP model trained solely on structured-illumination images of human specimens and phantoms estimates optical properties with approximately 46% improvement over SSOP, indicating adaptability to new, unseen tissue types. Given a training set that appropriately spans the target domain, GANPOP has the potential to enable rapid and accurate wide-field measurements of optical properties.

Nuclei mymargin segmentation is a fundamental task for various computational pathology applications including nuclei morphology analysis, cell type classification, and cancer grading. Deep learning has emerged as a powerful approach to segmenting nuclei but the accuracy of convolutional neural networks (CNNs) depends on the volume and the quality of labeled histopathology data for training. In particular, conventional CNN-based approaches lack structured prediction capabilities, which are required to distinguish overlapping and clumped nuclei. Here, we present an approach to nuclei segmentation that overcomes these challenges by utilizing a conditional generative adversarial network (cGAN) trained with synthetic and real data. We generate a large dataset of H&E training images with perfect nuclei segmentation labels using an unpaired GAN framework. This synthetic data along with real histopathology data from six different organs are used to train a conditional GAN with spectral normalization and gradient penalty for nuclei segmentation. This adversarial regression framework enforces higher-order spacial-consistency when compared to conventional CNN models. We demonstrate that this nuclei segmentation approach generalizes across different organs, sites, patients and disease states, and outperforms conventional approaches, especially in isolating individual and overlapping nuclei.

To realize the full potential of deep learning for medical imaging, large annotated datasets are required for training. Such datasets are difficult to acquire due to privacy issues, lack of experts available for annotation, underrepresentation of rare conditions, and poor standardization. The lack of annotated data has been addressed in conventional vision applications using synthetic images refined via unsupervised adversarial training to look like real images. However, this approach is difficult to extend to general medical imaging because of the complex and diverse set of features found in real human tissues. We propose a novel framework that uses a reverse flow, where adversarial training is used to make real medical images more like synthetic images, and clinically-relevant features are preserved via self-regularization. These domain-adapted synthetic-like images can then be accurately interpreted by networks trained on large datasets of synthetic medical images. We implement this approach on the notoriously difficult task of depth-estimation from monocular endoscopy which has a variety of applications in colonoscopy, robotic surgery, and invasive endoscopic procedures. We train a depth estimator on a large data set of synthetic images generated using an accurate forward model of an endoscope and an anatomically-realistic colon. Our analysis demonstrates that the structural similarity of endoscopy depth estimation in a real pig colon predicted from a network trained solely on synthetic data improved by 78.7% by using reverse domain adaptation.