Prediction of OCT Images of Short-Term Response to Anti-VEGF Treatment for Diabetic Macular Edema Using Different Generative Adversarial Networks
18 Pages Posted: 5 Dec 2022
Abstract
Purpose: This study sought to assess the predictive performance of optical coherence tomography (OCT) images for the response of diabetic macular edema (DME) patients to anti-vascular endothelial growth factor (VEGF) therapy generated from baseline images using generative adversarial networks (GANs).
Methods: Patient information, including clinical and radiologic parameters, was obtained from inpatients at the Ophthalmology Department of Qilu Hospital. 715 and 103 pairs of pre-and post-treatment OCT images of DME patients were included in the training and validation sets, respectively. The post-treatment OCT images were used to assess the validity of the generated images. Six different GAN models (CycleGAN, PairGAN, Pix2pixHD, RegGAN, SPADE, UNIT) were applied to predict the efficacy of anti-VEGF treatment by generating OCT images. Independent screening and evaluation experiments were conducted to validate the quality and comparability of images generated by different GAN models.
Results: OCT images generated f GAN models exhibited high comparability to the real images, especially for edema absorption. RegGAN exhibited the highest prediction accuracy over the CycleGAN, PairGAN, Pix2pixHD, SPADE, and UNIT models. Further analyses were conducted based on the RegGAN. Retinal specialists found it difficult to accurately assess response with most synthetic images (95/103). A mean absolute error of 26.74 ± 21.28 μm was observed for central macular thickness (CMT) between the synthetic and real OCT images.
Conclusion: Different generative adversarial networks have different prognostic efficacy for DME, and RegGAN yielded the best performance in our study. Different GAN models yielded good accuracy in predicting the OCT-based response to anti-VEGF treatment at one month. Overall, the application of GAN models can assist clinicians in prognosis prediction of patients with DME to design better treatment strategies and follow-up schedules.
Note:
Funding Information: This work is partially supported by the Opening Project of Guangdong Province Key Laboratory of Big Data Analysis and Processing at Sun Yat-sen University (202001, 202202), the Natural Science Foundation of Guangdong Province (2019A1515012048), and the Social Sciences Project of Guangzhou University of Chinese Medicine (2021SKYB01).
Declaration of Interests: The authors declare that they have no conflict of interest.
Ethics Approval Statement: Written informed consent was not required, given the retrospective nature of our study, and all images were fully anonymized. Moreover, this study was conducted following the ethical requirements established in the Declaration of Helsinki. The institutional review board of Qilu Hospital also approved this study (Ethical Code: 2021 [068]).
Keywords: Diabetic macular edema, generative adversarial networks, optical coherence tomography, anti-vascular endothelial growth factor, prognostic predictions
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