# Unpaired Translation of Chest X-ray Images for Lung Opacity Diagnosis via Adaptive Activation Masks and Cross-Domain Alignment

arXiv: https://arxiv.org/abs/2503.19860 · HTML: https://mlsanity.com/paper/2503.19860/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 21 of its 30 references that are in the map.
- First posted on arXiv 25 Mar 2025.

## Builds on (most cited first, 21 of 21)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [MobileNets: Efficient Convolutional Neural Networks for Mobile Vision Applications](https://mlsanity.com/paper/1704.04861/) (2017)
- [Pyramid Scene Parsing Network](https://mlsanity.com/paper/1612.01105/) (2016)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Demystifying MMD GANs](https://mlsanity.com/paper/1801.01401/) (2018)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [Multimodal Unsupervised Image-to-Image Translation](https://mlsanity.com/paper/1804.04732/) (2018)
- [Unsupervised Image-to-Image Translation Networks](https://mlsanity.com/paper/1703.00848/) (2017)
- [CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning](https://mlsanity.com/paper/1711.05225/) (2017)
- [DualGAN: Unsupervised Dual Learning for Image-to-Image Translation](https://mlsanity.com/paper/1704.02510/) (2017)
- [Diverse Image-to-Image Translation via Disentangled Representations](https://mlsanity.com/paper/1808.00948/) (2018)
- [Learning to Discover Cross-Domain Relations with Generative Adversarial Networks](https://mlsanity.com/paper/1703.05192/) (2017)
- [CE-Net: Context Encoder Network for 2D Medical Image Segmentation](https://mlsanity.com/paper/1903.02740/) (2019)
- [Unpaired Image-to-Image Translation using Adversarial Consistency Loss](https://mlsanity.com/paper/2003.04858/) (2020)
- [UVCGAN: UNet Vision Transformer cycle-consistent GAN for unpaired image-to-image translation](https://mlsanity.com/paper/2203.02557/) (2022)
- [Abnormal Chest X-ray Identification With Generative Adversarial One-Class Classifier](https://mlsanity.com/paper/1903.02040/) (2019)

## Built on by (most cited first, 2 of 2)

- [UniMedVL: Unifying Medical Multimodal Understanding and Generation through Observation-Knowledge-Analysis](https://mlsanity.com/paper/2510.15710/) (2025)
- [RetinaLogos: Fine-Grained Synthesis of High-Resolution Retinal Images Through Captions](https://mlsanity.com/paper/2505.12887/) (2025)

## Abstract (arXiv)

Chest X-ray radiographs (CXRs) play a pivotal role in diagnosing and monitoring cardiopulmonary diseases. However, lung opacities in CXRs frequently obscure anatomical structures, impeding clear identification of lung borders and complicating the localization of pathology. This challenge significantly hampers segmentation accuracy and precise lesion identification, which are crucial for diagnosis. To tackle these issues, our study proposes an unpaired CXR translation framework that converts CXRs with lung opacities into counterparts without lung opacities while preserving semantic features. Central to our approach is the use of adaptive activation masks to selectively modify opacity regions in lung CXRs. Cross-domain alignment ensures translated CXRs without opacity issues align with feature maps and prediction labels from a pre-trained CXR lesion classifier, facilitating the interpretability of the translation process. We validate our method using RSNA, MIMIC-CXR-JPG and JSRT datasets, demonstrating superior translation quality through lower Frechet Inception Distance (FID) and Kernel Inception Distance (KID) scores compared to existing methods (FID: 67.18 vs. 210.4, KID: 0.01604 vs. 0.225). Evaluation on RSNA opacity, MIMIC acute respiratory distress syndrome (ARDS) patient CXRs and JSRT CXRs show our method enhances segmentation accuracy of lung borders and improves lesion classification, further underscoring its potential in clinical settings (RSNA: mIoU: 76.58% vs. 62.58%, Sensitivity: 85.58% vs. 77.03%; MIMIC ARDS: mIoU: 86.20% vs. 72.07%, Sensitivity: 92.68% vs. 86.85%; JSRT: mIoU: 91.08% vs. 85.6%, Sensitivity: 97.62% vs. 95.04%). Our approach advances CXR imaging analysis, especially in investigating segmentation impacts through image translation techniques.