# Lung-DDPM: Semantic Layout-guided Diffusion Models for Thoracic CT Image Synthesis

arXiv: https://arxiv.org/abs/2502.15204 · HTML: https://mlsanity.com/paper/2502.15204/

## Key facts

- Cited by 7 papers in the map (data through 14 Oct 2026).
- Placed in Medical imaging and segmentation, one of 14 directions in Diffusion models.
- Builds on 15 of its 42 references that are in the map.
- First posted on arXiv 21 Feb 2025.

## Placed in

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

## Builds on (most cited first, 15 of 15)

- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [High-Resolution Image Synthesis and Semantic Manipulation with Conditional GANs](https://mlsanity.com/paper/1711.11585/) (2017)
- [Is synthetic data from generative models ready for image recognition?](https://mlsanity.com/paper/2210.07574/) (2022)
- [Med3D: Transfer Learning for 3D Medical Image Analysis](https://mlsanity.com/paper/1904.00625/) (2019)
- [GAN-based Synthetic Medical Image Augmentation for increased CNN Performance in Liver Lesion Classification](https://mlsanity.com/paper/1803.01229/) (2018)
- [Conditional Diffusion Models for Semantic 3D Brain MRI Synthesis](https://mlsanity.com/paper/2305.18453/) (2023)
- [Hierarchical Amortized Training for Memory-efficient High Resolution 3D GAN](https://mlsanity.com/paper/2008.01910/) (2020)
- [Towards Data-Efficient Learning: A Benchmark for COVID-19 CT Lung and Infection Segmentation](https://mlsanity.com/paper/2004.12537/) (2020)
- [How much data is needed to train a medical image deep learning system to achieve necessary high accuracy?](https://mlsanity.com/paper/1511.06348/) (2015)
- [Make-A-Volume: Leveraging Latent Diffusion Models for Cross-Modality 3D Brain MRI Synthesis](https://mlsanity.com/paper/2307.10094/) (2023)
- [Exploring large scale public medical image datasets](https://mlsanity.com/paper/1907.12720/) (2019)
- [COVID-19 CT Image Synthesis with a Conditional Generative Adversarial Network](https://mlsanity.com/paper/2007.14638/) (2020)
- [Survival Prediction of Brain Cancer with Incomplete Radiology, Pathology, Genomics, and Demographic Data](https://mlsanity.com/paper/2203.04419/) (2022)
- [Generative Enhancement for 3D Medical Images](https://mlsanity.com/paper/2403.12852/) (2024)

## Built on by (most cited first, 7 of 7)

- [MedSegFactory: Text-Guided Generation of Medical Image-Mask Pairs](https://mlsanity.com/paper/2504.06897/) (2025)
- [Lung-DDPM+: Efficient Thoracic CT Image Synthesis using Diffusion Probabilistic Model](https://mlsanity.com/paper/2508.09327/) (2025)
- [Auditing Sybil: Explaining Deep Lung Cancer Risk Prediction Through Generative Interventional Attributions](https://mlsanity.com/paper/2602.02560/) (2026)
- [Knowledge-Guided 3D CT Generation: A Conditioning-Centric Taxonomy](https://mlsanity.com/paper/2608.09992/) (2026)
- [CTForensics: A Comprehensive Dataset and Method for AI-Generated CT Image Detection](https://mlsanity.com/paper/2603.01878/) (2026)
- [DiffSegLung: Diffusion Radiomic Distillation for Unsupervised Lung Pathology Segmentation](https://mlsanity.com/paper/2605.11758/) (2026)
- [MedSyn2: Flexible Control of 3D CT Generation via Text and Semantically-Defined Segmentation Prompts](https://mlsanity.com/paper/2606.00967/) (2026)

## Abstract (arXiv)

With the rapid development of artificial intelligence (AI), AI-assisted medical imaging analysis demonstrates remarkable performance in early lung cancer screening. However, the costly annotation process and privacy concerns limit the construction of large-scale medical datasets, hampering the further application of AI in healthcare. To address the data scarcity in lung cancer screening, we propose Lung-DDPM, a thoracic CT image synthesis approach that effectively generates high-fidelity 3D synthetic CT images, which prove helpful in downstream lung nodule segmentation tasks. Our method is based on semantic layout-guided denoising diffusion probabilistic models (DDPM), enabling anatomically reasonable, seamless, and consistent sample generation even from incomplete semantic layouts. Our results suggest that the proposed method outperforms other state-of-the-art (SOTA) generative models in image quality evaluation and downstream lung nodule segmentation tasks. Specifically, Lung-DDPM achieved superior performance on our large validation cohort, with a Fr'echet inception distance (FID) of 0.0047, maximum mean discrepancy (MMD) of 0.0070, and mean squared error (MSE) of 0.0024. These results were 7.4×, 3.1×, and 29.5× better than the second-best competitors, respectively. Furthermore, the lung nodule segmentation model, trained on a dataset combining real and Lung-DDPM-generated synthetic samples, attained a Dice Coefficient (Dice) of 0.3914 and sensitivity of 0.4393. This represents 8.8% and 18.6% improvements in Dice and sensitivity compared to the model trained solely on real samples. The experimental results highlight Lung-DDPM's potential for a broader range of medical imaging applications, such as general tumor segmentation, cancer survival estimation, and risk prediction. The code and pretrained models are available at https://github.com/Manem-Lab/Lung-DDPM/.