# Rethinking Medical Anomaly Detection in Brain MRI: An Image Quality Assessment Perspective

arXiv: https://arxiv.org/abs/2408.08228 · HTML: https://mlsanity.com/paper/2408.08228/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 15 of its 27 references that are in the map.
- First posted on arXiv 15 Aug 2024.

## Builds on (most cited first, 15 of 15)

- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [Unsupervised Anomaly Detection with Generative Adversarial Networks to Guide Marker Discovery](https://mlsanity.com/paper/1703.05921/) (2017)
- [The RSNA-ASNR-MICCAI BraTS 2021 Benchmark on Brain Tumor Segmentation and Radiogenomic Classification](https://mlsanity.com/paper/2107.02314/) (2021)
- [Improving Unsupervised Defect Segmentation by Applying Structural Similarity to Autoencoders](https://mlsanity.com/paper/1807.02011/) (2018)
- [Autoencoders for Unsupervised Anomaly Segmentation in Brain MR Images: A Comparative Study](https://mlsanity.com/paper/2004.03271/) (2020)
- [Deep Autoencoding Models for Unsupervised Anomaly Segmentation in Brain MR Images](https://mlsanity.com/paper/1804.04488/) (2018)
- [Unsupervised Detection of Lesions in Brain MRI using constrained adversarial auto-encoders](https://mlsanity.com/paper/1806.04972/) (2018)
- [Semi-supervised Contrastive Learning for Label-efficient Medical Image Segmentation](https://mlsanity.com/paper/2109.07407/) (2021)
- [Patched Diffusion Models for Unsupervised Anomaly Detection in Brain MRI](https://mlsanity.com/paper/2303.03758/) (2023)
- [Unsupervised Anomaly Detection in Medical Images Using Masked Diffusion Model](https://mlsanity.com/paper/2305.19867/) (2023)
- [Challenging Current Semi-Supervised Anomaly Segmentation Methods for Brain MRI](https://mlsanity.com/paper/2109.06023/) (2021)
- [Unsupervised Anomaly Localization with Structural Feature-Autoencoders](https://mlsanity.com/paper/2208.10992/) (2022)
- [U-Net v2: Rethinking the Skip Connections of U-Net for Medical Image Segmentation](https://mlsanity.com/paper/2311.17791/) (2023)
- [Masked Diffusion as Self-supervised Representation Learner](https://mlsanity.com/paper/2308.05695/) (2023)
- [Diffusion Models with Ensembled Structure-Based Anomaly Scoring for Unsupervised Anomaly Detection](https://mlsanity.com/paper/2403.14262/) (2024)

## Abstract (arXiv)

Reconstruction-based methods, particularly those leveraging autoencoders, have been widely adopted for anomaly detection task in brain MRI. Unlike most existing works try to improve the task accuracy through architectural or algorithmic innovations, we tackle this task from image quality assessment (IQA) perspective, an under-explored direction in the field. Due to the limitations of conventional metrics such as l1 in capturing the nuanced differences in reconstructed images for medical anomaly detection, we propose fusion quality, a novel metric that wisely integrates the structure-level sensitivity of Structural Similarity Index Measure (SSIM) with the pixel-level precision of l1. The metric offers a more comprehensive assessment of reconstruction quality, considering intensity (subtractive property of l1 and divisive property of SSIM), contrast, and structural similarity. Furthermore, the proposed metric makes subtle regional variations more impactful in the final assessment. Thus, considering the inherent divisive properties of SSIM, we design an average intensity ratio (AIR)-based data transformation that amplifies the divisive discrepancies between normal and abnormal regions, thereby enhancing anomaly detection. By fusing the aforementioned two components, we devise the IQA approach. Experimental results on two distinct brain MRI datasets show that our IQA approach significantly enhances medical anomaly detection performance when integrated with state-of-the-art baselines.