# Temporal Evolution of Knee Osteoarthritis: A Diffusion-based Morphing Model for X-ray Medical Image Synthesis

arXiv: https://arxiv.org/abs/2408.00891 · HTML: https://mlsanity.com/paper/2408.00891/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 17 of its 44 references that are in the map.
- First posted on arXiv 1 Aug 2024.

## Builds on (most cited first, 17 of 17)

- [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)
- [High-Resolution Image Synthesis with Latent Diffusion Models](https://mlsanity.com/paper/2112.10752/) (2021)
- [Improved Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2102.09672/) (2021)
- [Delving Deep into Rectifiers: Surpassing Human-Level Performance on ImageNet Classification](https://mlsanity.com/paper/1502.01852/) (2015)
- [Group Normalization](https://mlsanity.com/paper/1803.08494/) (2018)
- [YOLO9000: Better, Faster, Stronger](https://mlsanity.com/paper/1612.08242/) (2016)
- [Spatial Transformer Networks](https://mlsanity.com/paper/1506.02025/) (2015)
- [An Unsupervised Learning Model for Deformable Medical Image Registration](https://mlsanity.com/paper/1802.02604/) (2018)
- [Unsupervised Learning for Fast Probabilistic Diffeomorphic Registration](https://mlsanity.com/paper/1805.04605/) (2018)
- [Fast Unsupervised Brain Anomaly Detection and Segmentation with Diffusion Models](https://mlsanity.com/paper/2206.03461/) (2022)
- [Diffusion Deformable Model for 4D Temporal Medical Image Generation](https://mlsanity.com/paper/2206.13295/) (2022)
- [CoLa-Diff: Conditional Latent Diffusion Model for Multi-Modal MRI Synthesis](https://mlsanity.com/paper/2303.14081/) (2023)
- [Generation of Anonymous Chest Radiographs Using Latent Diffusion Models for Training Thoracic Abnormality Classification Systems](https://mlsanity.com/paper/2211.01323/) (2022)
- [Automatic Knee Osteoarthritis Diagnosis from Plain Radiographs: A Deep Learning-Based Approach](https://mlsanity.com/paper/1710.10589/) (2017)
- [Diffusion Models in Bioinformatics: A New Wave of Deep Learning Revolution in Action](https://mlsanity.com/paper/2302.10907/) (2023)
- [Assessing the capacity of a denoising diffusion probabilistic model to reproduce spatial context](https://mlsanity.com/paper/2309.10817/) (2023)

## Built on by (most cited first, 1 of 1)

- [Diffusion-based Counterfactual Augmentation: Towards Robust and Interpretable Knee Osteoarthritis Grading](https://mlsanity.com/paper/2506.15748/) (2025)

## Abstract (arXiv)

Knee Osteoarthritis (KOA) is a common musculoskeletal disorder that significantly affects the mobility of older adults. In the medical domain, images containing temporal data are frequently utilized to study temporal dynamics and statistically monitor disease progression. While deep learning-based generative models for natural images have been widely researched, there are comparatively few methods available for synthesizing temporal knee X-rays. In this work, we introduce a novel deep-learning model designed to synthesize intermediate X-ray images between a specific patient's healthy knee and severe KOA stages. During the testing phase, based on a healthy knee X-ray, the proposed model can produce a continuous and effective sequence of KOA X-ray images with varying degrees of severity. Specifically, we introduce a Diffusion-based Morphing Model by modifying the Denoising Diffusion Probabilistic Model. Our approach integrates diffusion and morphing modules, enabling the model to capture spatial morphing details between source and target knee X-ray images and synthesize intermediate frames along a geodesic path. A hybrid loss consisting of diffusion loss, morphing loss, and supervision loss was employed. We demonstrate that our proposed approach achieves the highest temporal frame synthesis performance, effectively augmenting data for classification models and simulating the progression of KOA.