# A multi-stage GAN for multi-organ chest X-ray image generation and segmentation

arXiv: https://arxiv.org/abs/2106.05132 · HTML: https://mlsanity.com/paper/2106.05132/

## Key facts

- Cited by 8 papers in the map (data through 14 Oct 2026).
- Builds on 42 of its 67 references that are in the map.
- First posted on arXiv 9 Jun 2021.

## Builds on (most cited first, 30 of 42)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [A Style-Based Generator Architecture for Generative Adversarial Networks](https://mlsanity.com/paper/1812.04948/) (2018)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [Analyzing and Improving the Image Quality of StyleGAN](https://mlsanity.com/paper/1912.04958/) (2019)
- [DeepLab: Semantic Image Segmentation with Deep Convolutional Nets, Atrous Convolution, and Fully Connected CRFs](https://mlsanity.com/paper/1606.00915/) (2016)
- [Progressive Growing of GANs for Improved Quality, Stability, and Variation](https://mlsanity.com/paper/1710.10196/) (2017)
- [Pyramid Scene Parsing Network](https://mlsanity.com/paper/1612.01105/) (2016)
- [Conditional Generative Adversarial Nets](https://mlsanity.com/paper/1411.1784/) (2014)
- [Photo-Realistic Single Image Super-Resolution Using a Generative Adversarial Network](https://mlsanity.com/paper/1609.04802/) (2016)
- [Context Encoders: Feature Learning by Inpainting](https://mlsanity.com/paper/1604.07379/) (2016)
- [Semantic Image Synthesis with Spatially-Adaptive Normalization](https://mlsanity.com/paper/1903.07291/) (2019)
- [High-Resolution Image Synthesis and Semantic Manipulation with Conditional GANs](https://mlsanity.com/paper/1711.11585/) (2017)
- [Unsupervised Image-to-Image Translation Networks](https://mlsanity.com/paper/1703.00848/) (2017)
- [Exploring Generalization in Deep Learning](https://mlsanity.com/paper/1706.08947/) (2017)
- [Unsupervised Anomaly Detection with Generative Adversarial Networks to Guide Marker Discovery](https://mlsanity.com/paper/1703.05921/) (2017)
- [Conditional Image Synthesis With Auxiliary Classifier GANs](https://mlsanity.com/paper/1610.09585/) (2016)
- [A Neural Algorithm of Artistic Style](https://mlsanity.com/paper/1508.06576/) (2015)
- [DualGAN: Unsupervised Dual Learning for Image-to-Image Translation](https://mlsanity.com/paper/1704.02510/) (2017)
- [Toward Multimodal Image-to-Image Translation](https://mlsanity.com/paper/1711.11586/) (2017)
- [GAN-based Synthetic Medical Image Augmentation for increased CNN Performance in Liver Lesion Classification](https://mlsanity.com/paper/1803.01229/) (2018)
- [Photographic Image Synthesis with Cascaded Refinement Networks](https://mlsanity.com/paper/1707.09405/) (2017)
- [Coupled Generative Adversarial Networks](https://mlsanity.com/paper/1606.07536/) (2016)
- [Generalization in Deep Learning](https://mlsanity.com/paper/1710.05468/) (2017)
- [Unsupervised Detection of Lesions in Brain MRI using constrained adversarial auto-encoders](https://mlsanity.com/paper/1806.04972/) (2018)
- [Semi-parametric Image Synthesis](https://mlsanity.com/paper/1804.10992/) (2018)
- [SegAN: Adversarial Network with Multi-scale L1 Loss for Medical Image Segmentation](https://mlsanity.com/paper/1706.01805/) (2017)
- [Unsupervised Learning for Cell-level Visual Representation in Histopathology Images with Generative Adversarial Networks](https://mlsanity.com/paper/1711.11317/) (2017)

## Built on by (most cited first, 8 of 8)

- [RoentGen: Vision-Language Foundation Model for Chest X-ray Generation](https://mlsanity.com/paper/2211.12737/) (2022)
- [Generative AI for Synthetic Data Across Multiple Medical Modalities: A Systematic Review of Recent Developments and Challenges](https://mlsanity.com/paper/2407.00116/) (2024)
- [XReal: Realistic Anatomy and Pathology-Aware X-ray Generation via Controllable Diffusion Model](https://mlsanity.com/paper/2403.09240/) (2024)
- [What Does DALL-E 2 Know About Radiology?](https://mlsanity.com/paper/2209.13696/) (2022)
- [Shifts in Doctors' Eye Movements Between Real and AI-Generated Medical Images](https://mlsanity.com/paper/2504.15007/) (2025)
- [orGAN: A Synthetic Data Augmentation Pipeline for Simultaneous Generation of Surgical Images and Ground Truth Labels](https://mlsanity.com/paper/2506.14303/) (2025)
- [AURAD: Anatomy-Pathology Unified Radiology Synthesis with Progressive Representations](https://mlsanity.com/paper/2509.04819/) (2025)
- [A Comparative Study of GAN-Based Deep Learning Models for Pneumonia Detection in Chest X-Rays](https://mlsanity.com/paper/2609.06276/) (2026)

## Abstract (arXiv)

Multi-organ segmentation of X-ray images is of fundamental importance for computer aided diagnosis systems. However, the most advanced semantic segmentation methods rely on deep learning and require a huge amount of labeled images, which are rarely available due to both the high cost of human resources and the time required for labeling. In this paper, we present a novel multi-stage generation algorithm based on Generative Adversarial Networks (GANs) that can produce synthetic images along with their semantic labels and can be used for data augmentation. The main feature of the method is that, unlike other approaches, generation occurs in several stages, which simplifies the procedure and allows it to be used on very small datasets. The method has been evaluated on the segmentation of chest radiographic images, showing promising results. The multistage approach achieves state-of-the-art and, when very few images are used to train the GANs, outperforms the corresponding single-stage approach.