# Unsupervised anomaly localization in high-resolution breast scans using deep pluralistic image completion

arXiv: https://arxiv.org/abs/2305.03098 · HTML: https://mlsanity.com/paper/2305.03098/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 30 of its 62 references that are in the map.
- First posted on arXiv 4 May 2023.

## Builds on (most cited first, 30 of 30)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [The Unreasonable Effectiveness of Deep Features as a Perceptual Metric](https://mlsanity.com/paper/1801.03924/) (2018)
- [ImageNet Large Scale Visual Recognition Challenge](https://mlsanity.com/paper/1409.0575/) (2014)
- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [Fashion-MNIST: a Novel Image Dataset for Benchmarking Machine Learning Algorithms](https://mlsanity.com/paper/1708.07747/) (2017)
- [What Uncertainties Do We Need in Bayesian Deep Learning for Computer Vision?](https://mlsanity.com/paper/1703.04977/) (2017)
- [Towards Total Recall in Industrial Anomaly Detection](https://mlsanity.com/paper/2106.08265/) (2021)
- [PaDiM: a Patch Distribution Modeling Framework for Anomaly Detection and Localization](https://mlsanity.com/paper/2011.08785/) (2020)
- [CutPaste: Self-Supervised Learning for Anomaly Detection and Localization](https://mlsanity.com/paper/2104.04015/) (2021)
- [Likelihood Ratios for Out-of-Distribution Detection](https://mlsanity.com/paper/1906.02845/) (2019)
- [Do Deep Generative Models Know What They Don't Know?](https://mlsanity.com/paper/1810.09136/) (2018)
- [Your Classifier is Secretly an Energy Based Model and You Should Treat it Like One](https://mlsanity.com/paper/1912.03263/) (2019)
- [Object Detection in Optical Remote Sensing Images: A Survey and A New Benchmark](https://mlsanity.com/paper/1909.00133/) (2019)
- [Deep multi-scale video prediction beyond mean square error](https://mlsanity.com/paper/1511.05440/) (2015)
- [Efficient Object Localization Using Convolutional Networks](https://mlsanity.com/paper/1411.4280/) (2014)
- [Patch SVDD: Patch-level SVDD for Anomaly Detection and Segmentation](https://mlsanity.com/paper/2006.16067/) (2020)
- [Input complexity and out-of-distribution detection with likelihood-based generative models](https://mlsanity.com/paper/1909.11480/) (2019)
- [Pluralistic Image Completion](https://mlsanity.com/paper/1903.04227/) (2019)
- [High-Fidelity Pluralistic Image Completion with Transformers](https://mlsanity.com/paper/2103.14031/) (2021)
- [Generative Probabilistic Novelty Detection with Adversarial Autoencoders](https://mlsanity.com/paper/1807.02588/) (2018)
- [Inpainting Transformer for Anomaly Detection](https://mlsanity.com/paper/2104.13897/) (2021)
- [PD-GAN: Probabilistic Diverse GAN for Image Inpainting](https://mlsanity.com/paper/2105.02201/) (2021)
- [Anomaly Detection using Deep Learning based Image Completion](https://mlsanity.com/paper/1811.06861/) (2018)
- [Novelty Detection Via Blurring](https://mlsanity.com/paper/1911.11943/) (2019)
- [Detection of masses and architectural distortions in digital breast tomosynthesis: a publicly available dataset of 5,060 patients and a deep learning model](https://mlsanity.com/paper/2011.07995/) (2020)
- [Deep Unsupervised Image Anomaly Detection: An Information Theoretic Framework](https://mlsanity.com/paper/2012.04837/) (2020)
- [Probabilistic Semantic Inpainting with Pixel Constrained CNNs](https://mlsanity.com/paper/1810.03728/) (2018)
- [Dropout Induced Noise for Co-Creative GAN Systems](https://mlsanity.com/paper/1909.04474/) (2019)

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

- [A systematic study of the foreground-background imbalance problem in deep learning for object detection](https://mlsanity.com/paper/2306.16539/) (2023)
- [ART-ASyn: Anatomy-aware Realistic Texture-based Anomaly Synthesis Framework for Chest X-Rays](https://mlsanity.com/paper/2512.00310/) (2025)

## Abstract (arXiv)

Automated tumor detection in Digital Breast Tomosynthesis (DBT) is a difficult task due to natural tumor rarity, breast tissue variability, and high resolution. Given the scarcity of abnormal images and the abundance of normal images for this problem, an anomaly detection/localization approach could be well-suited. However, most anomaly localization research in machine learning focuses on non-medical datasets, and we find that these methods fall short when adapted to medical imaging datasets. The problem is alleviated when we solve the task from the image completion perspective, in which the presence of anomalies can be indicated by a discrepancy between the original appearance and its auto-completion conditioned on the surroundings. However, there are often many valid normal completions given the same surroundings, especially in the DBT dataset, making this evaluation criterion less precise. To address such an issue, we consider pluralistic image completion by exploring the distribution of possible completions instead of generating fixed predictions. This is achieved through our novel application of spatial dropout on the completion network during inference time only, which requires no additional training cost and is effective at generating diverse completions. We further propose minimum completion distance (MCD), a new metric for detecting anomalies, thanks to these stochastic completions. We provide theoretical as well as empirical support for the superiority over existing methods of using the proposed method for anomaly localization. On the DBT dataset, our model outperforms other state-of-the-art methods by at least 10% AUROC for pixel-level detection.