Artificial intelligence to generate medical images: augmenting the cardiologist's visual clinical workflow

Artificial intelligence (AI) offers great promise in cardiology, and medicine broadly, for its ability to tirelessly integrate vast amounts of data. Applications in medical imaging are particularly attractive, as images are a powerful means to convey rich information and are extensively utilized in cardiology practice. Departing from other AI approaches in cardiology focused on task automation and pattern recognition, we describe a digital health platform to synthesize enhanced, yet familiar, clinical images to augment the cardiologist's visual clinical workflow. In this article, we present the framework, technical fundamentals, and functional applications of the methodology, especially as it pertains to intravascular imaging. A conditional generative adversarial network was trained with annotated images of atherosclerotic diseased arteries to generate synthetic optical coherence tomography and intravascular ultrasound images on the basis of specified plaque morphology. Systems leveraging this unique and flexible construct, whereby a pair of neural networks is competitively trained in tandem, can rapidly generate useful images. These synthetic images replicate the style, and in several ways exceed the content and function, of normally acquired images. By using this technique and employing AI in such applications, one can ameliorate challenges in image quality, interpretability, coherence, completeness, and granularity, thereby enhancing medical education and clinical decision-making.