# Cascaded Multi-path Shortcut Diffusion Model for Medical Image Translation

arXiv: https://arxiv.org/abs/2405.12223 · HTML: https://mlsanity.com/paper/2405.12223/

## Key facts

- Cited by 9 papers in the map (data through 14 Oct 2026).
- Placed in Medical imaging and segmentation, one of 14 directions in Diffusion models.
- Builds on 32 of its 53 references that are in the map.
- First posted on arXiv 6 Apr 2024.

## Placed in

- Diffusion models / [Medical imaging and segmentation](https://mlsanity.com/diffusion/medical-imaging-and-segmentation/)

## Builds on (most cited first, 30 of 32)

- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [Dropout as a Bayesian Approximation: Representing Model Uncertainty in Deep Learning](https://mlsanity.com/paper/1506.02142/) (2015)
- [Generative Modeling by Estimating Gradients of the Data Distribution](https://mlsanity.com/paper/1907.05600/) (2019)
- [Improved Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2102.09672/) (2021)
- [Palette: Image-to-Image Diffusion Models](https://mlsanity.com/paper/2111.05826/) (2021)
- [Solving Inverse Problems in Medical Imaging with Score-Based Generative Models](https://mlsanity.com/paper/2111.08005/) (2021)
- [fastMRI: An Open Dataset and Benchmarks for Accelerated MRI](https://mlsanity.com/paper/1811.08839/) (2018)
- [ResShift: Efficient Diffusion Model for Image Super-resolution by Residual Shifting](https://mlsanity.com/paper/2307.12348/) (2023)
- [Come-Closer-Diffuse-Faster: Accelerating Conditional Diffusion Models for Inverse Problems through Stochastic Contraction](https://mlsanity.com/paper/2112.05146/) (2021)
- [Diffusion Models for Medical Image Analysis: A Comprehensive Survey](https://mlsanity.com/paper/2211.07804/) (2022)
- [A Deep Cascade of Convolutional Neural Networks for Dynamic MR Image Reconstruction](https://mlsanity.com/paper/1704.02422/) (2017)
- [I2SB: Image-to-Image Schr"odinger Bridge](https://mlsanity.com/paper/2302.05872/) (2023)
- [Diffusion Models for Implicit Image Segmentation Ensembles](https://mlsanity.com/paper/2112.03145/) (2021)
- [Unsupervised Medical Image Translation with Adversarial Diffusion Models](https://mlsanity.com/paper/2207.08208/) (2022)
- [MedGAN: Medical Image Translation using GANs](https://mlsanity.com/paper/1806.06397/) (2018)
- [UNIT-DDPM: UNpaired Image Translation with Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2104.05358/) (2021)
- [Solving 3D Inverse Problems using Pre-trained 2D Diffusion Models](https://mlsanity.com/paper/2211.10655/) (2022)
- [Assessing Reliability and Challenges of Uncertainty Estimations for Medical Image Segmentation](https://mlsanity.com/paper/1907.03338/) (2019)
- [A Morphology Focused Diffusion Probabilistic Model for Synthesis of Histopathology Images](https://mlsanity.com/paper/2209.13167/) (2022)
- [DuDoRNet: Learning a Dual-Domain Recurrent Network for Fast MRI Reconstruction with Deep T1 Prior](https://mlsanity.com/paper/2001.03799/) (2020)
- [Conversion Between CT and MRI Images Using Diffusion and Score-Matching Models](https://mlsanity.com/paper/2209.12104/) (2022)
- [Inconsistency-aware Uncertainty Estimation for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2110.08762/) (2021)
- [PET image denoising based on denoising diffusion probabilistic models](https://mlsanity.com/paper/2209.06167/) (2022)
- [Improving 3D Imaging with Pre-Trained Perpendicular 2D Diffusion Models](https://mlsanity.com/paper/2303.08440/) (2023)
- [CoreDiff: Contextual Error-Modulated Generalized Diffusion Model for Low-Dose CT Denoising and Generalization](https://mlsanity.com/paper/2304.01814/) (2023)
- [DU-GAN: Generative Adversarial Networks with Dual-Domain U-Net Based Discriminators for Low-Dose CT Denoising](https://mlsanity.com/paper/2108.10772/) (2021)
- [Synthetic CT Generation from MRI using 3D Transformer-based Denoising Diffusion Model](https://mlsanity.com/paper/2305.19467/) (2023)
- [MR-Contrast-Aware Image-to-Image Translations with Generative Adversarial Networks](https://mlsanity.com/paper/2104.01449/) (2021)

## Built on by (most cited first, 9 of 9)

- [Brain Latent Progression: Individual-based Spatiotemporal Disease Progression on 3D Brain MRIs via Latent Diffusion](https://mlsanity.com/paper/2502.08560/) (2025)
- [2.5D Multi-view Averaging Diffusion Model for 3D Medical Image Translation: Application to Low-count PET Reconstruction with CT-less Attenuation Correction](https://mlsanity.com/paper/2406.08374/) (2024)
- [Regression is all you need for medical image translation](https://mlsanity.com/paper/2505.02048/) (2025)
- [Cross-modality image synthesis from TOF-MRA to CTA using diffusion-based models](https://mlsanity.com/paper/2409.10089/) (2024)
- [From Transthoracic to Transesophageal: Cross-Modality Generation using LoRA Diffusion](https://mlsanity.com/paper/2508.13077/) (2025)
- [Human-Guided Shade Artifact Suppression in CBCT-to-MDCT Translation via Schr"odinger Bridge with Conditional Diffusion](https://mlsanity.com/paper/2507.11025/) (2025)
- [DECADE: A Temporally-Consistent Unsupervised Diffusion Model for Enhanced Rb-82 Dynamic Cardiac PET Image Denoising](https://mlsanity.com/paper/2603.07759/) (2026)
- [TuLaBM: Tumor-Biased Latent Bridge Matching for Contrast-Enhanced MRI Synthesis](https://mlsanity.com/paper/2603.19386/) (2026)
- [PredRA: Fast Medical Image Translation by Deterministic Component Extraction and Controlled Stochastic Refinement](https://mlsanity.com/paper/2609.31912/) (2026)

## Abstract (arXiv)

Image-to-image translation is a vital component in medical imaging processing, with many uses in a wide range of imaging modalities and clinical scenarios. Previous methods include Generative Adversarial Networks (GANs) and Diffusion Models (DMs), which offer realism but suffer from instability and lack uncertainty estimation. Even though both GAN and DM methods have individually exhibited their capability in medical image translation tasks, the potential of combining a GAN and DM to further improve translation performance and to enable uncertainty estimation remains largely unexplored. In this work, we address these challenges by proposing a Cascade Multi-path Shortcut Diffusion Model (CMDM) for high-quality medical image translation and uncertainty estimation. To reduce the required number of iterations and ensure robust performance, our method first obtains a conditional GAN-generated prior image that will be used for the efficient reverse translation with a DM in the subsequent step. Additionally, a multi-path shortcut diffusion strategy is employed to refine translation results and estimate uncertainty. A cascaded pipeline further enhances translation quality, incorporating residual averaging between cascades. We collected three different medical image datasets with two sub-tasks for each dataset to test the generalizability of our approach. Our experimental results found that CMDM can produce high-quality translations comparable to state-of-the-art methods while providing reasonable uncertainty estimations that correlate well with the translation error.