Segmentation of regions of interest (ROIs) for identifying abnormalities is a leading problem in medical imaging. Using machine learning for this problem generally requires manually annotated ground-truth segmentations, demanding extensive time and resources from radiologists. This work presents a weakly supervised approach that utilizes binary image-level labels, which are much simpler to acquire, to effectively segment anomalies in 2D magnetic resonance images without ground truth annotations. We train a generative adversarial network (GAN) that converts cancerous images to healthy variants, which are used along with localization seeds as priors to generate improved weakly supervised segmentations. The non-cancerous variants can also be used to evaluate the segmentations in a weakly supervised fashion, which allows for the most effective segmentations to be identified and then applied to downstream clinical classification tasks. On the Multimodal Brain Tumor Segmentation (BraTS) 2020 dataset, our proposed method generates and identifies segmentations that achieve test Dice coefficients of 83.91%. Using these segmentations for pathology classification results with a test AUC of 93.32% which is comparable to the test AUC of 95.80% achieved when using true segmentations.
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