Interactive High-Quality Skin Lesion Generation using Diffusion Models for VR-based Dermatological Education

Pielage, Leon; Schmidle, Paul; Marschall, Bernhard; Risse, Benjamin

Abstract

Malignant melanoma is one of the most lethal forms of cancer when not detected early. As a result, cancer screening programs have been implemented internationally, all of which require visual inspection of skin lesions. Early melanoma detection is a crucial competence in medical and dermatological education, and it is primarily trained using 2D imagery. However, given the intrinsic 3D nature of skin lesions and the importance of incorporating additional contextual information about the patient (e.g., skin type, nearby lesions, etc.), this approach falls short of providing a comprehensive and scalable learning experience. A potential solution is the use of Virtual Reality (VR) scenarios, which can offer an effective strategy to train skin cancer screenings in a realistic 3D setting, thereby enhancing medical students’ awareness of early melanoma detection. In this paper, we present a comprehensive pipeline and models for generating malignant melanomas and benign nevi, which can be utilized in VR-based medical training. We use diffusion models for the generation of skin lesions, which we have enhanced with various guiding strategies to give educators maximum flexibility in designing scenarios and seamlessly placing lesions on virtual agents. Additionally, we have developed a tool which comprises a graphical user interface (GUI) enabling the generation of new lesions and adapting existing ones using an intuitive and interactive inpainting strategy. The tool also offers a novel custom upsampling strategy to achieve a sufficient resolution required for diagnostic purposes. The generated skin lesions have been validated in a user study with trained dermatologists, confirming the overall high quality of the generated lesions and the utility for educational purposes.