Deep convolutional generative adversarial networks (DCGANs) are newly developed tools for generating synthesized images. To determine the clinical utility of synthesized images, we generated breast ultrasound images and assessed their quality and clinical value. After retrospectively collecting 528 images of 144 benign masses and 529 images of 216 malignant masses in the breasts, synthesized images were generated using a DCGAN with 50, 100, 200, 500, and 1000 epochs. The synthesized (n = 20) and original (n = 40) images were evaluated by two radiologists, who scored them for overall quality, definition of anatomic structures, and visualization of the masses on a five-point scale. They also scored the possibility of images being original. Although there was no significant difference between the images synthesized with 1000 and 500 epochs, the latter were evaluated as being of higher quality than all other images. Moreover, 2.5%, 0%, 12.5%, 37.5%, and 22.5% of the images synthesized with 50, 100, 200, 500, and 1000 epochs, respectively, and 14% of the original images were indistinguishable from one another. Interobserver agreement was very good (|r| = 0.708-0.825, p < 0.001). Therefore, DCGAN can generate high-quality and realistic synthesized breast ultrasound images that are indistinguishable from the original images.
Keywords: artificial intelligence; breast imaging; convolutional neural network; deep learning; generative adversarial networks; ultrasound.