# Synomaly Noise and Multi-Stage Diffusion: A Novel Approach for Unsupervised Anomaly Detection in Medical Images

arXiv: https://arxiv.org/abs/2411.04004 · HTML: https://mlsanity.com/paper/2411.04004/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 25 of its 49 references that are in the map.
- First posted on arXiv 6 Nov 2024.

## Builds on (most cited first, 25 of 25)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Diffusion Models Beat GANs on Image Synthesis](https://mlsanity.com/paper/2105.05233/) (2021)
- [SAM 2: Segment Anything in Images and Videos](https://mlsanity.com/paper/2408.00714/) (2024)
- [Unsupervised Anomaly Detection with Generative Adversarial Networks to Guide Marker Discovery](https://mlsanity.com/paper/1703.05921/) (2017)
- [Memorizing Normality to Detect Anomaly: Memory-augmented Deep Autoencoder for Unsupervised Anomaly Detection](https://mlsanity.com/paper/1904.02639/) (2019)
- [CutPaste: Self-Supervised Learning for Anomaly Detection and Localization](https://mlsanity.com/paper/2104.04015/) (2021)
- [The RSNA-ASNR-MICCAI BraTS 2021 Benchmark on Brain Tumor Segmentation and Radiogenomic Classification](https://mlsanity.com/paper/2107.02314/) (2021)
- [The Liver Tumor Segmentation Benchmark (LiTS)](https://mlsanity.com/paper/1901.04056/) (2019)
- [GANomaly: Semi-Supervised Anomaly Detection via Adversarial Training](https://mlsanity.com/paper/1805.06725/) (2018)
- [Deep Generative Modelling: A Comparative Review of VAEs, GANs, Normalizing Flows, Energy-Based and Autoregressive Models](https://mlsanity.com/paper/2103.04922/) (2021)
- [Deep Learning for Medical Anomaly Detection -- A Survey](https://mlsanity.com/paper/2012.02364/) (2020)
- [Context-encoding Variational Autoencoder for Unsupervised Anomaly Detection](https://mlsanity.com/paper/1812.05941/) (2018)
- [Mask, Stitch, and Re-Sample: Enhancing Robustness and Generalizability in Anomaly Detection through Automatic Diffusion Models](https://mlsanity.com/paper/2305.19643/) (2023)
- [Patched Diffusion Models for Unsupervised Anomaly Detection in Brain MRI](https://mlsanity.com/paper/2303.03758/) (2023)
- [Detecting Outliers with Foreign Patch Interpolation](https://mlsanity.com/paper/2011.04197/) (2020)
- [Detecting Outliers with Poisson Image Interpolation](https://mlsanity.com/paper/2107.02622/) (2021)
- [ArSDM: Colonoscopy Images Synthesis with Adaptive Refinement Semantic Diffusion Models](https://mlsanity.com/paper/2309.01111/) (2023)
- [MI-SegNet: Mutual Information-Based US Segmentation for Unseen Domain Generalization](https://mlsanity.com/paper/2303.12649/) (2023)
- [Intelligent Robotic Sonographer: Mutual Information-based Disentangled Reward Learning from Few Demonstrations](https://mlsanity.com/paper/2307.03705/) (2023)
- [Diffusion as Sound Propagation: Physics-inspired Model for Ultrasound Image Generation](https://mlsanity.com/paper/2407.05428/) (2024)
- [Brainomaly: Unsupervised Neurologic Disease Detection Utilizing Unannotated T1-weighted Brain MR Images](https://mlsanity.com/paper/2302.09200/) (2023)
- [ACAT: Adversarial Counterfactual Attention for Classification and Detection in Medical Imaging](https://mlsanity.com/paper/2303.15421/) (2023)
- [DefCor-Net: Physics-Aware Ultrasound Deformation Correction](https://mlsanity.com/paper/2308.03865/) (2023)
- [VibNet: Vibration-Boosted Needle Detection in Ultrasound Images](https://mlsanity.com/paper/2403.14523/) (2024)
- [Class-Aware Cartilage Segmentation for Autonomous US-CT Registration in Robotic Intercostal Ultrasound Imaging](https://mlsanity.com/paper/2406.04100/) (2024)

## Built on by (most cited first, 3 of 3)

- [Speckle2Self: Self-Supervised Ultrasound Speckle Reduction Without Clean Data](https://mlsanity.com/paper/2507.06828/) (2025)
- [Unsupervised Deep Generative Models for Anomaly Detection in Neuroimaging: A Systematic Scoping Review](https://mlsanity.com/paper/2510.14462/) (2025)
- [MTL-MAD: Multi-Task Learners are Effective Medical Anomaly Detectors](https://mlsanity.com/paper/2605.05891/) (2026)

## Abstract (arXiv)

Anomaly detection in medical imaging plays a crucial role in identifying pathological regions across various imaging modalities, such as brain MRI, liver CT, and carotid ultrasound (US). However, training fully supervised segmentation models is often hindered by the scarcity of expert annotations and the complexity of diverse anatomical structures. To address these issues, we propose a novel unsupervised anomaly detection framework based on a diffusion model that incorporates a synthetic anomaly (Synomaly) noise function and a multi-stage diffusion process. Synomaly noise introduces synthetic anomalies into healthy images during training, allowing the model to effectively learn anomaly removal. The multi-stage diffusion process is introduced to progressively denoise images, preserving fine details while improving the quality of anomaly-free reconstructions. The generated high-fidelity counterfactual healthy images can further enhance the interpretability of the segmentation models, as well as provide a reliable baseline for evaluating the extent of anomalies and supporting clinical decision-making. Notably, the unsupervised anomaly detection model is trained purely on healthy images, eliminating the need for anomalous training samples and pixel-level annotations. We validate the proposed approach on brain MRI, liver CT datasets, and carotid US. The experimental results demonstrate that the proposed framework outperforms existing state-of-the-art unsupervised anomaly detection methods, achieving performance comparable to fully supervised segmentation models in the US dataset. Ablation studies further highlight the contributions of Synomaly noise and the multi-stage diffusion process in improving anomaly segmentation. These findings underscore the potential of our approach as a robust and annotation-efficient alternative for medical anomaly detection.