Daily Papers

Development of artificial intelligence (AI) techniques in medical imaging requires access to large-scale and diverse datasets for training and evaluation. In dermatology, obtaining such datasets remains challenging due to significant variations in patient populations, illumination conditions, and acquisition system characteristics. In this work, we propose S-SYNTH, the first knowledge-based, adaptable open-source skin simulation framework to rapidly generate synthetic skin, 3D models and digitally rendered images, using an anatomically inspired multi-layer, multi-component skin and growing lesion model. The skin model allows for controlled variation in skin appearance, such as skin color, presence of hair, lesion shape, and blood fraction among other parameters. We use this framework to study the effect of possible variations on the development and evaluation of AI models for skin lesion segmentation, and show that results obtained using synthetic data follow similar comparative trends as real dermatologic images, while mitigating biases and limitations from existing datasets including small dataset size, lack of diversity, and underrepresentation.

With the continuous advancement of image generation technology, advanced models such as GPT-Image-1 and Qwen-Image have achieved remarkable text-to-image consistency and world knowledge However, these models still fall short in photorealistic image generation. Even on simple T2I tasks, they tend to produce " fake" images with distinct AI artifacts, often characterized by "overly smooth skin" and "oily facial sheens". To recapture the original goal of "indistinguishable-from-reality" generation, we propose RealGen, a photorealistic text-to-image framework. RealGen integrates an LLM component for prompt optimization and a diffusion model for realistic image generation. Inspired by adversarial generation, RealGen introduces a "Detector Reward" mechanism, which quantifies artifacts and assesses realism using both semantic-level and feature-level synthetic image detectors. We leverage this reward signal with the GRPO algorithm to optimize the entire generation pipeline, significantly enhancing image realism and detail. Furthermore, we propose RealBench, an automated evaluation benchmark employing Detector-Scoring and Arena-Scoring. It enables human-free photorealism assessment, yielding results that are more accurate and aligned with real user experience. Experiments demonstrate that RealGen significantly outperforms general models like GPT-Image-1 and Qwen-Image, as well as specialized photorealistic models like FLUX-Krea, in terms of realism, detail, and aesthetics. The code is available at https://github.com/yejy53/RealGen.

A major barrier to developing vision large language models (LLMs) in dermatology is the lack of large image--text pairs dataset. We introduce DermaSynth, a dataset comprising of 92,020 synthetic image--text pairs curated from 45,205 images (13,568 clinical and 35,561 dermatoscopic) for dermatology-related clinical tasks. Leveraging state-of-the-art LLMs, using Gemini 2.0, we used clinically related prompts and self-instruct method to generate diverse and rich synthetic texts. Metadata of the datasets were incorporated into the input prompts by targeting to reduce potential hallucinations. The resulting dataset builds upon open access dermatological image repositories (DERM12345, BCN20000, PAD-UFES-20, SCIN, and HIBA) that have permissive CC-BY-4.0 licenses. We also fine-tuned a preliminary Llama-3.2-11B-Vision-Instruct model, DermatoLlama 1.0, on 5,000 samples. We anticipate this dataset to support and accelerate AI research in dermatology. Data and code underlying this work are accessible at https://github.com/abdurrahimyilmaz/DermaSynth.

AI-generated medical images are gaining growing popularity due to their potential to address the data scarcity challenge in the real world. However, the issue of accurate identification of these synthetic images, particularly when they exhibit remarkable realism with their real copies, remains a concern. To mitigate this challenge, image generators such as DALLE and Imagen, have integrated digital watermarks aimed at facilitating the discernment of synthetic images' authenticity. These watermarks are embedded within the image pixels and are invisible to the human eye while remains their detectability. Nevertheless, a comprehensive investigation into the potential impact of these invisible watermarks on the utility of synthetic medical images has been lacking. In this study, we propose the incorporation of invisible watermarks into synthetic medical images and seek to evaluate their efficacy in the context of downstream classification tasks. Our goal is to pave the way for discussions on the viability of such watermarks in boosting the detectability of synthetic medical images, fortifying ethical standards, and safeguarding against data pollution and potential scams.

Artificial intelligence is poised to augment dermatological care by enabling scalable image-based diagnostics. Yet, the development of robust and equitable models remains hindered by datasets that fail to capture the clinical and demographic complexity of real-world practice. This complexity stems from region-specific disease distributions, wide variation in skin tones, and the underrepresentation of outpatient scenarios from non-Western populations. We introduce DermaCon-IN, a prospectively curated dermatology dataset comprising over 5,450 clinical images from approximately 3,000 patients across outpatient clinics in South India. Each image is annotated by board-certified dermatologists with over 240 distinct diagnoses, structured under a hierarchical, etiology-based taxonomy adapted from Rook's classification. The dataset captures a wide spectrum of dermatologic conditions and tonal variation commonly seen in Indian outpatient care. We benchmark a range of architectures including convolutional models (ResNet, DenseNet, EfficientNet), transformer-based models (ViT, MaxViT, Swin), and Concept Bottleneck Models to establish baseline performance and explore how anatomical and concept-level cues may be integrated. These results are intended to guide future efforts toward interpretable and clinically realistic models. DermaCon-IN provides a scalable and representative foundation for advancing dermatology AI in real-world settings.

Background: Health datasets from clinical sources do not reflect the breadth and diversity of disease in the real world, impacting research, medical education, and artificial intelligence (AI) tool development. Dermatology is a suitable area to develop and test a new and scalable method to create representative health datasets. Methods: We used Google Search advertisements to invite contributions to an open access dataset of images of dermatology conditions, demographic and symptom information. With informed contributor consent, we describe and release this dataset containing 10,408 images from 5,033 contributions from internet users in the United States over 8 months starting March 2023. The dataset includes dermatologist condition labels as well as estimated Fitzpatrick Skin Type (eFST) and Monk Skin Tone (eMST) labels for the images. Results: We received a median of 22 submissions/day (IQR 14-30). Female (66.72%) and younger (52% < age 40) contributors had a higher representation in the dataset compared to the US population, and 32.6% of contributors reported a non-White racial or ethnic identity. Over 97.5% of contributions were genuine images of skin conditions. Dermatologist confidence in assigning a differential diagnosis increased with the number of available variables, and showed a weaker correlation with image sharpness (Spearman's P values <0.001 and 0.01 respectively). Most contributions were short-duration (54% with onset < 7 days ago ) and 89% were allergic, infectious, or inflammatory conditions. eFST and eMST distributions reflected the geographical origin of the dataset. The dataset is available at github.com/google-research-datasets/scin . Conclusion: Search ads are effective at crowdsourcing images of health conditions. The SCIN dataset bridges important gaps in the availability of representative images of common skin conditions.

This study explores the utilization of Dermatoscopic synthetic data generated through stable diffusion models as a strategy for enhancing the robustness of machine learning model training. Synthetic data generation plays a pivotal role in mitigating challenges associated with limited labeled datasets, thereby facilitating more effective model training. In this context, we aim to incorporate enhanced data transformation techniques by extending the recent success of few-shot learning and a small amount of data representation in text-to-image latent diffusion models. The optimally tuned model is further used for rendering high-quality skin lesion synthetic data with diverse and realistic characteristics, providing a valuable supplement and diversity to the existing training data. We investigate the impact of incorporating newly generated synthetic data into the training pipeline of state-of-art machine learning models, assessing its effectiveness in enhancing model performance and generalization to unseen real-world data. Our experimental results demonstrate the efficacy of the synthetic data generated through stable diffusion models helps in improving the robustness and adaptability of end-to-end CNN and vision transformer models on two different real-world skin lesion datasets.

The emergence of vision-language models has transformed medical AI, enabling unprecedented advances in diagnostic capability and clinical applications. However, progress in dermatology has lagged behind other medical domains due to the lack of standard image-text pairs. Existing dermatological datasets are limited in both scale and depth, offering only single-label annotations across a narrow range of diseases instead of rich textual descriptions, and lacking the crucial clinical context needed for real-world applications. To address these limitations, we present Derm1M, the first large-scale vision-language dataset for dermatology, comprising 1,029,761 image-text pairs. Built from diverse educational resources and structured around a standard ontology collaboratively developed by experts, Derm1M provides comprehensive coverage for over 390 skin conditions across four hierarchical levels and 130 clinical concepts with rich contextual information such as medical history, symptoms, and skin tone. To demonstrate Derm1M potential in advancing both AI research and clinical application, we pretrained a series of CLIP-like models, collectively called DermLIP, on this dataset. The DermLIP family significantly outperforms state-of-the-art foundation models on eight diverse datasets across multiple tasks, including zero-shot skin disease classification, clinical and artifacts concept identification, few-shot/full-shot learning, and cross-modal retrieval. Our dataset and code will be public.

Training of neural networks for automated diagnosis of pigmented skin lesions is hampered by the small size and lack of diversity of available datasets of dermatoscopic images. We tackle this problem by releasing the HAM10000 ("Human Against Machine with 10000 training images") dataset. We collected dermatoscopic images from different populations acquired and stored by different modalities. Given this diversity we had to apply different acquisition and cleaning methods and developed semi-automatic workflows utilizing specifically trained neural networks. The final dataset consists of 10015 dermatoscopic images which are released as a training set for academic machine learning purposes and are publicly available through the ISIC archive. This benchmark dataset can be used for machine learning and for comparisons with human experts. Cases include a representative collection of all important diagnostic categories in the realm of pigmented lesions. More than 50% of lesions have been confirmed by pathology, while the ground truth for the rest of the cases was either follow-up, expert consensus, or confirmation by in-vivo confocal microscopy.

Skin cancer is one of the most threatening diseases worldwide. However, diagnosing skin cancer correctly is challenging. Recently, deep learning algorithms have emerged to achieve excellent performance on various tasks. Particularly, they have been applied to the skin disease diagnosis tasks. In this paper, we present a review on deep learning methods and their applications in skin disease diagnosis. We first present a brief introduction to skin diseases and image acquisition methods in dermatology, and list several publicly available skin datasets for training and testing algorithms. Then, we introduce the conception of deep learning and review popular deep learning architectures. Thereafter, popular deep learning frameworks facilitating the implementation of deep learning algorithms and performance evaluation metrics are presented. As an important part of this article, we then review the literature involving deep learning methods for skin disease diagnosis from several aspects according to the specific tasks. Additionally, we discuss the challenges faced in the area and suggest possible future research directions. The major purpose of this article is to provide a conceptual and systematically review of the recent works on skin disease diagnosis with deep learning. Given the popularity of deep learning, there remains great challenges in the area, as well as opportunities that we can explore in the future.

Recent advancements in text-to-image (T2I) generation models have transformed the field. However, challenges persist in generating images that reflect demanding textual descriptions, especially for fine-grained details and unusual relationships. Existing evaluation metrics focus on text-image alignment but overlook the realism of the generated image, which can be crucial for downstream applications like data augmentation in machine learning. To address this gap, we propose REAL, an automatic evaluation framework that assesses realism of T2I outputs along three dimensions: fine-grained visual attributes, unusual visual relationships, and visual styles. REAL achieves a Spearman's rho score of up to 0.62 in alignment with human judgement and demonstrates utility in ranking and filtering augmented data for tasks like image captioning, classification, and visual relationship detection. Empirical results show that high-scoring images evaluated by our metrics improve F1 scores of image classification by up to 11.3%, while low-scoring ones degrade that by up to 4.95%. We benchmark four major T2I models across the realism dimensions, providing insights for future improvements in T2I output realism.

Skin diseases affect millions of people worldwide, across all ethnicities. Increasing diagnosis accessibility requires fair and accurate segmentation and classification of dermatology images. However, the scarcity of annotated medical images, especially for rare diseases and underrepresented skin tones, poses a challenge to the development of fair and accurate models. In this study, we introduce a Fair, Efficient, and Diverse Diffusion-based framework for skin lesion segmentation and malignancy classification. FEDD leverages semantically meaningful feature embeddings learned through a denoising diffusion probabilistic backbone and processes them via linear probes to achieve state-of-the-art performance on Diverse Dermatology Images (DDI). We achieve an improvement in intersection over union of 0.18, 0.13, 0.06, and 0.07 while using only 5%, 10%, 15%, and 20% labeled samples, respectively. Additionally, FEDD trained on 10% of DDI demonstrates malignancy classification accuracy of 81%, 14% higher compared to the state-of-the-art. We showcase high efficiency in data-constrained scenarios while providing fair performance for diverse skin tones and rare malignancy conditions. Our newly annotated DDI segmentation masks and training code can be found on https://github.com/hectorcarrion/fedd.

Multi-annotator medical image segmentation is an important research problem, but requires annotated datasets that are expensive to collect. Dermoscopic skin lesion imaging allows human experts and AI systems to observe morphological structures otherwise not discernable from regular clinical photographs. However, currently there are no large-scale publicly available multi-annotator skin lesion segmentation (SLS) datasets with annotator-labels for dermoscopic skin lesion imaging. We introduce ISIC MultiAnnot++, a large public multi-annotator skin lesion segmentation dataset for images from the ISIC Archive. The final dataset contains 17,684 segmentation masks spanning 14,967 dermoscopic images, where 2,394 dermoscopic images have 2-5 segmentations per image, making it the largest publicly available SLS dataset. Further, metadata about the segmentation, including the annotators' skill level and segmentation tool, is included, enabling research on topics such as annotator-specific preference modeling for segmentation and annotator metadata analysis. We provide an analysis on the characteristics of this dataset, curated data partitions, and consensus segmentation masks.

Realistic image super-resolution (Real-ISR) aims to reproduce perceptually realistic image details from a low-quality input. The commonly used adversarial training based Real-ISR methods often introduce unnatural visual artifacts and fail to generate realistic textures for natural scene images. The recently developed generative stable diffusion models provide a potential solution to Real-ISR with pre-learned strong image priors. However, the existing methods along this line either fail to keep faithful pixel-wise image structures or resort to extra skipped connections to reproduce details, which requires additional training in image space and limits their extension to other related tasks in latent space such as image stylization. In this work, we propose a pixel-aware stable diffusion (PASD) network to achieve robust Real-ISR as well as personalized stylization. In specific, a pixel-aware cross attention module is introduced to enable diffusion models perceiving image local structures in pixel-wise level, while a degradation removal module is used to extract degradation insensitive features to guide the diffusion process together with image high level information. By simply replacing the base diffusion model with a personalized one, our method can generate diverse stylized images without the need to collect pairwise training data. PASD can be easily integrated into existing diffusion models such as Stable Diffusion. Experiments on Real-ISR and personalized stylization demonstrate the effectiveness of our proposed approach. The source code and models can be found at https://github.com/yangxy/PASD.

This article summarizes the BCN20000 dataset, composed of 19424 dermoscopic images of skin lesions captured from 2010 to 2016 in the facilities of the Hospital Cl\'inic in Barcelona. With this dataset, we aim to study the problem of unconstrained classification of dermoscopic images of skin cancer, including lesions found in hard-to-diagnose locations (nails and mucosa), large lesions which do not fit in the aperture of the dermoscopy device, and hypo-pigmented lesions. The BCN20000 will be provided to the participants of the ISIC Challenge 2019, where they will be asked to train algorithms to classify dermoscopic images of skin cancer automatically.

Skin lesion datasets consist predominantly of normal samples with only a small percentage of abnormal ones, giving rise to the class imbalance problem. Also, skin lesion images are largely similar in overall appearance owing to the low inter-class variability. In this paper, we propose a two-stage framework for automatic classification of skin lesion images using adversarial training and transfer learning toward melanoma detection. In the first stage, we leverage the inter-class variation of the data distribution for the task of conditional image synthesis by learning the inter-class mapping and synthesizing under-represented class samples from the over-represented ones using unpaired image-to-image translation. In the second stage, we train a deep convolutional neural network for skin lesion classification using the original training set combined with the newly synthesized under-represented class samples. The training of this classifier is carried out by minimizing the focal loss function, which assists the model in learning from hard examples, while down-weighting the easy ones. Experiments conducted on a dermatology image benchmark demonstrate the superiority of our proposed approach over several standard baseline methods, achieving significant performance improvements. Interestingly, we show through feature visualization and analysis that our method leads to context based lesion assessment that can reach an expert dermatologist level.

Medical vision-language models (VLMs) have shown promise as clinical assistants across various medical fields. However, specialized dermatology VLM capable of delivering professional and detailed diagnostic analysis remains underdeveloped, primarily due to less specialized text descriptions in current dermatology multimodal datasets. To address this issue, we propose MM-Skin, the first large-scale multimodal dermatology dataset that encompasses 3 imaging modalities, including clinical, dermoscopic, and pathological and nearly 10k high-quality image-text pairs collected from professional textbooks. In addition, we generate over 27k diverse, instruction-following vision question answering (VQA) samples (9 times the size of current largest dermatology VQA dataset). Leveraging public datasets and MM-Skin, we developed SkinVL, a dermatology-specific VLM designed for precise and nuanced skin disease interpretation. Comprehensive benchmark evaluations of SkinVL on VQA, supervised fine-tuning (SFT) and zero-shot classification tasks across 8 datasets, reveal its exceptional performance for skin diseases in comparison to both general and medical VLM models. The introduction of MM-Skin and SkinVL offers a meaningful contribution to advancing the development of clinical dermatology VLM assistants. MM-Skin is available at https://github.com/ZwQ803/MM-Skin

Current AI-assisted skin image diagnosis has achieved dermatologist-level performance in classifying skin cancer, driven by rapid advancements in deep learning architectures. However, unlike traditional vision tasks, skin images in general present unique challenges due to the limited availability of well-annotated datasets, complex variations in conditions, and the necessity for detailed interpretations to ensure patient safety. Previous segmentation methods have sought to reduce image noise and enhance diagnostic performance, but these techniques require fine-grained, pixel-level ground truth masks for training. In contrast, with the rise of foundation models, the Segment Anything Model (SAM) has been introduced to facilitate promptable segmentation, enabling the automation of the segmentation process with simple yet effective prompts. Efforts applying SAM predominantly focus on dermatoscopy images, which present more easily identifiable lesion boundaries than clinical photos taken with smartphones. This limitation constrains the practicality of these approaches to real-world applications. To overcome the challenges posed by noisy clinical photos acquired via non-standardized protocols and to improve diagnostic accessibility, we propose a novel Cross-Attentive Fusion framework for interpretable skin lesion diagnosis. Our method leverages SAM to generate visual concepts for skin diseases using prompts, integrating local visual concepts with global image features to enhance model performance. Extensive evaluation on two skin disease datasets demonstrates our proposed method's effectiveness on lesion diagnosis and interpretability.

Dermatological diagnosis represents a complex multimodal challenge that requires integrating visual features with specialized clinical knowledge. While vision-language pretraining (VLP) has advanced medical AI, its effectiveness in dermatology is limited by text length constraints and the lack of structured texts. In this paper, we introduce MAKE, a Multi-Aspect Knowledge-Enhanced vision-language pretraining framework for zero-shot dermatological tasks. Recognizing that comprehensive dermatological descriptions require multiple knowledge aspects that exceed standard text constraints, our framework introduces: (1) a multi-aspect contrastive learning strategy that decomposes clinical narratives into knowledge-enhanced sub-texts through large language models, (2) a fine-grained alignment mechanism that connects subcaptions with diagnostically relevant image features, and (3) a diagnosis-guided weighting scheme that adaptively prioritizes different sub-captions based on clinical significance prior. Through pretraining on 403,563 dermatological image-text pairs collected from education resources, MAKE significantly outperforms state-of-the-art VLP models on eight datasets across zero-shot skin disease classification, concept annotation, and cross-modal retrieval tasks. Our code will be made publicly available at https: //github.com/SiyuanYan1/MAKE.

Skin conditions affect an estimated 1.9 billion people worldwide. A shortage of dermatologists causes long wait times and leads patients to seek dermatologic care from general practitioners. However, the diagnostic accuracy of general practitioners has been reported to be only 0.24-0.70 (compared to 0.77-0.96 for dermatologists), resulting in referral errors, delays in care, and errors in diagnosis and treatment. In this paper, we developed a deep learning system (DLS) to provide a differential diagnosis of skin conditions for clinical cases (skin photographs and associated medical histories). The DLS distinguishes between 26 skin conditions that represent roughly 80% of the volume of skin conditions seen in primary care. The DLS was developed and validated using de-identified cases from a teledermatology practice serving 17 clinical sites via a temporal split: the first 14,021 cases for development and the last 3,756 cases for validation. On the validation set, where a panel of three board-certified dermatologists defined the reference standard for every case, the DLS achieved 0.71 and 0.93 top-1 and top-3 accuracies respectively. For a random subset of the validation set (n=963 cases), 18 clinicians reviewed the cases for comparison. On this subset, the DLS achieved a 0.67 top-1 accuracy, non-inferior to board-certified dermatologists (0.63, p<0.001), and higher than primary care physicians (PCPs, 0.45) and nurse practitioners (NPs, 0.41). The top-3 accuracy showed a similar trend: 0.90 DLS, 0.75 dermatologists, 0.60 PCPs, and 0.55 NPs. These results highlight the potential of the DLS to augment general practitioners to accurately diagnose skin conditions by suggesting differential diagnoses that may not have been considered. Future work will be needed to prospectively assess the clinical impact of using this tool in actual clinical workflows.

Skin diseases affect over a third of the global population, yet their impact is often underestimated. Automating skin disease classification to assist doctors with their prognosis might be difficult. Nevertheless, due to efficient feature extraction pipelines, deep learning techniques have shown much promise for various tasks, including dermatological disease identification. This study uses a skin disease dataset with 31 classes and compares it with all versions of Vision Transformers, Swin Transformers and DivoV2. The analysis is also extended to compare with benchmark convolution-based architecture presented in the literature. Transfer learning with ImageNet1k weights on the skin disease dataset contributes to a high test accuracy of 96.48\% and an F1-Score of 0.9727 using DinoV2, which is almost a 10\% improvement over this data's current benchmark results. The performance of DinoV2 was also compared for the HAM10000 and Dermnet datasets to test the model's robustness, and the trained model overcomes the benchmark results by a slight margin in test accuracy and in F1-Score on the 23 and 7 class datasets. The results are substantiated using explainable AI frameworks like GradCAM and SHAP, which provide precise image locations to map the disease, assisting dermatologists in early detection, prompt prognosis, and treatment.

Modeling and producing lifelike clothed human images has attracted researchers' attention from different areas for decades, with the complexity from highly articulated and structured content. Rendering algorithms decompose and simulate the imaging process of a camera, while are limited by the accuracy of modeled variables and the efficiency of computation. Generative models can produce impressively vivid human images, however still lacking in controllability and editability. This paper studies photorealism enhancement of rendered images, leveraging generative power from diffusion models on the controlled basis of rendering. We introduce a novel framework to translate rendered images into their realistic counterparts, which consists of two stages: Domain Knowledge Injection (DKI) and Realistic Image Generation (RIG). In DKI, we adopt positive (real) domain finetuning and negative (rendered) domain embedding to inject knowledge into a pretrained Text-to-image (T2I) diffusion model. In RIG, we generate the realistic image corresponding to the input rendered image, with a Texture-preserving Attention Control (TAC) to preserve fine-grained clothing textures, exploiting the decoupled features encoded in the UNet structure. Additionally, we introduce SynFashion dataset, featuring high-quality digital clothing images with diverse textures. Extensive experimental results demonstrate the superiority and effectiveness of our method in rendered-to-real image translation.

Diagnosing and treating skin diseases require advanced visual skills across domains and the ability to synthesize information from multiple imaging modalities. While current deep learning models excel at specific tasks like skin cancer diagnosis from dermoscopic images, they struggle to meet the complex, multimodal requirements of clinical practice. Here, we introduce PanDerm, a multimodal dermatology foundation model pretrained through self-supervised learning on over 2 million real-world skin disease images from 11 clinical institutions across 4 imaging modalities. We evaluated PanDerm on 28 diverse benchmarks, including skin cancer screening, risk stratification, differential diagnosis of common and rare skin conditions, lesion segmentation, longitudinal monitoring, and metastasis prediction and prognosis. PanDerm achieved state-of-the-art performance across all evaluated tasks, often outperforming existing models when using only 10% of labeled data. We conducted three reader studies to assess PanDerm's potential clinical utility. PanDerm outperformed clinicians by 10.2% in early-stage melanoma detection through longitudinal analysis, improved clinicians' skin cancer diagnostic accuracy by 11% on dermoscopy images, and enhanced non-dermatologist healthcare providers' differential diagnosis by 16.5% across 128 skin conditions on clinical photographs. These results demonstrate PanDerm's potential to improve patient care across diverse clinical scenarios and serve as a model for developing multimodal foundation models in other medical specialties, potentially accelerating the integration of AI support in healthcare. The code can be found at https://github.com/SiyuanYan1/PanDerm.

Skin lesion datasets provide essential information for understanding various skin conditions and developing effective diagnostic tools. They aid the artificial intelligence-based early detection of skin cancer, facilitate treatment planning, and contribute to medical education and research. Published large datasets have partially coverage the subclassifications of the skin lesions. This limitation highlights the need for more expansive and varied datasets to reduce false predictions and help improve the failure analysis for skin lesions. This study presents a diverse dataset comprising 12,345 dermatoscopic images with 38 subclasses of skin lesions collected in Turkiye which comprises different skin types in the transition zone between Europe and Asia. Each subgroup contains high-resolution photos and expert annotations, providing a strong and reliable basis for future research. The detailed analysis of each subgroup provided in this study facilitates targeted research endeavors and enhances the depth of understanding regarding the skin lesions. This dataset distinguishes itself through a diverse structure with 5 super classes, 15 main classes, 38 subclasses and its 12,345 high-resolution dermatoscopic images.

Artificial intelligence has significantly advanced skin cancer diagnosis by enabling rapid and accurate detection of malignant lesions. In this domain, most publicly available image datasets consist of single, isolated skin lesions positioned at the center of the image. While these lesion-centric datasets have been fundamental for developing diagnostic algorithms, they lack the context of the surrounding skin, which is critical for improving lesion detection. The iToBoS dataset was created to address this challenge. It includes 16,954 images of skin regions from 100 participants, captured using 3D total body photography. Each image roughly corresponds to a 7 times 9 cm section of skin with all suspicious lesions annotated using bounding boxes. Additionally, the dataset provides metadata such as anatomical location, age group, and sun damage score for each image. This dataset aims to facilitate training and benchmarking of algorithms, with the goal of enabling early detection of skin cancer and deployment of this technology in non-clinical environments.

Generative models, such as diffusion models (DMs), variational autoencoders (VAEs), and generative adversarial networks (GANs), produce images with a level of authenticity that makes them nearly indistinguishable from real photos and artwork. While this capability is beneficial for many industries, the difficulty of identifying synthetic images leaves online media platforms vulnerable to impersonation and misinformation attempts. To support the development of defensive methods, we introduce ImagiNet, a high-resolution and balanced dataset for synthetic image detection, designed to mitigate potential biases in existing resources. It contains 200K examples, spanning four content categories: photos, paintings, faces, and uncategorized. Synthetic images are produced with open-source and proprietary generators, whereas real counterparts of the same content type are collected from public datasets. The structure of ImagiNet allows for a two-track evaluation system: i) classification as real or synthetic and ii) identification of the generative model. To establish a baseline, we train a ResNet-50 model using a self-supervised contrastive objective (SelfCon) for each track. The model demonstrates state-of-the-art performance and high inference speed across established benchmarks, achieving an AUC of up to 0.99 and balanced accuracy ranging from 86% to 95%, even under social network conditions that involve compression and resizing. Our data and code are available at https://github.com/delyan-boychev/imaginet.

Diabetic foot ulcers are a common manifestation of lesions on the diabetic foot, a syndrome acquired as a long-term complication of diabetes mellitus. Accompanying neuropathy and vascular damage promote acquisition of pressure injuries and tissue death due to ischaemia. Affected areas are prone to infections, hindering the healing progress. The research at hand investigates an approach on classification of infection and ischaemia, conducted as part of the Diabetic Foot Ulcer Challenge (DFUC) 2021. Different models of the EfficientNet family are utilized in ensembles. An extension strategy for the training data is applied, involving pseudo-labeling for unlabeled images, and extensive generation of synthetic images via pix2pixHD to cope with severe class imbalances. The resulting extended training dataset features 8.68 times the size of the baseline and shows a real to synthetic image ratio of 1:3. Performances of models and ensembles trained on the baseline and extended training dataset are compared. Synthetic images featured a broad qualitative variety. Results show that models trained on the extended training dataset as well as their ensemble benefit from the large extension. F1-Scores for rare classes receive outstanding boosts, while those for common classes are either not harmed or boosted moderately. A critical discussion concretizes benefits and identifies limitations, suggesting improvements. The work concludes that classification performance of individual models as well as that of ensembles can be boosted utilizing synthetic images. Especially performance for rare classes benefits notably.

The rapid advancement of Artificial Intelligence (AI) in biomedical imaging and radiotherapy is hindered by the limited availability of large imaging data repositories. With recent research and improvements in denoising diffusion probabilistic models (DDPM), high quality synthetic medical scans are now possible. Despite this, there is currently no way of generating multiple related images, such as a corresponding ground truth which can be used to train models, so synthetic scans are often manually annotated before use. This research introduces a novel architecture that is able to generate multiple, related PET-CT-tumour mask pairs using paired networks and conditional encoders. Our approach includes innovative, time step-controlled mechanisms and a `noise-seeding' strategy to improve DDPM sampling consistency. While our model requires a modified perceptual loss function to ensure accurate feature alignment we show generation of clearly aligned synthetic images and improvement in segmentation accuracy with generated images.

This paper presents our team's participation in the MEDIQA-ClinicalNLP2024 shared task B. We present a novel approach to diagnosing clinical dermatology cases by integrating large multimodal models, specifically leveraging the capabilities of GPT-4V under a retriever and a re-ranker framework. Our investigation reveals that GPT-4V, when used as a retrieval agent, can accurately retrieve the correct skin condition 85% of the time using dermatological images and brief patient histories. Additionally, we empirically show that Naive Chain-of-Thought (CoT) works well for retrieval while Medical Guidelines Grounded CoT is required for accurate dermatological diagnosis. Further, we introduce a Multi-Agent Conversation (MAC) framework and show its superior performance and potential over the best CoT strategy. The experiments suggest that using naive CoT for retrieval and multi-agent conversation for critique-based diagnosis, GPT-4V can lead to an early and accurate diagnosis of dermatological conditions. The implications of this work extend to improving diagnostic workflows, supporting dermatological education, and enhancing patient care by providing a scalable, accessible, and accurate diagnostic tool.

With the widespread application of artificial intelligence (AI), particularly deep learning (DL) and vision-based large language models (VLLMs), in skin disease diagnosis, the need for interpretability becomes crucial. However, existing dermatology datasets are limited in their inclusion of concept-level meta-labels, and none offer rich medical descriptions in natural language. This deficiency impedes the advancement of LLM-based methods in dermatological diagnosis. To address this gap and provide a meticulously annotated dermatology dataset with comprehensive natural language descriptions, we introduce SkinCAP: a multi-modal dermatology dataset annotated with rich medical captions. SkinCAP comprises 4,000 images sourced from the Fitzpatrick 17k skin disease dataset and the Diverse Dermatology Images dataset, annotated by board-certified dermatologists to provide extensive medical descriptions and captions. Notably, SkinCAP represents the world's first such dataset and is publicly available at https://huggingface.co/datasets/joshuachou/SkinCAP.

Millions of melanocytic skin lesions are examined by pathologists each year, the majority of which concern common nevi (i.e., ordinary moles). While most of these lesions can be diagnosed in seconds, writing the corresponding pathology report is much more time-consuming. Automating part of the report writing could, therefore, alleviate the increasing workload of pathologists. In this work, we develop a vision-language model specifically for the pathology domain of cutaneous melanocytic lesions. The model follows the Contrastive Captioner framework and was trained and evaluated using a melanocytic lesion dataset of 42,512 H&E-stained whole slide images and 19,645 corresponding pathology reports. Our results show that the quality scores of model-generated reports were on par with pathologist-written reports for common nevi, assessed by an expert pathologist in a reader study. While report generation revealed to be more difficult for rare melanocytic lesion subtypes, the cross-modal retrieval performance for these cases was considerably better.

Deep learning algorithms require extensive data to achieve robust performance. However, data availability is often restricted in the medical domain due to patient privacy concerns. Synthetic data presents a possible solution to these challenges. Recently, image generative models have found increasing use for medical applications but are often designed for singular medical specialties and imaging modalities, thus limiting their broader utility. To address this, we introduce MediSyn: a text-guided, latent diffusion model capable of generating synthetic images from 6 medical specialties and 10 image types. The synthetic images are validated by expert clinicians for alignment with their corresponding text prompts. Furthermore, a direct comparison of the synthetic images against the real images confirms that our model synthesizes novel images and, crucially, may preserve patient privacy. Finally, classifiers trained on a mixture of synthetic and real data achieve similar performance to those trained on twice the amount of real data. Our findings highlight the immense potential for generalist image generative models to accelerate algorithmic research and development in medicine.

How does the accuracy of deep neural network models trained to classify clinical images of skin conditions vary across skin color? While recent studies demonstrate computer vision models can serve as a useful decision support tool in healthcare and provide dermatologist-level classification on a number of specific tasks, darker skin is underrepresented in the data. Most publicly available data sets do not include Fitzpatrick skin type labels. We annotate 16,577 clinical images sourced from two dermatology atlases with Fitzpatrick skin type labels and open-source these annotations. Based on these labels, we find that there are significantly more images of light skin types than dark skin types in this dataset. We train a deep neural network model to classify 114 skin conditions and find that the model is most accurate on skin types similar to those it was trained on. In addition, we evaluate how an algorithmic approach to identifying skin tones, individual typology angle, compares with Fitzpatrick skin type labels annotated by a team of human labelers.

Multimodal Large Language Models (MLLMs) show promise for medical applications, yet progress in dermatology lags due to limited training data, narrow task coverage, and lack of clinically-grounded supervision that mirrors expert diagnostic workflows. We present a comprehensive framework to address these gaps. First, we introduce DermoInstruct, a large-scale morphology-anchored instruction corpus comprising 211,243 images and 772,675 trajectories across five task formats, capturing the complete diagnostic pipeline from morphological observation and clinical reasoning to final diagnosis. Second, we establish DermoBench, a rigorous benchmark evaluating 11 tasks across four clinical axes: Morphology, Diagnosis, Reasoning, and Fairness, including a challenging subset of 3,600 expert-verified open-ended instances and human performance baselines. Third, we develop DermoGPT, a dermatology reasoning MLLM trained via supervised fine-tuning followed by our Morphologically-Anchored Visual-Inference-Consistent (MAVIC) reinforcement learning objective, which enforces consistency between visual observations and diagnostic conclusions. At inference, we deploy Confidence-Consistency Test-time adaptation (CCT) for robust predictions. Experiments show DermoGPT significantly outperforms 16 representative baselines across all axes, achieving state-of-the-art performance while substantially narrowing the human-AI gap. DermoInstruct, DermoBench and DermoGPT will be made publicly available at https://github.com/mendicant04/DermoGPT upon acceptance.

As deep learning models gain attraction in medical data, ensuring transparent and trustworthy decision-making is essential. In skin cancer diagnosis, while advancements in lesion detection and classification have improved accuracy, the black-box nature of these methods poses challenges in understanding their decision processes, leading to trust issues among physicians. This study leverages the CLIP (Contrastive Language-Image Pretraining) model, trained on different skin lesion datasets, to capture meaningful relationships between visual features and diagnostic criteria terms. To further enhance transparency, we propose a method called MedGrad E-CLIP, which builds on gradient-based E-CLIP by incorporating a weighted entropy mechanism designed for complex medical imaging like skin lesions. This approach highlights critical image regions linked to specific diagnostic descriptions. The developed integrated pipeline not only classifies skin lesions by matching corresponding descriptions but also adds an essential layer of explainability developed especially for medical data. By visually explaining how different features in an image relates to diagnostic criteria, this approach demonstrates the potential of advanced vision-language models in medical image analysis, ultimately improving transparency, robustness, and trust in AI-driven diagnostic systems.

This article describes the design, implementation, and results of the latest installment of the dermoscopic image analysis benchmark challenge. The goal is to support research and development of algorithms for automated diagnosis of melanoma, the most lethal skin cancer. The challenge was divided into 3 tasks: lesion segmentation, feature detection, and disease classification. Participation involved 593 registrations, 81 pre-submissions, 46 finalized submissions (including a 4-page manuscript), and approximately 50 attendees, making this the largest standardized and comparative study in this field to date. While the official challenge duration and ranking of participants has concluded, the dataset snapshots remain available for further research and development.

In this work, we tackle the challenging problem of learning-based single-view 3D hair modeling. Due to the great difficulty of collecting paired real image and 3D hair data, using synthetic data to provide prior knowledge for real domain becomes a leading solution. This unfortunately introduces the challenge of domain gap. Due to the inherent difficulty of realistic hair rendering, existing methods typically use orientation maps instead of hair images as input to bridge the gap. We firmly think an intermediate representation is essential, but we argue that orientation map using the dominant filtering-based methods is sensitive to uncertain noise and far from a competent representation. Thus, we first raise this issue up and propose a novel intermediate representation, termed as HairStep, which consists of a strand map and a depth map. It is found that HairStep not only provides sufficient information for accurate 3D hair modeling, but also is feasible to be inferred from real images. Specifically, we collect a dataset of 1,250 portrait images with two types of annotations. A learning framework is further designed to transfer real images to the strand map and depth map. It is noted that, an extra bonus of our new dataset is the first quantitative metric for 3D hair modeling. Our experiments show that HairStep narrows the domain gap between synthetic and real and achieves state-of-the-art performance on single-view 3D hair reconstruction.

In recent years, methods for producing highly realistic synthetic images have significantly advanced, allowing the creation of high-quality images from text prompts that describe the desired content. Even more impressively, Stable Diffusion (SD) models now provide users with the option of creating synthetic images in an image-to-image translation fashion, modifying images in the latent space of advanced autoencoders. This striking evolution, however, brings an alarming consequence: it is possible to pass an image through SD autoencoders to reproduce a synthetic copy of the image with high realism and almost no visual artifacts. This process, known as SD image laundering, can transform real images into lookalike synthetic ones and risks complicating forensic analysis for content authenticity verification. Our paper investigates the forensic implications of image laundering, revealing a serious potential to obscure traces of real content, including sensitive and harmful materials that could be mistakenly classified as synthetic, thereby undermining the protection of individuals depicted. To address this issue, we propose a two-stage detection pipeline that effectively differentiates between pristine, laundered, and fully synthetic images (those generated from text prompts), showing robustness across various conditions. Finally, we highlight another alarming property of image laundering, which appears to mask the unique artifacts exploited by forensic detectors to solve the camera model identification task, strongly undermining their performance. Our experimental code is available at https://github.com/polimi-ispl/synthetic-image-detection.

Feature vectors provided by pre-trained deep artificial neural networks have become a dominant source for image representation in recent literature. Their contribution to the performance of image analysis can be improved through finetuning. As an ultimate solution, one might even train a deep network from scratch with the domain-relevant images, a highly desirable option which is generally impeded in pathology by lack of labeled images and the computational expense. In this study, we propose a new network, namely KimiaNet, that employs the topology of the DenseNet with four dense blocks, fine-tuned and trained with histopathology images in different configurations. We used more than 240,000 image patches with 1000x1000 pixels acquired at 20x magnification through our proposed "highcellularity mosaic" approach to enable the usage of weak labels of 7,126 whole slide images of formalin-fixed paraffin-embedded human pathology samples publicly available through the The Cancer Genome Atlas (TCGA) repository. We tested KimiaNet using three public datasets, namely TCGA, endometrial cancer images, and colorectal cancer images by evaluating the performance of search and classification when corresponding features of different networks are used for image representation. As well, we designed and trained multiple convolutional batch-normalized ReLU (CBR) networks. The results show that KimiaNet provides superior results compared to the original DenseNet and smaller CBR networks when used as feature extractor to represent histopathology images.

Over the last years, many face analysis tasks have accomplished astounding performance, with applications including face generation and 3D face reconstruction from a single "in-the-wild" image. Nevertheless, to the best of our knowledge, there is no method which can produce render-ready high-resolution 3D faces from "in-the-wild" images and this can be attributed to the: (a) scarcity of available data for training, and (b) lack of robust methodologies that can successfully be applied on very high-resolution data. In this work, we introduce the first method that is able to reconstruct photorealistic render-ready 3D facial geometry and BRDF from a single "in-the-wild" image. We capture a large dataset of facial shape and reflectance, which we have made public. We define a fast facial photorealistic differentiable rendering methodology with accurate facial skin diffuse and specular reflection, self-occlusion and subsurface scattering approximation. With this, we train a network that disentangles the facial diffuse and specular BRDF components from a shape and texture with baked illumination, reconstructed with a state-of-the-art 3DMM fitting method. Our method outperforms the existing arts by a significant margin and reconstructs high-resolution 3D faces from a single low-resolution image, that can be rendered in various applications, and bridge the uncanny valley.

Vision-language models in pathology enable multimodal case retrieval and automated report generation. Many of the models developed so far, however, have been trained on pathology reports that include information which cannot be inferred from paired whole slide images (e.g., patient history), potentially leading to hallucinated sentences in generated reports. To this end, we investigate how the selection of information from pathology reports for vision-language modeling affects the quality of the multimodal representations and generated reports. More concretely, we compare a model trained on full reports against a model trained on preprocessed reports that only include sentences describing the cell and tissue appearances based on the H&E-stained slides. For the experiments, we built upon the BLIP-2 framework and used a cutaneous melanocytic lesion dataset of 42,433 H&E-stained whole slide images and 19,636 corresponding pathology reports. Model performance was assessed using image-to-text and text-to-image retrieval, as well as qualitative evaluation of the generated reports by an expert pathologist. Our results demonstrate that text preprocessing prevents hallucination in report generation. Despite the improvement in the quality of the generated reports, training the vision-language model on full reports showed better cross-modal retrieval performance.

Chest radiography is an extremely powerful imaging modality, allowing for a detailed inspection of a patient's thorax, but requiring specialized training for proper interpretation. With the advent of high performance general purpose computer vision algorithms, the accurate automated analysis of chest radiographs is becoming increasingly of interest to researchers. However, a key challenge in the development of these techniques is the lack of sufficient data. Here we describe MIMIC-CXR-JPG v2.0.0, a large dataset of 377,110 chest x-rays associated with 227,827 imaging studies sourced from the Beth Israel Deaconess Medical Center between 2011 - 2016. Images are provided with 14 labels derived from two natural language processing tools applied to the corresponding free-text radiology reports. MIMIC-CXR-JPG is derived entirely from the MIMIC-CXR database, and aims to provide a convenient processed version of MIMIC-CXR, as well as to provide a standard reference for data splits and image labels. All images have been de-identified to protect patient privacy. The dataset is made freely available to facilitate and encourage a wide range of research in medical computer vision.

The digitization of histology slides has revolutionized pathology, providing massive datasets for cancer diagnosis and research. Contrastive self-supervised and vision-language models have been shown to effectively mine large pathology datasets to learn discriminative representations. On the other hand, generative models, capable of synthesizing realistic and diverse images, present a compelling solution to address unique problems in pathology that involve synthesizing images; overcoming annotated data scarcity, enabling privacy-preserving data sharing, and performing inherently generative tasks, such as virtual staining. We introduce PixCell, the first diffusion-based generative foundation model for histopathology. We train PixCell on PanCan-30M, a vast, diverse dataset derived from 69,184 H\&E-stained whole slide images covering various cancer types. We employ a progressive training strategy and a self-supervision-based conditioning that allows us to scale up training without any annotated data. PixCell generates diverse and high-quality images across multiple cancer types, which we find can be used in place of real data to train a self-supervised discriminative model. Synthetic images shared between institutions are subject to fewer regulatory barriers than would be the case with real clinical images. Furthermore, we showcase the ability to precisely control image generation using a small set of annotated images, which can be used for both data augmentation and educational purposes. Testing on a cell segmentation task, a mask-guided PixCell enables targeted data augmentation, improving downstream performance. Finally, we demonstrate PixCell's ability to use H\&E structural staining to infer results from molecular marker studies; we use this capability to infer IHC staining from H\&E images. Our trained models are publicly released to accelerate research in computational pathology.

Skin disease is one of the most common types of human diseases, which may happen to everyone regardless of age, gender or race. Due to the high visual diversity, human diagnosis highly relies on personal experience; and there is a serious shortage of experienced dermatologists in many countries. To alleviate this problem, computer-aided diagnosis with state-of-the-art (SOTA) machine learning techniques would be a promising solution. In this paper, we aim at understanding the performance of convolutional neural network (CNN) based approaches. We first build two versions of skin disease datasets from Internet images: (a) Skin-10, which contains 10 common classes of skin disease with a total of 10,218 images; (b) Skin-100, which is a larger dataset that consists of 19,807 images of 100 skin disease classes. Based on these datasets, we benchmark several SOTA CNN models and show that the accuracy of skin-100 is much lower than the accuracy of skin-10. We then implement an ensemble method based on several CNN models and achieve the best accuracy of 79.01\% for Skin-10 and 53.54\% for Skin-100. We also present an object detection based approach by introducing bounding boxes into the Skin-10 dataset. Our results show that object detection can help improve the accuracy of some skin disease classes.

Single-view depth estimation can be remarkably effective if there is enough ground-truth depth data for supervised training. However, there are scenarios, especially in medicine in the case of endoscopies, where such data cannot be obtained. In such cases, multi-view self-supervision and synthetic-to-real transfer serve as alternative approaches, however, with a considerable performance reduction in comparison to supervised case. Instead, we propose a single-view self-supervised method that achieves a performance similar to the supervised case. In some medical devices, such as endoscopes, the camera and light sources are co-located at a small distance from the target surfaces. Thus, we can exploit that, for any given albedo and surface orientation, pixel brightness is inversely proportional to the square of the distance to the surface, providing a strong single-view self-supervisory signal. In our experiments, our self-supervised models deliver accuracies comparable to those of fully supervised ones, while being applicable without depth ground-truth data.

The default strategy for training single-view Large Reconstruction Models (LRMs) follows the fully supervised route using large-scale datasets of synthetic 3D assets or multi-view captures. Although these resources simplify the training procedure, they are hard to scale up beyond the existing datasets and they are not necessarily representative of the real distribution of object shapes. To address these limitations, in this paper, we introduce Real3D, the first LRM system that can be trained using single-view real-world images. Real3D introduces a novel self-training framework that can benefit from both the existing synthetic data and diverse single-view real images. We propose two unsupervised losses that allow us to supervise LRMs at the pixel- and semantic-level, even for training examples without ground-truth 3D or novel views. To further improve performance and scale up the image data, we develop an automatic data curation approach to collect high-quality examples from in-the-wild images. Our experiments show that Real3D consistently outperforms prior work in four diverse evaluation settings that include real and synthetic data, as well as both in-domain and out-of-domain shapes. Code and model can be found here: https://hwjiang1510.github.io/Real3D/

Recent advances in diffusion models have enabled the creation of deceptively real images, posing significant security risks when misused. In this study, we empirically show that different timesteps of DDIM inversion reveal varying subtle distinctions between synthetic and real images that are extractable for detection, in the forms of such as Fourier power spectrum high-frequency discrepancies and inter-pixel variance distributions. Based on these observations, we propose a novel synthetic image detection method that directly utilizes features of intermediately noised images by training an ensemble on multiple noised timesteps, circumventing conventional reconstruction-based strategies. To enhance human comprehension, we introduce a metric-grounded explanation generation and refinement module to identify and explain AI-generated flaws. Additionally, we construct the GenHard and GenExplain benchmarks to provide detection samples of greater difficulty and high-quality rationales for fake images. Extensive experiments show that our method achieves state-of-the-art performance with 98.91% and 95.89% detection accuracy on regular and challenging samples respectively, and demonstrates generalizability and robustness. Our code and datasets are available at https://github.com/Shadowlized/ESIDE.

Recent image generation models such as Stable Diffusion have exhibited an impressive ability to generate fairly realistic images starting from a simple text prompt. Could such models render real images obsolete for training image prediction models? In this paper, we answer part of this provocative question by investigating the need for real images when training models for ImageNet classification. Provided only with the class names that have been used to build the dataset, we explore the ability of Stable Diffusion to generate synthetic clones of ImageNet and measure how useful these are for training classification models from scratch. We show that with minimal and class-agnostic prompt engineering, ImageNet clones are able to close a large part of the gap between models produced by synthetic images and models trained with real images, for the several standard classification benchmarks that we consider in this study. More importantly, we show that models trained on synthetic images exhibit strong generalization properties and perform on par with models trained on real data for transfer. Project page: https://europe.naverlabs.com/imagenet-sd/

We present a novel approach to single-view face relighting in the wild. Handling non-diffuse effects, such as global illumination or cast shadows, has long been a challenge in face relighting. Prior work often assumes Lambertian surfaces, simplified lighting models or involves estimating 3D shape, albedo, or a shadow map. This estimation, however, is error-prone and requires many training examples with lighting ground truth to generalize well. Our work bypasses the need for accurate estimation of intrinsic components and can be trained solely on 2D images without any light stage data, multi-view images, or lighting ground truth. Our key idea is to leverage a conditional diffusion implicit model (DDIM) for decoding a disentangled light encoding along with other encodings related to 3D shape and facial identity inferred from off-the-shelf estimators. We also propose a novel conditioning technique that eases the modeling of the complex interaction between light and geometry by using a rendered shading reference to spatially modulate the DDIM. We achieve state-of-the-art performance on standard benchmark Multi-PIE and can photorealistically relight in-the-wild images. Please visit our page: https://diffusion-face-relighting.github.io

Recent advances in generative imagery have brought forth outpainting and inpainting models that can produce high-quality, plausible image content in unknown regions, but the content these models hallucinate is necessarily inauthentic, since the models lack sufficient context about the true scene. In this work, we propose RealFill, a novel generative approach for image completion that fills in missing regions of an image with the content that should have been there. RealFill is a generative inpainting model that is personalized using only a few reference images of a scene. These reference images do not have to be aligned with the target image, and can be taken with drastically varying viewpoints, lighting conditions, camera apertures, or image styles. Once personalized, RealFill is able to complete a target image with visually compelling contents that are faithful to the original scene. We evaluate RealFill on a new image completion benchmark that covers a set of diverse and challenging scenarios, and find that it outperforms existing approaches by a large margin. See more results on our project page: https://realfill.github.io

To synthesize high-fidelity samples, diffusion models typically require auxiliary data to guide the generation process. However, it is impractical to procure the painstaking patch-level annotation effort required in specialized domains like histopathology and satellite imagery; it is often performed by domain experts and involves hundreds of millions of patches. Modern-day self-supervised learning (SSL) representations encode rich semantic and visual information. In this paper, we posit that such representations are expressive enough to act as proxies to fine-grained human labels. We introduce a novel approach that trains diffusion models conditioned on embeddings from SSL. Our diffusion models successfully project these features back to high-quality histopathology and remote sensing images. In addition, we construct larger images by assembling spatially consistent patches inferred from SSL embeddings, preserving long-range dependencies. Augmenting real data by generating variations of real images improves downstream classifier accuracy for patch-level and larger, image-scale classification tasks. Our models are effective even on datasets not encountered during training, demonstrating their robustness and generalizability. Generating images from learned embeddings is agnostic to the source of the embeddings. The SSL embeddings used to generate a large image can either be extracted from a reference image, or sampled from an auxiliary model conditioned on any related modality (e.g. class labels, text, genomic data). As proof of concept, we introduce the text-to-large image synthesis paradigm where we successfully synthesize large pathology and satellite images out of text descriptions.

Vision-Language Models (VLMs) show promise in medical image analysis, yet their capacity for structured reasoning in complex domains like dermatology is often limited by data scarcity and the high computational cost of advanced training techniques. To address these challenges, we introduce DermIQ-VLM, a VLM developed through a multi-stage, resource-efficient methodology designed to emulate a dermatologist's diagnostic process. Our primary contribution is a modified version of Grouped Relative Policy Optimization (GRPO), called GRPO++, which stabilizes the powerful but data-intensive GRPO framework. Our proposed training pipeline first employs GRPO++ for reasoning-oriented disease recognition, followed by supervised fine-tuning for conversational ability. To mitigate factual errors introduced during this step, we then align the model using Direct Preference Optimization (DPO), leveraging a Knowledge Graph-based system as a scalable proxy for expert preference. A preliminary evaluation on a curated dermatological dataset demonstrates that our proposed methodology yields notable performance gains over standard fine-tuning approaches. These findings validate the potential of our pipeline as a feasible pathway for developing specialized, reliable VLMs in resource-constrained environments.

This work summarizes the results of the largest skin image analysis challenge in the world, hosted by the International Skin Imaging Collaboration (ISIC), a global partnership that has organized the world's largest public repository of dermoscopic images of skin. The challenge was hosted in 2018 at the Medical Image Computing and Computer Assisted Intervention (MICCAI) conference in Granada, Spain. The dataset included over 12,500 images across 3 tasks. 900 users registered for data download, 115 submitted to the lesion segmentation task, 25 submitted to the lesion attribute detection task, and 159 submitted to the disease classification task. Novel evaluation protocols were established, including a new test for segmentation algorithm performance, and a test for algorithm ability to generalize. Results show that top segmentation algorithms still fail on over 10% of images on average, and algorithms with equal performance on test data can have different abilities to generalize. This is an important consideration for agencies regulating the growing set of machine learning tools in the healthcare domain, and sets a new standard for future public challenges in healthcare.

Creating high-quality and realistic images is now possible thanks to the impressive advancements in image generation. A description in natural language of your desired output is all you need to obtain breathtaking results. However, as the use of generative models grows, so do concerns about the propagation of malicious content and misinformation. Consequently, the research community is actively working on the development of novel fake detection techniques, primarily focusing on low-level features and possible fingerprints left by generative models during the image generation process. In a different vein, in our work, we leverage human semantic knowledge to investigate the possibility of being included in frameworks of fake image detection. To achieve this, we collect a novel dataset of partially manipulated images using diffusion models and conduct an eye-tracking experiment to record the eye movements of different observers while viewing real and fake stimuli. A preliminary statistical analysis is conducted to explore the distinctive patterns in how humans perceive genuine and altered images. Statistical findings reveal that, when perceiving counterfeit samples, humans tend to focus on more confined regions of the image, in contrast to the more dispersed observational pattern observed when viewing genuine images. Our dataset is publicly available at: https://github.com/aimagelab/unveiling-the-truth.

One of the key impediments for developing and assessing robust medical imaging algorithms is limited access to large-scale datasets with suitable annotations. Synthetic data generated with plausible physical and biological constraints may address some of these data limitations. We propose the use of physics simulations to generate synthetic images with pixel-level segmentation annotations, which are notoriously difficult to obtain. Specifically, we apply this approach to breast imaging analysis and release T-SYNTH, a large-scale open-source dataset of paired 2D digital mammography (DM) and 3D digital breast tomosynthesis (DBT) images. Our initial experimental results indicate that T-SYNTH images show promise for augmenting limited real patient datasets for detection tasks in DM and DBT. Our data and code are publicly available at https://github.com/DIDSR/tsynth-release.

Benchmark datasets in computer vision often contain off-topic images, near duplicates, and label errors, leading to inaccurate estimates of model performance. In this paper, we revisit the task of data cleaning and formalize it as either a ranking problem, which significantly reduces human inspection effort, or a scoring problem, which allows for automated decisions based on score distributions. We find that a specific combination of context-aware self-supervised representation learning and distance-based indicators is effective in finding issues without annotation biases. This methodology, which we call SelfClean, surpasses state-of-the-art performance in detecting off-topic images, near duplicates, and label errors within widely-used image datasets, such as ImageNet-1k, Food-101N, and STL-10, both for synthetic issues and real contamination. We apply the detailed method to multiple image benchmarks, identify up to 16% of issues, and confirm an improvement in evaluation reliability upon cleaning. The official implementation can be found at: https://github.com/Digital-Dermatology/SelfClean.

Achieving robust performance and fairness across diverse patient populations remains a challenge in developing clinically deployable deep learning models for diagnostic imaging. Synthetic data generation has emerged as a promising strategy to address limitations in dataset scale and diversity. We introduce RoentGen-v2, a text-to-image diffusion model for chest radiographs that enables fine-grained control over both radiographic findings and patient demographic attributes, including sex, age, and race/ethnicity. RoentGen-v2 is the first model to generate clinically plausible images with demographic conditioning, facilitating the creation of a large, demographically balanced synthetic dataset comprising over 565,000 images. We use this large synthetic dataset to evaluate optimal training pipelines for downstream disease classification models. In contrast to prior work that combines real and synthetic data naively, we propose an improved training strategy that leverages synthetic data for supervised pretraining, followed by fine-tuning on real data. Through extensive evaluation on over 137,000 chest radiographs from five institutions, we demonstrate that synthetic pretraining consistently improves model performance, generalization to out-of-distribution settings, and fairness across demographic subgroups. Across datasets, synthetic pretraining led to a 6.5% accuracy increase in the performance of downstream classification models, compared to a modest 2.7% increase when naively combining real and synthetic data. We observe this performance improvement simultaneously with the reduction of the underdiagnosis fairness gap by 19.3%. These results highlight the potential of synthetic imaging to advance equitable and generalizable medical deep learning under real-world data constraints. We open source our code, trained models, and synthetic dataset at https://github.com/StanfordMIMI/RoentGen-v2 .

Detecting fake images is becoming a major goal of computer vision. This need is becoming more and more pressing with the continuous improvement of synthesis methods based on Generative Adversarial Networks (GAN), and even more with the appearance of powerful methods based on Diffusion Models (DM). Towards this end, it is important to gain insight into which image features better discriminate fake images from real ones. In this paper we report on our systematic study of a large number of image generators of different families, aimed at discovering the most forensically relevant characteristics of real and generated images. Our experiments provide a number of interesting observations and shed light on some intriguing properties of synthetic images: (1) not only the GAN models but also the DM and VQ-GAN (Vector Quantized Generative Adversarial Networks) models give rise to visible artifacts in the Fourier domain and exhibit anomalous regular patterns in the autocorrelation; (2) when the dataset used to train the model lacks sufficient variety, its biases can be transferred to the generated images; (3) synthetic and real images exhibit significant differences in the mid-high frequency signal content, observable in their radial and angular spectral power distributions.

Multimodal models trained on large natural image-text pair datasets have exhibited astounding abilities in generating high-quality images. Medical imaging data is fundamentally different to natural images, and the language used to succinctly capture relevant details in medical data uses a different, narrow but semantically rich, domain-specific vocabulary. Not surprisingly, multi-modal models trained on natural image-text pairs do not tend to generalize well to the medical domain. Developing generative imaging models faithfully representing medical concepts while providing compositional diversity could mitigate the existing paucity of high-quality, annotated medical imaging datasets. In this work, we develop a strategy to overcome the large natural-medical distributional shift by adapting a pre-trained latent diffusion model on a corpus of publicly available chest x-rays (CXR) and their corresponding radiology (text) reports. We investigate the model's ability to generate high-fidelity, diverse synthetic CXR conditioned on text prompts. We assess the model outputs quantitatively using image quality metrics, and evaluate image quality and text-image alignment by human domain experts. We present evidence that the resulting model (RoentGen) is able to create visually convincing, diverse synthetic CXR images, and that the output can be controlled to a new extent by using free-form text prompts including radiology-specific language. Fine-tuning this model on a fixed training set and using it as a data augmentation method, we measure a 5% improvement of a classifier trained jointly on synthetic and real images, and a 3% improvement when trained on a larger but purely synthetic training set. Finally, we observe that this fine-tuning distills in-domain knowledge in the text-encoder and can improve its representation capabilities of certain diseases like pneumothorax by 25%.

The lack of labeled datasets in 3D vision for surgical scenes inhibits the development of robust 3D reconstruction algorithms in the medical domain. Despite the popularity of Neural Radiance Fields and 3D Gaussian Splatting in the general computer vision community, these systems have yet to find consistent success in surgical scenes due to challenges such as non-stationary lighting and non-Lambertian surfaces. As a result, the need for labeled surgical datasets continues to grow. In this work, we introduce a differentiable rendering framework for material and lighting estimation from endoscopic images and known geometry. Compared to previous approaches that model lighting and material jointly as radiance, we explicitly disentangle these scene properties for robust and photorealistic novel view synthesis. To disambiguate the training process, we formulate domain-specific properties inherent in surgical scenes. Specifically, we model the scene lighting as a simple spotlight and material properties as a bidirectional reflectance distribution function, parameterized by a neural network. By grounding color predictions in the rendering equation, we can generate photorealistic images at arbitrary camera poses. We evaluate our method with various sequences from the Colonoscopy 3D Video Dataset and show that our method produces competitive novel view synthesis results compared with other approaches. Furthermore, we demonstrate that synthetic data can be used to develop 3D vision algorithms by finetuning a depth estimation model with our rendered outputs. Overall, we see that the depth estimation performance is on par with fine-tuning with the original real images.

Recent technological advances in synthetic data have enabled the generation of images with such high quality that human beings cannot tell the difference between real-life photographs and Artificial Intelligence (AI) generated images. Given the critical necessity of data reliability and authentication, this article proposes to enhance our ability to recognise AI-generated images through computer vision. Initially, a synthetic dataset is generated that mirrors the ten classes of the already available CIFAR-10 dataset with latent diffusion which provides a contrasting set of images for comparison to real photographs. The model is capable of generating complex visual attributes, such as photorealistic reflections in water. The two sets of data present as a binary classification problem with regard to whether the photograph is real or generated by AI. This study then proposes the use of a Convolutional Neural Network (CNN) to classify the images into two categories; Real or Fake. Following hyperparameter tuning and the training of 36 individual network topologies, the optimal approach could correctly classify the images with 92.98% accuracy. Finally, this study implements explainable AI via Gradient Class Activation Mapping to explore which features within the images are useful for classification. Interpretation reveals interesting concepts within the image, in particular, noting that the actual entity itself does not hold useful information for classification; instead, the model focuses on small visual imperfections in the background of the images. The complete dataset engineered for this study, referred to as the CIFAKE dataset, is made publicly available to the research community for future work.

Diffusion models have shown remarkable success in visual synthesis, but have also raised concerns about potential abuse for malicious purposes. In this paper, we seek to build a detector for telling apart real images from diffusion-generated images. We find that existing detectors struggle to detect images generated by diffusion models, even if we include generated images from a specific diffusion model in their training data. To address this issue, we propose a novel image representation called DIffusion Reconstruction Error (DIRE), which measures the error between an input image and its reconstruction counterpart by a pre-trained diffusion model. We observe that diffusion-generated images can be approximately reconstructed by a diffusion model while real images cannot. It provides a hint that DIRE can serve as a bridge to distinguish generated and real images. DIRE provides an effective way to detect images generated by most diffusion models, and it is general for detecting generated images from unseen diffusion models and robust to various perturbations. Furthermore, we establish a comprehensive diffusion-generated benchmark including images generated by eight diffusion models to evaluate the performance of diffusion-generated image detectors. Extensive experiments on our collected benchmark demonstrate that DIRE exhibits superiority over previous generated-image detectors. The code and dataset are available at https://github.com/ZhendongWang6/DIRE.

Skin cancer is a widespread, global, and potentially deadly disease, which over the last three decades has afflicted more lives in the USA than all other forms of cancer combined. There have been a lot of promising recent works utilizing deep network architectures, such as FCNs, U-Nets, and ResNets, for developing automated skin lesion segmentation. This paper investigates various pre- and post-processing techniques for improving the performance of U-Nets as measured by the Jaccard Index. The dataset provided as part of the "2017 ISBI Challenges on Skin Lesion Analysis Towards Melanoma Detection" was used for this evaluation and the performance of the finalist competitors was the standard for comparison. The pre-processing techniques employed in the proposed system included contrast enhancement, artifact removal, and vignette correction. More advanced image transformations, such as local binary patterns and wavelet decomposition, were also employed to augment the raw grayscale images used as network input features. While the performance of the proposed system fell short of the winners of the challenge, it was determined that using wavelet decomposition as an early transformation step improved the overall performance of the system over pre- and post-processing steps alone.

Continuum robots are advancing bronchoscopy procedures by accessing complex lung airways and enabling targeted interventions. However, their development is limited by the lack of realistic training and test environments: Real data is difficult to collect due to ethical constraints and patient safety concerns, and developing autonomy algorithms requires realistic imaging and physical feedback. We present ROOM (Realistic Optical Observation in Medicine), a comprehensive simulation framework designed for generating photorealistic bronchoscopy training data. By leveraging patient CT scans, our pipeline renders multi-modal sensor data including RGB images with realistic noise and light specularities, metric depth maps, surface normals, optical flow and point clouds at medically relevant scales. We validate the data generated by ROOM in two canonical tasks for medical robotics -- multi-view pose estimation and monocular depth estimation, demonstrating diverse challenges that state-of-the-art methods must overcome to transfer to these medical settings. Furthermore, we show that the data produced by ROOM can be used to fine-tune existing depth estimation models to overcome these challenges, also enabling other downstream applications such as navigation. We expect that ROOM will enable large-scale data generation across diverse patient anatomies and procedural scenarios that are challenging to capture in clinical settings. Code and data: https://github.com/iamsalvatore/room.

Critical retained foreign objects (RFOs), including surgical instruments like sponges and needles, pose serious patient safety risks and carry significant financial and legal implications for healthcare institutions. Detecting critical RFOs using artificial intelligence remains challenging due to their rarity and the limited availability of chest X-ray datasets that specifically feature critical RFOs cases. Existing datasets only contain non-critical RFOs, like necklace or zipper, further limiting their utility for developing clinically impactful detection algorithms. To address these limitations, we introduce "Hopkins RFOs Bench", the first and largest dataset of its kind, containing 144 chest X-ray images of critical RFO cases collected over 18 years from the Johns Hopkins Health System. Using this dataset, we benchmark several state-of-the-art object detection models, highlighting the need for enhanced detection methodologies for critical RFO cases. Recognizing data scarcity challenges, we further explore image synthetic methods to bridge this gap. We evaluate two advanced synthetic image methods, DeepDRR-RFO, a physics-based method, and RoentGen-RFO, a diffusion-based method, for creating realistic radiographs featuring critical RFOs. Our comprehensive analysis identifies the strengths and limitations of each synthetic method, providing insights into effectively utilizing synthetic data to enhance model training. The Hopkins RFOs Bench and our findings significantly advance the development of reliable, generalizable AI-driven solutions for detecting critical RFOs in clinical chest X-rays.

Medical image segmentation exhibits intra- and inter-annotator variability due to ambiguous object boundaries, annotator preferences, expertise, and tools, among other factors. Lesions with ambiguous boundaries, e.g., spiculated or infiltrative nodules, or irregular borders per the ABCD rule, are particularly prone to disagreement and are often associated with malignancy. In this work, we curate IMA++, the largest multi-annotator skin lesion segmentation dataset, on which we conduct an in-depth study of variability due to annotator, malignancy, tool, and skill factors. We find a statistically significant (p<0.001) association between inter-annotator agreement (IAA), measured using Dice, and the malignancy of skin lesions. We further show that IAA can be accurately predicted directly from dermoscopic images, achieving a mean absolute error of 0.108. Finally, we leverage this association by utilizing IAA as a "soft" clinical feature within a multi-task learning objective, yielding a 4.2% improvement in balanced accuracy averaged across multiple model architectures and across IMA++ and four public dermoscopic datasets. The code is available at https://github.com/sfu-mial/skin-IAV.

Real-image super-resolution (Real-ISR) seeks to recover HR images from LR inputs with mixed, unknown degradations. While diffusion models surpass GANs in perceptual quality, they under-reconstruct high-frequency (HF) details due to a low-frequency (LF) bias and a depth-wise "low-first, high-later" hierarchy. We introduce FRAMER, a plug-and-play training scheme that exploits diffusion priors without changing the backbone or inference. At each denoising step, the final-layer feature map teaches all intermediate layers. Teacher and student feature maps are decomposed into LF/HF bands via FFT masks to align supervision with the model's internal frequency hierarchy. For LF, an Intra Contrastive Loss (IntraCL) stabilizes globally shared structure. For HF, an Inter Contrastive Loss (InterCL) sharpens instance-specific details using random-layer and in-batch negatives. Two adaptive modulators, Frequency-based Adaptive Weight (FAW) and Frequency-based Alignment Modulation (FAM), reweight per-layer LF/HF signals and gate distillation by current similarity. Across U-Net and DiT backbones (e.g., Stable Diffusion 2, 3), FRAMER consistently improves PSNR/SSIM and perceptual metrics (LPIPS, NIQE, MANIQA, MUSIQ). Ablations validate the final-layer teacher and random-layer negatives.

Scalp disorders are highly prevalent worldwide, yet remain underdiagnosed due to limited access to expert evaluation and the high cost of annotation. Although AI-based approaches hold great promise, their practical deployment is hindered by challenges such as severe data imbalance and the absence of pixel-level segmentation labels. To address these issues, we propose ScalpVision, an AI-driven system for the holistic diagnosis of scalp diseases. In ScalpVision, effective hair segmentation is achieved using pseudo image-label pairs and an innovative prompting method in the absence of traditional hair masking labels. Additionally, ScalpVision introduces DiffuseIT-M, a generative model adopted for dataset augmentation while maintaining hair information, facilitating improved predictions of scalp disease severity. Our experimental results affirm ScalpVision's efficiency in diagnosing a variety of scalp conditions, showcasing its potential as a valuable tool in dermatological care. Our code is available at https://github.com/winston1214/ScalpVision.

Real-world image super-resolution is a critical image processing task, where two key evaluation criteria are the fidelity to the original image and the visual realness of the generated results. Although existing methods based on diffusion models excel in visual realness by leveraging strong priors, they often struggle to achieve an effective balance between fidelity and realness. In our preliminary experiments, we observe that a linear combination of multiple models outperforms individual models, motivating us to harness the strengths of different models for a more effective trade-off. Based on this insight, we propose a distillation-based approach that leverages the geometric decomposition of both fidelity and realness, alongside the performance advantages of multiple teacher models, to strike a more balanced trade-off. Furthermore, we explore the controllability of this trade-off, enabling a flexible and adjustable super-resolution process, which we call CTSR (Controllable Trade-off Super-Resolution). Experiments conducted on several real-world image super-resolution benchmarks demonstrate that our method surpasses existing state-of-the-art approaches, achieving superior performance across both fidelity and realness metrics.

Generating realistic synthetic microscopy images is critical for training deep learning models in label-scarce environments, such as cell counting with many cells per image. However, traditional domain adaptation methods often struggle to bridge the domain gap when synthetic images lack the complex textures and visual patterns of real samples. In this work, we adapt the Inversion-Based Style Transfer (InST) framework originally designed for artistic style transfer to biomedical microscopy images. Our method combines latent-space Adaptive Instance Normalization with stochastic inversion in a diffusion model to transfer the style from real fluorescence microscopy images to synthetic ones, while weakly preserving content structure. We evaluate the effectiveness of our InST-based synthetic dataset for downstream cell counting by pre-training and fine-tuning EfficientNet-B0 models on various data sources, including real data, hard-coded synthetic data, and the public Cell200-s dataset. Models trained with our InST-synthesized images achieve up to 37\% lower Mean Absolute Error (MAE) compared to models trained on hard-coded synthetic data, and a 52\% reduction in MAE compared to models trained on Cell200-s (from 53.70 to 25.95 MAE). Notably, our approach also outperforms models trained on real data alone (25.95 vs. 27.74 MAE). Further improvements are achieved when combining InST-synthesized data with lightweight domain adaptation techniques such as DACS with CutMix. These findings demonstrate that InST-based style transfer most effectively reduces the domain gap between synthetic and real microscopy data. Our approach offers a scalable path for enhancing cell counting performance while minimizing manual labeling effort. The source code and resources are publicly available at: https://github.com/MohammadDehghan/InST-Microscopy.

The steady improvement of Diffusion Models for visual synthesis has given rise to many new and interesting use cases of synthetic images but also has raised concerns about their potential abuse, which poses significant societal threats. To address this, fake images need to be detected and attributed to their source model, and given the frequent release of new generators, realistic applications need to consider an Open-Set scenario where some models are unseen at training time. Existing forensic techniques are either limited to Closed-Set settings or to GAN-generated images, relying on fragile frequency-based "fingerprint" features. By contrast, we propose a simple yet effective framework that incorporates features from large pre-trained foundation models to perform Open-Set origin attribution of synthetic images produced by various generative models, including Diffusion Models. We show that our method leads to remarkable attribution performance, even in the low-data regime, exceeding the performance of existing methods and generalizes better on images obtained from a diverse set of architectures. We make the code publicly available at: https://github.com/ciodar/UniversalAttribution.

In this paper, we address a key scientific problem in machine learning: Given a training set for an image classification task, can we train a generative model on this dataset to enhance the classification performance? (i.e., closed-set generative data augmentation). We start by exploring the distinctions and similarities between real images and closed-set synthetic images generated by advanced generative models. Through extensive experiments, we offer systematic insights into the effective use of closed-set synthetic data for augmentation. Notably, we empirically determine the equivalent scale of synthetic images needed for augmentation. In addition, we also show quantitative equivalence between the real data augmentation and open-set generative augmentation (generative models trained using data beyond the given training set). While it aligns with the common intuition that real images are generally preferred, our empirical formulation also offers a guideline to quantify the increased scale of synthetic data augmentation required to achieve comparable image classification performance. Our results on natural and medical image datasets further illustrate how this effect varies with the baseline training set size and the amount of synthetic data incorporated.

Nailfold capillaroscopy is a well-established method for assessing health conditions, but the untapped potential of automated medical image analysis using machine learning remains despite recent advancements. In this groundbreaking study, we present a pioneering effort in constructing a comprehensive dataset-321 images, 219 videos, 68 clinic reports, with expert annotations-that serves as a crucial resource for training deep-learning models. Leveraging this dataset, we propose an end-to-end nailfold capillary analysis pipeline capable of automatically detecting and measuring diverse morphological and dynamic features. Experimental results demonstrate sub-pixel measurement accuracy and 90% accuracy in predicting abnormality portions, highlighting its potential for advancing quantitative medical research and enabling pervasive computing in healthcare. We've shared our open-source codes and data (available at https://github.com/THU-CS-PI-LAB/ANFC-Automated-Nailfold-Capillary) to contribute to transformative progress in computational medical image analysis.

With the advent of smartphone indirect ophthalmoscopy, teleophthalmology - the use of specialist ophthalmology assets at a distance from the patient - has experienced a breakthrough, promising enormous benefits especially for healthcare in distant, inaccessible or opthalmologically underserved areas, where specialists are either unavailable or too few in number. However, accurate teleophthalmology requires high-quality ophthalmoscopic imagery. This paper considers three feature families - statistical metrics, gradient-based metrics and wavelet transform coefficient derived indicators - as possible metrics to identify unsharp or blurry images. By using standard machine learning techniques, the suitability of these features for image quality assessment is confirmed, albeit on a rather small data set. With the increased availability and decreasing cost of digital ophthalmoscopy on one hand and the increased prevalence of diabetic retinopathy worldwide on the other, creating tools that can determine whether an image is likely to be diagnostically suitable can play a significant role in accelerating and streamlining the teleophthalmology process. This paper highlights the need for more research in this area, including the compilation of a diverse database of ophthalmoscopic imagery, annotated with quality markers, to train the Point of Acquisition error detection algorithms of the future.

Synthetic Data Generation (SDG) based on Artificial Intelligence (AI) can transform the way clinical medicine is delivered by overcoming privacy barriers that currently render clinical data sharing difficult. This is the key to accelerating the development of digital tools contributing to enhanced patient safety. Such tools include robust data-driven clinical decision support systems, and example-based digital training tools that will enable healthcare professionals to improve their diagnostic performance for enhanced patient safety. This study focuses on the clinical evaluation of medical SDG, with a proof-of-concept investigation on diagnosing Inflammatory Bowel Disease (IBD) using Wireless Capsule Endoscopy (WCE) images. Its scientific contributions include a) a novel protocol for the systematic Clinical Evaluation of Medical Image Synthesis (CEMIS); b) a novel variational autoencoder-based model for the generation of high-resolution synthetic WCE images; and c) a comprehensive evaluation of the synthetic images using the CEMIS protocol by 10 international WCE specialists, in terms of image quality, diversity, and realism, as well as their utility for clinical decision-making. The results show that TIDE-II generates clinically plausible, very realistic WCE images, of improved quality compared to relevant state-of-the-art generative models. Concludingly, CEMIS can serve as a reference for future research on medical image-generation techniques, while the adaptation/extension of the architecture of TIDE-II to other imaging domains can be promising.

Purpose: Medical imaging has become increasingly important in diagnosing and treating oncological patients, particularly in radiotherapy. Recent advances in synthetic computed tomography (sCT) generation have increased interest in public challenges to provide data and evaluation metrics for comparing different approaches openly. This paper describes a dataset of brain and pelvis computed tomography (CT) images with rigidly registered CBCT and MRI images to facilitate the development and evaluation of sCT generation for radiotherapy planning. Acquisition and validation methods: The dataset consists of CT, CBCT, and MRI of 540 brains and 540 pelvic radiotherapy patients from three Dutch university medical centers. Subjects' ages ranged from 3 to 93 years, with a mean age of 60. Various scanner models and acquisition settings were used across patients from the three data-providing centers. Details are available in CSV files provided with the datasets. Data format and usage notes: The data is available on Zenodo (https://doi.org/10.5281/zenodo.7260705) under the SynthRAD2023 collection. The images for each subject are available in nifti format. Potential applications: This dataset will enable the evaluation and development of image synthesis algorithms for radiotherapy purposes on a realistic multi-center dataset with varying acquisition protocols. Synthetic CT generation has numerous applications in radiation therapy, including diagnosis, treatment planning, treatment monitoring, and surgical planning.

Synthetic medical data offers a scalable solution for training robust models, but significant domain gaps limit its generalizability to real-world clinical settings. This paper addresses the challenge of cross-domain translation between synthetic and real X-ray images of the head, focusing on bridging discrepancies in attenuation behavior, noise characteristics, and soft tissue representation. We propose MedShift, a unified class-conditional generative model based on Flow Matching and Schrodinger Bridges, which enables high-fidelity, unpaired image translation across multiple domains. Unlike prior approaches that require domain-specific training or rely on paired data, MedShift learns a shared domain-agnostic latent space and supports seamless translation between any pair of domains seen during training. We introduce X-DigiSkull, a new dataset comprising aligned synthetic and real skull X-rays under varying radiation doses, to benchmark domain translation models. Experimental results demonstrate that, despite its smaller model size compared to diffusion-based approaches, MedShift offers strong performance and remains flexible at inference time, as it can be tuned to prioritize either perceptual fidelity or structural consistency, making it a scalable and generalizable solution for domain adaptation in medical imaging. The code and dataset are available at https://caetas.github.io/medshift.html

Chest X-rays (CXR) are the most common medical imaging study and are used to diagnose multiple medical conditions. This study examines the impact of synthetic data supplementation, using diffusion models, on the performance of deep learning (DL) classifiers for CXR analysis. We employed three datasets: CheXpert, MIMIC-CXR, and Emory Chest X-ray, training conditional denoising diffusion probabilistic models (DDPMs) to generate synthetic frontal radiographs. Our approach ensured that synthetic images mirrored the demographic and pathological traits of the original data. Evaluating the classifiers' performance on internal and external datasets revealed that synthetic data supplementation enhances model accuracy, particularly in detecting less prevalent pathologies. Furthermore, models trained on synthetic data alone approached the performance of those trained on real data. This suggests that synthetic data can potentially compensate for real data shortages in training robust DL models. However, despite promising outcomes, the superiority of real data persists.

The recently developed and publicly available synthetic image generation methods and services make it possible to create extremely realistic imagery on demand, raising great risks for the integrity and safety of online information. State-of-the-art Synthetic Image Detection (SID) research has led to strong evidence on the advantages of feature extraction from foundation models. However, such extracted features mostly encapsulate high-level visual semantics instead of fine-grained details, which are more important for the SID task. On the contrary, shallow layers encode low-level visual information. In this work, we leverage the image representations extracted by intermediate Transformer blocks of CLIP's image-encoder via a lightweight network that maps them to a learnable forgery-aware vector space capable of generalizing exceptionally well. We also employ a trainable module to incorporate the importance of each Transformer block to the final prediction. Our method is compared against the state-of-the-art by evaluating it on 20 test datasets and exhibits an average +10.6% absolute performance improvement. Notably, the best performing models require just a single epoch for training (~8 minutes). Code available at https://github.com/mever-team/rine.

During their formative years, radiology trainees are required to interpret hundreds of mammograms per month, with the objective of becoming apt at discerning the subtle patterns differentiating benign from malignant lesions. Unfortunately, medico-legal and technical hurdles make it difficult to access and query medical images for training. In this paper we train a generative adversarial network (GAN) to synthesize 512 x 512 high-resolution mammograms. The resulting model leads to the unsupervised separation of high-level features (e.g. the standard mammography views and the nature of the breast lesions), with stochastic variation in the generated images (e.g. breast adipose tissue, calcification), enabling user-controlled global and local attribute-editing of the synthesized images. We demonstrate the model's ability to generate anatomically and medically relevant mammograms by achieving an average AUC of 0.54 in a double-blind study on four expert mammography radiologists to distinguish between generated and real images, ascribing to the high visual quality of the synthesized and edited mammograms, and to their potential use in advancing and facilitating medical education.

Biomedical datasets are often constrained by stringent privacy requirements and frequently suffer from severe class imbalance. These two aspects hinder the development of accurate machine learning models. While generative AI offers a promising solution, producing synthetic images of sufficient quality for training robust classifiers remains challenging. This work addresses the classification of individual white blood cells, a critical task in diagnosing hematological malignancies such as acute myeloid leukemia (AML). We introduce CytoDiff, a stable diffusion model fine-tuned with LoRA weights and guided by few-shot samples that generates high-fidelity synthetic white blood cell images. Our approach demonstrates substantial improvements in classifier performance when training data is limited. Using a small, highly imbalanced real dataset, the addition of 5,000 synthetic images per class improved ResNet classifier accuracy from 27\% to 78\% (+51\%). Similarly, CLIP-based classification accuracy increased from 62\% to 77\% (+15\%). These results establish synthetic image generation as a valuable tool for biomedical machine learning, enhancing data coverage and facilitating secure data sharing while preserving patient privacy. Paper code is publicly available at https://github.com/JanCarreras24/CytoDiff.

Diffusion models have revolutionized image generation, yet several challenges restrict their application to large-image domains, such as digital pathology and satellite imagery. Given that it is infeasible to directly train a model on 'whole' images from domains with potential gigapixel sizes, diffusion-based generative methods have focused on synthesizing small, fixed-size patches extracted from these images. However, generating small patches has limited applicability since patch-based models fail to capture the global structures and wider context of large images, which can be crucial for synthesizing (semantically) accurate samples. To overcome this limitation, we present ZoomLDM, a diffusion model tailored for generating images across multiple scales. Central to our approach is a novel magnification-aware conditioning mechanism that utilizes self-supervised learning (SSL) embeddings and allows the diffusion model to synthesize images at different 'zoom' levels, i.e., fixed-size patches extracted from large images at varying scales. ZoomLDM synthesizes coherent histopathology images that remain contextually accurate and detailed at different zoom levels, achieving state-of-the-art image generation quality across all scales and excelling in the data-scarce setting of generating thumbnails of entire large images. The multi-scale nature of ZoomLDM unlocks additional capabilities in large image generation, enabling computationally tractable and globally coherent image synthesis up to 4096 times 4096 pixels and 4times super-resolution. Additionally, multi-scale features extracted from ZoomLDM are highly effective in multiple instance learning experiments.

The applicability of current lesion segmentation models for chest X-rays (CXRs) has been limited both by a small number of target labels and the reliance on long, detailed expert-level text inputs, creating a barrier to practical use. To address these limitations, we introduce a new paradigm: instruction-guided lesion segmentation (ILS), which is designed to segment diverse lesion types based on simple, user-friendly instructions. Under this paradigm, we construct MIMIC-ILS, the first large-scale instruction-answer dataset for CXR lesion segmentation, using our fully automated multimodal pipeline that generates annotations from chest X-ray images and their corresponding reports. MIMIC-ILS contains 1.1M instruction-answer pairs derived from 192K images and 91K unique segmentation masks, covering seven major lesion types. To empirically demonstrate its utility, we introduce ROSALIA, a vision-language model fine-tuned on MIMIC-ILS. ROSALIA can segment diverse lesions and provide textual explanations in response to user instructions. The model achieves high segmentation and textual accuracy in our newly proposed task, highlighting the effectiveness of our pipeline and the value of MIMIC-ILS as a foundational resource for pixel-level CXR lesion grounding.

X-ray images play a vital role in the intraoperative processes due to their high resolution and fast imaging speed and greatly promote the subsequent segmentation, registration and reconstruction. However, over-dosed X-rays superimpose potential risks to human health to some extent. Data-driven algorithms from volume scans to X-ray images are restricted by the scarcity of paired X-ray and volume data. Existing methods are mainly realized by modelling the whole X-ray imaging procedure. In this study, we propose a learning-based approach termed CT2X-GAN to synthesize the X-ray images in an end-to-end manner using the content and style disentanglement from three different image domains. Our method decouples the anatomical structure information from CT scans and style information from unpaired real X-ray images/ digital reconstructed radiography (DRR) images via a series of decoupling encoders. Additionally, we introduce a novel consistency regularization term to improve the stylistic resemblance between synthesized X-ray images and real X-ray images. Meanwhile, we also impose a supervised process by computing the similarity of computed real DRR and synthesized DRR images. We further develop a pose attention module to fully strengthen the comprehensive information in the decoupled content code from CT scans, facilitating high-quality multi-view image synthesis in the lower 2D space. Extensive experiments were conducted on the publicly available CTSpine1K dataset and achieved 97.8350, 0.0842 and 3.0938 in terms of FID, KID and defined user-scored X-ray similarity, respectively. In comparison with 3D-aware methods (pi-GAN, EG3D), CT2X-GAN is superior in improving the synthesis quality and realistic to the real X-ray images.

Optical coherence tomography (OCT) is a non-invasive imaging modality which is widely used in clinical ophthalmology. OCT images are capable of visualizing deep retinal layers which is crucial for early diagnosis of retinal diseases. In this paper, we describe a comprehensive open-access database containing more than 500 highresolution images categorized into different pathological conditions. The image classes include Normal (NO), Macular Hole (MH), Age-related Macular Degeneration (AMD), Central Serous Retinopathy (CSR), and Diabetic Retinopathy (DR). The images were obtained from a raster scan protocol with a 2mm scan length and 512x1024 pixel resolution. We have also included 25 normal OCT images with their corresponding ground truth delineations which can be used for an accurate evaluation of OCT image segmentation. In addition, we have provided a user-friendly GUI which can be used by clinicians for manual (and semi-automated) segmentation.

Medical imaging is essential in modern radiotherapy, supporting diagnosis, treatment planning, and monitoring. Synthetic imaging, particularly synthetic computed tomography (sCT), is gaining traction in radiotherapy. The SynthRAD2025 dataset and Grand Challenge promote advancements in sCT generation by providing a benchmarking platform for algorithms using cone-beam CT (CBCT) and magnetic resonance imaging (MRI). The dataset includes 2362 cases: 890 MRI-CT and 1472 CBCT-CT pairs from head-and-neck, thoracic, and abdominal cancer patients treated at five European university medical centers (UMC Groningen, UMC Utrecht, Radboud UMC, LMU University Hospital Munich, and University Hospital of Cologne). Data were acquired with diverse scanners and protocols. Pre-processing, including rigid and deformable image registration, ensures high-quality, modality-aligned images. Extensive quality assurance validates image consistency and usability. All imaging data is provided in MetaImage (.mha) format, ensuring compatibility with medical image processing tools. Metadata, including acquisition parameters and registration details, is available in structured CSV files. To maintain dataset integrity, SynthRAD2025 is divided into training (65%), validation (10%), and test (25%) sets. The dataset is accessible at https://doi.org/10.5281/zenodo.14918089 under the SynthRAD2025 collection. This dataset supports benchmarking and the development of synthetic imaging techniques for radiotherapy applications. Use cases include sCT generation for MRI-only and MR-guided photon/proton therapy, CBCT-based dose calculations, and adaptive radiotherapy workflows. By integrating diverse acquisition settings, SynthRAD2025 fosters robust, generalizable image synthesis algorithms, advancing personalized cancer care and adaptive radiotherapy.

Replacing the background and simultaneously adjusting foreground objects is a challenging task in image editing. Current techniques for generating such images relies heavily on user interactions with image editing softwares, which is a tedious job for professional retouchers. To reduce their workload, some exciting progress has been made on generating images with a given background. However, these models can neither adjust the position and scale of the foreground objects, nor guarantee the semantic consistency between foreground and background. To overcome these limitations, we propose a framework -- ART(Auto-Retoucher), to generate images with sufficient semantic and spatial consistency. Images are first processed by semantic matting and scene parsing modules, then a multi-task verifier model will give two confidence scores for the current background and position setting. We demonstrate that our jointly optimized verifier model successfully improves the visual consistency, and our ART framework performs well on images with the human body as foregrounds.

Deep neural networks can generate images that are astonishingly realistic, so much so that it is often hard for humans to distinguish them from actual photos. These achievements have been largely made possible by Generative Adversarial Networks (GANs). While deep fake images have been thoroughly investigated in the image domain - a classical approach from the area of image forensics - an analysis in the frequency domain has been missing so far. In this paper, we address this shortcoming and our results reveal that in frequency space, GAN-generated images exhibit severe artifacts that can be easily identified. We perform a comprehensive analysis, showing that these artifacts are consistent across different neural network architectures, data sets, and resolutions. In a further investigation, we demonstrate that these artifacts are caused by upsampling operations found in all current GAN architectures, indicating a structural and fundamental problem in the way images are generated via GANs. Based on this analysis, we demonstrate how the frequency representation can be used to identify deep fake images in an automated way, surpassing state-of-the-art methods.

Confocal fluorescence microscopy is one of the most accessible and widely used imaging techniques for the study of biological processes. Scanning confocal microscopy allows the capture of high-quality images from 3D samples, yet suffers from well-known limitations such as photobleaching and phototoxicity of specimens caused by intense light exposure, which limits its use in some applications, especially for living cells. Cellular damage can be alleviated by changing imaging parameters to reduce light exposure, often at the expense of image quality. Machine/deep learning methods for single-image super-resolution (SISR) can be applied to restore image quality by upscaling lower-resolution (LR) images to produce high-resolution images (HR). These SISR methods have been successfully applied to photo-realistic images due partly to the abundance of publicly available data. In contrast, the lack of publicly available data partly limits their application and success in scanning confocal microscopy. In this paper, we introduce a large scanning confocal microscopy dataset named SR-CACO-2 that is comprised of low- and high-resolution image pairs marked for three different fluorescent markers. It allows the evaluation of performance of SISR methods on three different upscaling levels (X2, X4, X8). SR-CACO-2 contains the human epithelial cell line Caco-2 (ATCC HTB-37), and it is composed of 22 tiles that have been translated in the form of 9,937 image patches for experiments with SISR methods. Given the new SR-CACO-2 dataset, we also provide benchmarking results for 15 state-of-the-art methods that are representative of the main SISR families. Results show that these methods have limited success in producing high-resolution textures, indicating that SR-CACO-2 represents a challenging problem. Our dataset, code and pretrained weights are available: https://github.com/sbelharbi/sr-caco-2.

Most recent real-world image super-resolution (Real-ISR) methods employ pre-trained text-to-image (T2I) diffusion models to synthesize the high-quality image either from random Gaussian noise, which yields realistic results but is slow due to iterative denoising, or directly from the input low-quality image, which is efficient but at the price of lower output quality. These approaches train ControlNet or LoRA modules while keeping the pre-trained model fixed, which often introduces over-enhanced artifacts and hallucinations, suffering from the robustness to inputs of varying degradations. Recent visual autoregressive (AR) models, such as pre-trained Infinity, can provide strong T2I generation capabilities while offering superior efficiency by using the bitwise next-scale prediction strategy. Building upon next-scale prediction, we introduce a robust Real-ISR framework, namely Next-Scale Autoregressive Modeling (NSARM). Specifically, we train NSARM in two stages: a transformation network is first trained to map the input low-quality image to preliminary scales, followed by an end-to-end full-model fine-tuning. Such a comprehensive fine-tuning enhances the robustness of NSARM in Real-ISR tasks without compromising its generative capability. Extensive quantitative and qualitative evaluations demonstrate that as a pure AR model, NSARM achieves superior visual results over existing Real-ISR methods while maintaining a fast inference speed. Most importantly, it demonstrates much higher robustness to the quality of input images, showing stronger generalization performance. Project page: https://github.com/Xiangtaokong/NSARM

Recent advancements in medical imaging and artificial intelligence (AI) have greatly enhanced diagnostic capabilities, but the development of effective deep learning (DL) models is still constrained by the lack of high-quality annotated datasets. The traditional manual annotation process by medical experts is time- and resource-intensive, limiting the scalability of these datasets. In this work, we introduce a robust and versatile framework that combines AI and crowdsourcing to improve both the quality and quantity of medical image datasets across different modalities. Our approach utilises a user-friendly online platform that enables a diverse group of crowd annotators to label medical images efficiently. By integrating the MedSAM segmentation AI with this platform, we accelerate the annotation process while maintaining expert-level quality through an algorithm that merges crowd-labelled images. Additionally, we employ pix2pixGAN, a generative AI model, to expand the training dataset with synthetic images that capture realistic morphological features. These methods are combined into a cohesive framework designed to produce an enhanced dataset, which can serve as a universal pre-processing pipeline to boost the training of any medical deep learning segmentation model. Our results demonstrate that this framework significantly improves model performance, especially when training data is limited.

Unifying diverse image generation tasks within a single framework remains a fundamental challenge in visual generation. While large language models (LLMs) achieve unification through task-agnostic data and generation, existing visual generation models fail to meet these principles. Current approaches either rely on per-task datasets and large-scale training or adapt pre-trained image models with task-specific modifications, limiting their generalizability. In this work, we explore video models as a foundation for unified image generation, leveraging their inherent ability to model temporal correlations. We introduce RealGeneral, a novel framework that reformulates image generation as a conditional frame prediction task, analogous to in-context learning in LLMs. To bridge the gap between video models and condition-image pairs, we propose (1) a Unified Conditional Embedding module for multi-modal alignment and (2) a Unified Stream DiT Block with decoupled adaptive LayerNorm and attention mask to mitigate cross-modal interference. RealGeneral demonstrates effectiveness in multiple important visual generation tasks, e.g., it achieves a 14.5% improvement in subject similarity for customized generation and a 10% enhancement in image quality for canny-to-image task. Project page: https://lyne1.github.io/RealGeneral/

The rapid expansion of mobile internet has resulted in a substantial increase in user-generated content (UGC) images, thereby making the thorough assessment of UGC images both urgent and essential. Recently, multimodal large language models (MLLMs) have shown great potential in image quality assessment (IQA) and image aesthetic assessment (IAA). Despite this progress, effectively scoring the quality and aesthetics of UGC images still faces two main challenges: 1) A single score is inadequate to capture the hierarchical human perception. 2) How to use MLLMs to output numerical scores, such as mean opinion scores (MOS), remains an open question. To address these challenges, we introduce a novel dataset, named Realistic image Quality and Aesthetic (RealQA), including 14,715 UGC images, each of which is annoted with 10 fine-grained attributes. These attributes span three levels: low level (e.g., image clarity), middle level (e.g., subject integrity) and high level (e.g., composition). Besides, we conduct a series of in-depth and comprehensive investigations into how to effectively predict numerical scores using MLLMs. Surprisingly, by predicting just two extra significant digits, the next token paradigm can achieve SOTA performance. Furthermore, with the help of chain of thought (CoT) combined with the learnt fine-grained attributes, the proposed method can outperform SOTA methods on five public datasets for IQA and IAA with superior interpretability and show strong zero-shot generalization for video quality assessment (VQA). The code and dataset will be released.

While deep learning based approaches have demonstrated expert-level performance in dermatological diagnosis tasks, they have also been shown to exhibit biases toward certain demographic attributes, particularly skin types (e.g., light versus dark), a fairness concern that must be addressed. We propose CIRCLe, a skin color invariant deep representation learning method for improving fairness in skin lesion classification. CIRCLe is trained to classify images by utilizing a regularization loss that encourages images with the same diagnosis but different skin types to have similar latent representations. Through extensive evaluation and ablation studies, we demonstrate CIRCLe's superior performance over the state-of-the-art when evaluated on 16k+ images spanning 6 Fitzpatrick skin types and 114 diseases, using classification accuracy, equal opportunity difference (for light versus dark groups), and normalized accuracy range, a new measure we propose to assess fairness on multiple skin type groups.

The rapid advancement of generative models, particularly diffusion-based methods, has significantly improved the realism of synthetic images. As new generative models continuously emerge, detecting generated images remains a critical challenge. While fully supervised, and few-shot methods have been proposed, maintaining an updated dataset is time-consuming and challenging. Consequently, zero-shot methods have gained increasing attention in recent years. We find that existing zero-shot methods often struggle to adapt to specific image domains, such as artistic images, limiting their real-world applicability. In this work, we introduce CLIDE, a novel zero-shot detection method based on conditional likelihood approximation. Our approach computes likelihoods conditioned on real images, enabling adaptation across diverse image domains. We extensively evaluate CLIDE, demonstrating SOTA performance on a large-scale general dataset and significantly outperform existing methods in domain-specific cases. These results demonstrate the robustness of our method and underscore the need of broad, domain-aware generalization for the AI-generated image detection task. Code is available at https://tinyurl.com/clide-detector.

Chest X-ray imaging (CXR) is an important diagnostic tool used in hospitals to assess patient conditions and monitor changes over time. Generative models, specifically diffusion-based models, have shown promise in generating realistic synthetic X-rays. However, these models mainly focus on conditional generation using single-time-point data, i.e., typically CXRs taken at a specific time with their corresponding reports, limiting their clinical utility, particularly for capturing temporal changes. To address this limitation, we propose a novel framework, EHRXDiff, which predicts future CXR images by integrating previous CXRs with subsequent medical events, e.g., prescriptions, lab measures, etc. Our framework dynamically tracks and predicts disease progression based on a latent diffusion model, conditioned on the previous CXR image and a history of medical events. We comprehensively evaluate the performance of our framework across three key aspects, including clinical consistency, demographic consistency, and visual realism. We demonstrate that our framework generates high-quality, realistic future images that capture potential temporal changes, suggesting its potential for further development as a clinical simulation tool. This could offer valuable insights for patient monitoring and treatment planning in the medical field.

Skin tone as a demographic bias and inconsistent human labeling poses challenges in dermatology AI. We take another angle to investigate color contrast's impact, beyond skin tones, on malignancy detection in skin disease datasets: We hypothesize that in addition to skin tones, the color difference between the lesion area and skin also plays a role in malignancy detection performance of dermatology AI models. To study this, we first propose a robust labeling method to quantify color contrast scores of each image and validate our method by showing small labeling variations. More importantly, applying our method to the only diverse-skin tone and pathologically-confirmed skin disease dataset DDI, yields DDI-CoCo Dataset, and we observe a performance gap between the high and low color difference groups. This disparity remains consistent across various state-of-the-art (SoTA) image classification models, which supports our hypothesis. Furthermore, we study the interaction between skin tone and color difference effects and suggest that color difference can be an additional reason behind model performance bias between skin tones. Our work provides a complementary angle to dermatology AI for improving skin disease detection.

Anomaly detection (AD) aims at detecting abnormal samples that deviate from the expected normal patterns. Generally, it can be trained merely on normal data, without a requirement for abnormal samples, and thereby plays an important role in rare disease recognition and health screening in the medical domain. Despite the emergence of numerous methods for medical AD, the lack of a fair and comprehensive evaluation causes ambiguous conclusions and hinders the development of this field. To address this problem, this paper builds a benchmark with unified comparison. Seven medical datasets with five image modalities, including chest X-rays, brain MRIs, retinal fundus images, dermatoscopic images, and histopathology images, are curated for extensive evaluation. Thirty typical AD methods, including reconstruction and self-supervised learning-based methods, are involved in comparison of image-level anomaly classification and pixel-level anomaly segmentation. Furthermore, for the first time, we systematically investigate the effect of key components in existing methods, revealing unresolved challenges and potential future directions. The datasets and code are available at https://github.com/caiyu6666/MedIAnomaly.

Recent improvements in synthetic data generation make it possible to produce images that are highly photorealistic and indistinguishable from real ones. Furthermore, synthetic generation pipelines have the potential to generate an unlimited number of images. The combination of high photorealism and scale turn the synthetic data into a promising candidate for potentially improving various machine learning (ML) pipelines. Thus far, a large body of research in this field has focused on using synthetic images for training, by augmenting and enlarging training data. In contrast to using synthetic data for training, in this work we explore whether synthetic data can be beneficial for model selection. Considering the task of image classification, we demonstrate that when data is scarce, synthetic data can be used to replace the held out validation set, thus allowing to train on a larger dataset.

Synthetic medical data generation has opened up new possibilities in the healthcare domain, offering a powerful tool for simulating clinical scenarios, enhancing diagnostic and treatment quality, gaining granular medical knowledge, and accelerating the development of unbiased algorithms. In this context, we present a novel approach called ViewXGen, designed to overcome the limitations of existing methods that rely on general domain pipelines using only radiology reports to generate frontal-view chest X-rays. Our approach takes into consideration the diverse view positions found in the dataset, enabling the generation of chest X-rays with specific views, which marks a significant advancement in the field. To achieve this, we introduce a set of specially designed tokens for each view position, tailoring the generation process to the user's preferences. Furthermore, we leverage multi-view chest X-rays as input, incorporating valuable information from different views within the same study. This integration rectifies potential errors and contributes to faithfully capturing abnormal findings in chest X-ray generation. To validate the effectiveness of our approach, we conducted statistical analyses, evaluating its performance in a clinical efficacy metric on the MIMIC-CXR dataset. Also, human evaluation demonstrates the remarkable capabilities of ViewXGen, particularly in producing realistic view-specific X-rays that closely resemble the original images.

The widespread and rapid adoption of AI-generated content, created by models such as Generative Adversarial Networks (GANs) and Diffusion Models, has revolutionized the digital media landscape by allowing efficient and creative content generation. However, these models also blur the difference between real images and AI-generated synthetic images, raising concerns regarding content authenticity and integrity. While many existing solutions to detect fake images focus solely on classification and higher-resolution images, they often lack transparency in their decision-making, making it difficult for users to understand why an image is classified as fake. In this paper, we present VERITAS, a comprehensive framework that not only accurately detects whether a small (32x32) image is AI-generated but also explains why it was classified that way through artifact localization and semantic reasoning. VERITAS produces human-readable explanations that describe key artifacts in synthetic images. We show that this architecture offers clear explanations of the basis of zero-shot synthetic image detection tasks. Code and relevant prompts can be found at https://github.com/V-i-g-n-e-s-h-N/VERITAS .

Disease progression simulation is a crucial area of research that has significant implications for clinical diagnosis, prognosis, and treatment. One major challenge in this field is the lack of continuous medical imaging monitoring of individual patients over time. To address this issue, we develop a novel framework termed Progressive Image Editing (PIE) that enables controlled manipulation of disease-related image features, facilitating precise and realistic disease progression simulation. Specifically, we leverage recent advancements in text-to-image generative models to simulate disease progression accurately and personalize it for each patient. We theoretically analyze the iterative refining process in our framework as a gradient descent with an exponentially decayed learning rate. To validate our framework, we conduct experiments in three medical imaging domains. Our results demonstrate the superiority of PIE over existing methods such as Stable Diffusion Walk and Style-Based Manifold Extrapolation based on CLIP score (Realism) and Disease Classification Confidence (Alignment). Our user study collected feedback from 35 veteran physicians to assess the generated progressions. Remarkably, 76.2% of the feedback agrees with the fidelity of the generated progressions. To our best knowledge, PIE is the first of its kind to generate disease progression images meeting real-world standards. It is a promising tool for medical research and clinical practice, potentially allowing healthcare providers to model disease trajectories over time, predict future treatment responses, and improve patient outcomes.

Recent style transfer models have provided promising artistic results. However, given a photograph as a reference style, existing methods are limited by spatial distortions or unrealistic artifacts, which should not happen in real photographs. We introduce a theoretically sound correction to the network architecture that remarkably enhances photorealism and faithfully transfers the style. The key ingredient of our method is wavelet transforms that naturally fits in deep networks. We propose a wavelet corrected transfer based on whitening and coloring transforms (WCT^2) that allows features to preserve their structural information and statistical properties of VGG feature space during stylization. This is the first and the only end-to-end model that can stylize a 1024times1024 resolution image in 4.7 seconds, giving a pleasing and photorealistic quality without any post-processing. Last but not least, our model provides a stable video stylization without temporal constraints. Our code, generated images, and pre-trained models are all available at https://github.com/ClovaAI/WCT2.

We propose a 3D generation pipeline that uses diffusion models to generate realistic human digital avatars. Due to the wide variety of human identities, poses, and stochastic details, the generation of 3D human meshes has been a challenging problem. To address this, we decompose the problem into 2D normal map generation and normal map-based 3D reconstruction. Specifically, we first simultaneously generate realistic normal maps for the front and backside of a clothed human, dubbed dual normal maps, using a pose-conditional diffusion model. For 3D reconstruction, we ``carve'' the prior SMPL-X mesh to a detailed 3D mesh according to the normal maps through mesh optimization. To further enhance the high-frequency details, we present a diffusion resampling scheme on both body and facial regions, thus encouraging the generation of realistic digital avatars. We also seamlessly incorporate a recent text-to-image diffusion model to support text-based human identity control. Our method, namely, Chupa, is capable of generating realistic 3D clothed humans with better perceptual quality and identity variety.

Developing advanced medical imaging retrieval systems is challenging due to the varying definitions of `similar images' across different medical contexts. This challenge is compounded by the lack of large-scale, high-quality medical imaging retrieval datasets and benchmarks. In this paper, we propose a novel methodology that leverages dense radiology reports to define image-wise similarity ordering at multiple granularities in a scalable and fully automatic manner. Using this approach, we construct two comprehensive medical imaging retrieval datasets: MIMIC-IR for Chest X-rays and CTRATE-IR for CT scans, providing detailed image-image ranking annotations conditioned on diverse anatomical structures. Furthermore, we develop two retrieval systems, RadIR-CXR and model-ChestCT, which demonstrate superior performance in traditional image-image and image-report retrieval tasks. These systems also enable flexible, effective image retrieval conditioned on specific anatomical structures described in text, achieving state-of-the-art results on 77 out of 78 metrics.

Creating photorealistic avatars for individuals traditionally involves extensive capture sessions with complex and expensive studio devices like the LightStage system. While recent strides in neural representations have enabled the generation of photorealistic and animatable 3D avatars from quick phone scans, they have the capture-time lighting baked-in, lack facial details and have missing regions in areas such as the back of the ears. Thus, they lag in quality compared to studio-captured avatars. In this paper, we propose a method that bridges this gap by generating studio-like illuminated texture maps from short, monocular phone captures. We do this by parameterizing the phone texture maps using the W^+ space of a StyleGAN2, enabling near-perfect reconstruction. Then, we finetune a StyleGAN2 by sampling in the W^+ parameterized space using a very small set of studio-captured textures as an adversarial training signal. To further enhance the realism and accuracy of facial details, we super-resolve the output of the StyleGAN2 using carefully designed diffusion model that is guided by image gradients of the phone-captured texture map. Once trained, our method excels at producing studio-like facial texture maps from casual monocular smartphone videos. Demonstrating its capabilities, we showcase the generation of photorealistic, uniformly lit, complete avatars from monocular phone captures. http://shahrukhathar.github.io/2024/07/22/Bridging.html{The project page can be found here.}

Bokeh rendering methods play a key role in creating the visually appealing, softly blurred backgrounds seen in professional photography. While recent learning-based approaches show promising results, generating realistic Bokeh with variable strength remains challenging. Existing methods require additional inputs and suffer from unrealistic Bokeh reproduction due to reliance on synthetic data. In this work, we propose Bokehlicious, a highly efficient network that provides intuitive control over Bokeh strength through an Aperture-Aware Attention mechanism, mimicking the physical lens aperture. To further address the lack of high-quality real-world data, we present RealBokeh, a novel dataset featuring 23,000 high-resolution (24-MP) images captured by professional photographers, covering diverse scenes with varied aperture and focal length settings. Evaluations on both our new RealBokeh and established Bokeh rendering benchmarks show that Bokehlicious consistently outperforms SOTA methods while significantly reducing computational cost and exhibiting strong zero-shot generalization. Our method and dataset further extend to defocus deblurring, achieving competitive results on the RealDOF benchmark. Our code and data can be found at https://github.com/TimSeizinger/Bokehlicious

In this work, we present MedImageInsight, an open-source medical imaging embedding model. MedImageInsight is trained on medical images with associated text and labels across a diverse collection of domains, including X-Ray, CT, MRI, dermoscopy, OCT, fundus photography, ultrasound, histopathology, and mammography. Rigorous evaluations demonstrate MedImageInsight's ability to achieve state-of-the-art (SOTA) or human expert level performance across classification, image-image search, and fine-tuning tasks. Specifically, on public datasets, MedImageInsight achieves SOTA in CT 3D medical image retrieval, as well as SOTA in disease classification and search for chest X-ray, dermatology, and OCT imaging. Furthermore, MedImageInsight achieves human expert performance in bone age estimation (on both public and partner data), as well as AUC above 0.9 in most other domains. When paired with a text decoder, MedImageInsight achieves near SOTA level single image report findings generation with less than 10\% the parameters of other models. Compared to fine-tuning GPT-4o with only MIMIC-CXR data for the same task, MedImageInsight outperforms in clinical metrics, but underperforms on lexical metrics where GPT-4o sets a new SOTA. Importantly for regulatory purposes, MedImageInsight can generate ROC curves, adjust sensitivity and specificity based on clinical need, and provide evidence-based decision support through image-image search (which can also enable retrieval augmented generation). In an independent clinical evaluation of image-image search in chest X-ray, MedImageInsight outperformed every other publicly available foundation model evaluated by large margins (over 6 points AUC), and significantly outperformed other models in terms of AI fairness (across age and gender). We hope releasing MedImageInsight will help enhance collective progress in medical imaging AI research and development.

Task-specific deep learning models in histopathology offer promising opportunities for improving diagnosis, clinical research, and precision medicine. However, development of such models is often limited by availability of high-quality data. Foundation models in histopathology that learn general representations across a wide range of tissue types, diagnoses, and magnifications offer the potential to reduce the data, compute, and technical expertise necessary to develop task-specific deep learning models with the required level of model performance. In this work, we describe the development and evaluation of foundation models for histopathology via self-supervised learning (SSL). We first establish a diverse set of benchmark tasks involving 17 unique tissue types and 12 unique cancer types and spanning different optimal magnifications and task types. Next, we use this benchmark to explore and evaluate histopathology-specific SSL methods followed by further evaluation on held out patch-level and weakly supervised tasks. We found that standard SSL methods thoughtfully applied to histopathology images are performant across our benchmark tasks and that domain-specific methodological improvements can further increase performance. Our findings reinforce the value of using domain-specific SSL methods in pathology, and establish a set of high quality foundation models to enable further research across diverse applications.

Deep learning in computer vision has achieved great success with the price of large-scale labeled training data. However, exhaustive data annotation is impracticable for each task of all domains of interest, due to high labor costs and unguaranteed labeling accuracy. Besides, the uncontrollable data collection process produces non-IID training and test data, where undesired duplication may exist. All these nuisances may hinder the verification of typical theories and exposure to new findings. To circumvent them, an alternative is to generate synthetic data via 3D rendering with domain randomization. We in this work push forward along this line by doing profound and extensive research on bare supervised learning and downstream domain adaptation. Specifically, under the well-controlled, IID data setting enabled by 3D rendering, we systematically verify the typical, important learning insights, e.g., shortcut learning, and discover the new laws of various data regimes and network architectures in generalization. We further investigate the effect of image formation factors on generalization, e.g., object scale, material texture, illumination, camera viewpoint, and background in a 3D scene. Moreover, we use the simulation-to-reality adaptation as a downstream task for comparing the transferability between synthetic and real data when used for pre-training, which demonstrates that synthetic data pre-training is also promising to improve real test results. Lastly, to promote future research, we develop a new large-scale synthetic-to-real benchmark for image classification, termed S2RDA, which provides more significant challenges for transfer from simulation to reality. The code and datasets are available at https://github.com/huitangtang/On_the_Utility_of_Synthetic_Data.

The field of Machine Learning, a subset of Artificial Intelligence, has led to remarkable advancements in many areas, including medicine. Machine Learning algorithms require large datasets to train computer models successfully. Although there are medical image datasets available, more image datasets are needed from a variety of medical entities, especially cancer pathology. Even more scarce are ML-ready image datasets. To address this need, we created an image dataset (LC25000) with 25,000 color images in 5 classes. Each class contains 5,000 images of the following histologic entities: colon adenocarcinoma, benign colonic tissue, lung adenocarcinoma, lung squamous cell carcinoma, and benign lung tissue. All images are de-identified, HIPAA compliant, validated, and freely available for download to AI researchers.

The emergence of vision-language models (VLMs) has opened new possibilities for clinical reasoning and has shown promising performance in dermatological diagnosis. However, their trustworthiness and clinical utility are often limited by three major factors: (1) Data heterogeneity, where diverse datasets lack consistent diagnostic labels and clinical concept annotations; (2) Absence of grounded diagnostic rationales, leading to a scarcity of reliable reasoning supervision; and (3) Limited scalability and generalization, as models trained on small, densely annotated datasets struggle to transfer nuanced reasoning to large, sparsely-annotated ones. To address these limitations, we propose SkinR1, a novel dermatological VLM that combines deep, textbook-based reasoning with the broad generalization capabilities of reinforcement learning (RL). SkinR1 systematically resolves the key challenges through a unified, end-to-end framework. First, we design a textbook-based reasoning generator that synthesizes high-fidelity, hierarchy-aware, and differential-diagnosis (DDx)-informed trajectories, providing reliable expert-level supervision. Second, we leverage the constructed trajectories for supervised fine-tuning (SFT) empowering the model with grounded reasoning ability. Third, we develop a novel RL paradigm that, by incorporating the hierarchical structure of diseases, effectively transfers these grounded reasoning patterns to large-scale, sparse data. Extensive experiments on multiple dermatology datasets demonstrate that SkinR1 achieves superior diagnostic accuracy. The ablation study demonstrates the importance of the reasoning foundation instilled by SFT.

Despite the ever-increasing interest in applying deep learning (DL) models to medical imaging, the typical scarcity and imbalance of medical datasets can severely impact the performance of DL models. The generation of synthetic data that might be freely shared without compromising patient privacy is a well-known technique for addressing these difficulties. Inpainting algorithms are a subset of DL generative models that can alter one or more regions of an input image while matching its surrounding context and, in certain cases, non-imaging input conditions. Although the majority of inpainting techniques for medical imaging data use generative adversarial networks (GANs), the performance of these algorithms is frequently suboptimal due to their limited output variety, a problem that is already well-known for GANs. Denoising diffusion probabilistic models (DDPMs) are a recently introduced family of generative networks that can generate results of comparable quality to GANs, but with diverse outputs. In this paper, we describe a DDPM to execute multiple inpainting tasks on 2D axial slices of brain MRI with various sequences, and present proof-of-concept examples of its performance in a variety of evaluation scenarios. Our model and a public online interface to try our tool are available at: https://github.com/Mayo-Radiology-Informatics-Lab/MBTI

Real-world image super-resolution (Real-ISR) aims at restoring high-quality (HQ) images from low-quality (LQ) inputs corrupted by unknown and complex degradations. In particular, pretrained text-to-image (T2I) diffusion models provide strong generative priors to reconstruct credible and intricate details. However, T2I generation focuses on semantic consistency while Real-ISR emphasizes pixel-level reconstruction, which hinders existing methods from fully exploiting diffusion priors. To address this challenge, we introduce ConsisSR to handle both semantic and pixel-level consistency. Specifically, compared to coarse-grained text prompts, we exploit the more powerful CLIP image embedding and effectively leverage both modalities through our Hybrid Prompt Adapter (HPA) for semantic guidance. Secondly, we introduce Time-aware Latent Augmentation (TALA) to mitigate the inherent gap between T2I generation and Real-ISR consistency requirements. By randomly mixing LQ and HQ latent inputs, our model not only handle timestep-specific diffusion noise but also refine the accumulated latent representations. Last but not least, our GAN-Embedding strategy employs the pretrained Real-ESRGAN model to refine the diffusion start point. This accelerates the inference process to 10 steps while preserving sampling quality, in a training-free manner. Our method demonstrates state-of-the-art performance among both full-scale and accelerated models. The code will be made publicly available.

Industrial mushroom cultivation increasingly relies on computer vision for monitoring and automated harvesting. However, developing accurate detection and segmentation models requires large, precisely annotated datasets that are costly to produce. Synthetic data provides a scalable alternative, yet often lacks sufficient realism to generalize to real-world scenarios. This paper presents a novel workflow that integrates 3D rendering in Blender with a constrained diffusion model to automatically generate high-quality annotated, photorealistic synthetic images of Agaricus Bisporus mushrooms. This approach preserves full control over 3D scene configuration and annotations while achieving photorealism without the need for specialized computer graphics expertise. We release two synthetic datasets (each containing 6,000 images depicting over 250k mushroom instances) and evaluate Mask R-CNN models trained on them in a zero-shot setting. When tested on two independent real-world datasets (including a newly collected benchmark), our method achieves state-of-the-art segmentation performance (F1 = 0.859 on M18K), despite using only synthetic training data. Although the approach is demonstrated on Agaricus Bisporus mushrooms, the proposed pipeline can be readily adapted to other mushroom species or to other agricultural domains, such as fruit and leaf detection.

With the emergence of large-scale vision language models (VLM), it is now possible to produce realistic-looking radiology reports for chest X-ray images. However, their clinical translation has been hampered by the factual errors and hallucinations in the produced descriptions during inference. In this paper, we present a novel phrase-grounded fact-checking model (FC model) that detects errors in findings and their indicated locations in automatically generated chest radiology reports. Specifically, we simulate the errors in reports through a large synthetic dataset derived by perturbing findings and their locations in ground truth reports to form real and fake findings-location pairs with images. A new multi-label cross-modal contrastive regression network is then trained on this dataset. We present results demonstrating the robustness of our method in terms of accuracy of finding veracity prediction and localization on multiple X-ray datasets. We also show its effectiveness for error detection in reports of SOTA report generators on multiple datasets achieving a concordance correlation coefficient of 0.997 with ground truth-based verification, thus pointing to its utility during clinical inference in radiology workflows.

Generative image models can produce convincingly real images, with plausible shapes, textures, layouts and lighting. However, one domain in which they perform notably poorly is in the synthesis of transparent objects, which exhibit refraction, reflection, absorption and scattering. Refraction is a particular challenge, because refracted pixel rays often intersect with surfaces observed in other parts of the image, providing a constraint on the color. It is clear from inspection that generative models have not distilled the laws of optics sufficiently well to accurately render refractive objects. In this work, we consider the problem of generating images with accurate refraction, given a text prompt. We synchronize the pixels within the object's boundary with those outside by warping and merging the pixels using Snell's Law of Refraction, at each step of the generation trajectory. For those surfaces that are not directly observed in the image, but are visible via refraction or reflection, we recover their appearance by synchronizing the image with a second generated image -- a panorama centered at the object -- using the same warping and merging procedure. We demonstrate that our approach generates much more optically-plausible images that respect the physical constraints.

Skin carcinoma is the most prevalent form of cancer globally, accounting for over $8 billion in annual healthcare expenditures. Early diagnosis, accurate and timely treatment are critical to improving patient survival rates. In clinical settings, physicians document patient visits using detailed SOAP (Subjective, Objective, Assessment, and Plan) notes. However, manually generating these notes is labor-intensive and contributes to clinician burnout. In this work, we propose skin-SOAP, a weakly supervised multimodal framework to generate clinically structured SOAP notes from limited inputs, including lesion images and sparse clinical text. Our approach reduces reliance on manual annotations, enabling scalable, clinically grounded documentation while alleviating clinician burden and reducing the need for large annotated data. Our method achieves performance comparable to GPT-4o, Claude, and DeepSeek Janus Pro across key clinical relevance metrics. To evaluate this clinical relevance, we introduce two novel metrics MedConceptEval and Clinical Coherence Score (CCS) which assess semantic alignment with expert medical concepts and input features, respectively.

In this paper we propose a novel image representation called face X-ray for detecting forgery in face images. The face X-ray of an input face image is a greyscale image that reveals whether the input image can be decomposed into the blending of two images from different sources. It does so by showing the blending boundary for a forged image and the absence of blending for a real image. We observe that most existing face manipulation methods share a common step: blending the altered face into an existing background image. For this reason, face X-ray provides an effective way for detecting forgery generated by most existing face manipulation algorithms. Face X-ray is general in the sense that it only assumes the existence of a blending step and does not rely on any knowledge of the artifacts associated with a specific face manipulation technique. Indeed, the algorithm for computing face X-ray can be trained without fake images generated by any of the state-of-the-art face manipulation methods. Extensive experiments show that face X-ray remains effective when applied to forgery generated by unseen face manipulation techniques, while most existing face forgery detection or deepfake detection algorithms experience a significant performance drop.

The accelerated adoption of digital pathology and advances in deep learning have enabled the development of powerful models for various pathology tasks across a diverse array of diseases and patient cohorts. However, model training is often difficult due to label scarcity in the medical domain and the model's usage is limited by the specific task and disease for which it is trained. Additionally, most models in histopathology leverage only image data, a stark contrast to how humans teach each other and reason about histopathologic entities. We introduce CONtrastive learning from Captions for Histopathology (CONCH), a visual-language foundation model developed using diverse sources of histopathology images, biomedical text, and notably over 1.17 million image-caption pairs via task-agnostic pretraining. Evaluated on a suite of 13 diverse benchmarks, CONCH can be transferred to a wide range of downstream tasks involving either or both histopathology images and text, achieving state-of-the-art performance on histology image classification, segmentation, captioning, text-to-image and image-to-text retrieval. CONCH represents a substantial leap over concurrent visual-language pretrained systems for histopathology, with the potential to directly facilitate a wide array of machine learning-based workflows requiring minimal or no further supervised fine-tuning.