Not yet reviewed by Pith; the record is open.

The detection and localization of anomalies is one important medical image analysis task. Most commonly, Computer Vision anomaly detection approaches rely on manual annotations that are both time consuming and expensive to obtain. Unsupervised anomaly detection, or Out-of-Distribution detection, aims at identifying anomalous samples relying only on unannotated samples considered normal. In this study we present a new unsupervised anomaly detection method. Our method builds upon the self-supervised strategy consisting on training a segmentation network to identify local synthetic anomalies. Our contributions improve the synthetic anomaly generation process, making synthetic anomalies more heterogeneous and challenging by 1) using complex random shapes and 2) smoothing the edges of synthetic anomalies so networks cannot rely on the high gradient between image and synthetic anomalies. In our implementation we adopted standard practices in 3D medical image segmentation, including 3D U-Net architecture, patch-wise training and model ensembling. Our method was evaluated using a validation set with different types of synthetic anomalies. Our experiments show that our method improved substantially the baseline method performance. Additionally, we evaluated our method by participating in the Medical Out-of-Distribution (MOOD) Challenge held at MICCAI in 2022 and achieved first position in both sample-wise and pixel-wise tasks. Our experiments and results in the latest MOOD challenge show that our simple yet effective approach can substantially improve the performance of Out-of-Distribution detection techniques which rely on synthetic anomalies.