A Domain Adaptation Model for Carotid Ultrasound: Image Harmonization, Noise Reduction, and Impact on Cardiovascular Risk Markers

Deep learning has been used extensively for medical image analysis applications, assuming the training and test data adhere to the same probability distributions. However, a common challenge arises when dealing with medical images generated by different systems or even the same system with varying parameter settings. Such images often contain diverse textures and noise patterns, violating the assumption. Consequently, models trained on data from one machine or setting usually struggle to perform effectively on data from another. To address this issue in ultrasound images, we proposed a Generative Adversarial Network (GAN) based model in this paper. We formulated image harmonization and denoising tasks as an image-to-image translation task, wherein we modified the texture pattern and reduced noise in Carotid ultrasound images while keeping the image content (the anatomy) unchanged. The performance was evaluated using feature distribution and pixel-space similarity metrics. In addition, blood-to-tissue contrast and influence on computed risk markers (Gray scale median, GSM) were evaluated. The results showed that domain adaptation was achieved in both tasks (histogram correlation 0.920 and 0.844), as compared to no adaptation (0.890 and 0.707), and that the anatomy of the images was retained (structure similarity index measure of the arterial wall 0.71 and 0.80). In addition, the image noise level (contrast) did not change in the image harmonization task (-34.1 vs 35.2 dB) but was improved in the noise reduction task (-23.5 vs -46.7 dB). The model outperformed the CycleGAN in both tasks. Finally, the risk marker GSM increased by 7.6 (p<0.001) in task 1 but not in task 2. We conclude that domain translation models are powerful tools for ultrasound image improvement while retaining the underlying anatomy but that downstream calculations of risk markers may be affected.