# Diffuse-UDA: Addressing Unsupervised Domain Adaptation in Medical Image Segmentation with Appearance and Structure Aligned Diffusion Models

arXiv: https://arxiv.org/abs/2408.05985 · HTML: https://mlsanity.com/paper/2408.05985/

## Key facts

- Cited by 6 papers in the map (data through 14 Oct 2026).
- Placed in Medical imaging and segmentation, one of 14 directions in Diffusion models.
- Builds on 45 of its 81 references that are in the map.
- First posted on arXiv 12 Aug 2024.

## Placed in

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

## Builds on (most cited first, 30 of 45)

- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [Score-Based Generative Modeling through Stochastic Differential Equations](https://mlsanity.com/paper/2011.13456/) (2020)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [mixup: Beyond Empirical Risk Minimization](https://mlsanity.com/paper/1710.09412/) (2017)
- [CutMix: Regularization Strategy to Train Strong Classifiers with Localizable Features](https://mlsanity.com/paper/1905.04899/) (2019)
- [Diffusion Models: A Comprehensive Survey of Methods and Applications](https://mlsanity.com/paper/2209.00796/) (2022)
- [CyCADA: Cycle-Consistent Adversarial Domain Adaptation](https://mlsanity.com/paper/1711.03213/) (2017)
- [Learning to Adapt Structured Output Space for Semantic Segmentation](https://mlsanity.com/paper/1802.10349/) (2018)
- [FDA: Fourier Domain Adaptation for Semantic Segmentation](https://mlsanity.com/paper/2004.05498/) (2020)
- [Domain Adaptation for Medical Image Analysis: A Survey](https://mlsanity.com/paper/2102.09508/) (2021)
- [3D MRI brain tumor segmentation using autoencoder regularization](https://mlsanity.com/paper/1810.11654/) (2018)
- [Score-based diffusion models for accelerated MRI](https://mlsanity.com/paper/2110.05243/) (2021)
- [Semi-Supervised Semantic Segmentation Using Unreliable Pseudo-Labels](https://mlsanity.com/paper/2203.03884/) (2022)
- [nnFormer: Interleaved Transformer for Volumetric Segmentation](https://mlsanity.com/paper/2109.03201/) (2021)
- [MedSegDiff: Medical Image Segmentation with Diffusion Probabilistic Model](https://mlsanity.com/paper/2211.00611/) (2022)
- [Unsupervised Bidirectional Cross-Modality Adaptation via Deeply Synergistic Image and Feature Alignment for Medical Image Segmentation](https://mlsanity.com/paper/2002.02255/) (2020)
- [MedSegDiff-V2: Diffusion based Medical Image Segmentation with Transformer](https://mlsanity.com/paper/2301.11798/) (2023)
- [Bidirectional Copy-Paste for Semi-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2305.00673/) (2023)
- [Evaluation of Algorithms for Multi-Modality Whole Heart Segmentation: An Open-Access Grand Challenge](https://mlsanity.com/paper/1902.07880/) (2019)
- [Exploring Smoothness and Class-Separation for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2203.01324/) (2022)
- [Generative models improve fairness of medical classifiers under distribution shifts](https://mlsanity.com/paper/2304.09218/) (2023)
- [MedPerf: Open Benchmarking Platform for Medical Artificial Intelligence using Federated Evaluation](https://mlsanity.com/paper/2110.01406/) (2021)
- [Annotation-efficient deep learning for automatic medical image segmentation](https://mlsanity.com/paper/2012.04885/) (2020)
- [VoCo: A Simple-yet-Effective Volume Contrastive Learning Framework for 3D Medical Image Analysis](https://mlsanity.com/paper/2402.17300/) (2024)
- [SynSeg-Net: Synthetic Segmentation Without Target Modality Ground Truth](https://mlsanity.com/paper/1810.06498/) (2018)
- [Diffusion Deformable Model for 4D Temporal Medical Image Generation](https://mlsanity.com/paper/2206.13295/) (2022)
- [An automatic multi-tissue human fetal brain segmentation benchmark using the Fetal Tissue Annotation Dataset](https://mlsanity.com/paper/2010.15526/) (2020)
- [Understanding metric-related pitfalls in image analysis validation](https://mlsanity.com/paper/2302.01790/) (2023)
- [Enhancing Pseudo Label Quality for Semi-Supervised Domain-Generalized Medical Image Segmentation](https://mlsanity.com/paper/2201.08657/) (2022)
- [nnMamba: 3D Biomedical Image Segmentation, Classification and Landmark Detection with State Space Model](https://mlsanity.com/paper/2402.03526/) (2024)

## Built on by (most cited first, 6 of 6)

- [Ctrl-GenAug: Controllable Generative Augmentation for Medical Sequence Classification](https://mlsanity.com/paper/2409.17091/) (2024)
- [Adaptive Domain Shift in Diffusion Models for Cross-Modality Image Translation](https://mlsanity.com/paper/2601.18623/) (2026)
- [T2I-ConBench: Text-to-Image Benchmark for Continual Post-training](https://mlsanity.com/paper/2505.16875/) (2025)
- [Multi-Channel Uncertainty-Weighted Score Matching for Conditional Diffusion in Medical UDA](https://mlsanity.com/paper/2509.22476/) (2025)
- [BCMDA: Bidirectional Correlation Maps Domain Adaptation for Mixed Domain Semi-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2603.24691/) (2026)
- [SNR-Adaptive Unified Diffusion for Multi-Task Medical Image Segmentation](https://mlsanity.com/paper/2607.03103/) (2026)

## Abstract (arXiv)

The scarcity and complexity of voxel-level annotations in 3D medical imaging present significant challenges, particularly due to the domain gap between labeled datasets from well-resourced centers and unlabeled datasets from less-resourced centers. This disparity affects the fairness of artificial intelligence algorithms in healthcare. We introduce Diffuse-UDA, a novel method leveraging diffusion models to tackle Unsupervised Domain Adaptation (UDA) in medical image segmentation. Diffuse-UDA generates high-quality image-mask pairs with target domain characteristics and various structures, thereby enhancing UDA tasks. Initially, pseudo labels for target domain samples are generated. Subsequently, a specially tailored diffusion model, incorporating deformable augmentations, is trained on image-label or image-pseudo-label pairs from both domains. Finally, source domain labels guide the diffusion model to generate image-label pairs for the target domain. Comprehensive evaluations on several benchmarks demonstrate that Diffuse-UDA outperforms leading UDA and semi-supervised strategies, achieving performance close to or even surpassing the theoretical upper bound of models trained directly on target domain data. Diffuse-UDA offers a pathway to advance the development and deployment of AI systems in medical imaging, addressing disparities between healthcare environments. This approach enables the exploration of innovative AI-driven diagnostic tools, improves outcomes, saves time, and reduces human error.