# Diffusion Based Ambiguous Image Segmentation

arXiv: https://arxiv.org/abs/2504.05977 · HTML: https://mlsanity.com/paper/2504.05977/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 23 of its 25 references that are in the map.
- First posted on arXiv 8 Apr 2025.

## Builds on (most cited first, 23 of 23)

- [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)
- [Denoising Diffusion Implicit Models](https://mlsanity.com/paper/2010.02502/) (2020)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [You Only Look Once: Unified, Real-Time Object Detection](https://mlsanity.com/paper/1506.02640/) (2015)
- [Improved Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2102.09672/) (2021)
- [Variational Diffusion Models](https://mlsanity.com/paper/2107.00630/) (2021)
- [Simple diffusion: End-to-end diffusion for high resolution images](https://mlsanity.com/paper/2301.11093/) (2023)
- [Analog Bits: Generating Discrete Data using Diffusion Models with Self-Conditioning](https://mlsanity.com/paper/2208.04202/) (2022)
- [Understanding Diffusion Objectives as the ELBO with Simple Data Augmentation](https://mlsanity.com/paper/2303.00848/) (2023)
- [A Probabilistic U-Net for Segmentation of Ambiguous Images](https://mlsanity.com/paper/1806.05034/) (2018)
- [SegDiff: Image Segmentation with Diffusion Probabilistic Models](https://mlsanity.com/paper/2112.00390/) (2021)
- [Bayesian SegNet: Model Uncertainty in Deep Convolutional Encoder-Decoder Architectures for Scene Understanding](https://mlsanity.com/paper/1511.02680/) (2015)
- [Diffusion Models for Implicit Image Segmentation Ensembles](https://mlsanity.com/paper/2112.03145/) (2021)
- [On the Importance of Noise Scheduling for Diffusion Models](https://mlsanity.com/paper/2301.10972/) (2023)
- [MedSegDiff: Medical Image Segmentation with Diffusion Probabilistic Model](https://mlsanity.com/paper/2211.00611/) (2022)
- [PHiSeg: Capturing Uncertainty in Medical Image Segmentation](https://mlsanity.com/paper/1906.04045/) (2019)
- [MedSegDiff-V2: Diffusion based Medical Image Segmentation with Transformer](https://mlsanity.com/paper/2301.11798/) (2023)
- [Ambiguous Medical Image Segmentation using Diffusion Models](https://mlsanity.com/paper/2304.04745/) (2023)
- [Simpler Diffusion (SiD2): 1.5 FID on ImageNet512 with pixel-space diffusion](https://mlsanity.com/paper/2410.19324/) (2024)
- [A Survey on Deep Learning-based Architectures for Semantic Segmentation on 2D images](https://mlsanity.com/paper/1912.10230/) (2019)
- [Generalized Probabilistic U-Net for medical image segementation](https://mlsanity.com/paper/2207.12872/) (2022)
- [Effect of latent space distribution on the segmentation of images with multiple annotations](https://mlsanity.com/paper/2304.13476/) (2023)

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

- [Rethinking Uncertainty Quantification and Entanglement in Image Segmentation](https://mlsanity.com/paper/2603.18792/) (2026)

## Abstract (arXiv)

Medical image segmentation often involves inherent uncertainty due to variations in expert annotations. Capturing this uncertainty is an important goal and previous works have used various generative image models for the purpose of representing the full distribution of plausible expert ground truths. In this work, we explore the design space of diffusion models for generative segmentation, investigating the impact of noise schedules, prediction types, and loss weightings. Notably, we find that making the noise schedule harder with input scaling significantly improves performance. We conclude that x- and v-prediction outperform epsilon-prediction, likely because the diffusion process is in the discrete segmentation domain. Many loss weightings achieve similar performance as long as they give enough weight to the end of the diffusion process. We base our experiments on the LIDC-IDRI lung lesion dataset and obtain state-of-the-art (SOTA) performance. Additionally, we introduce a randomly cropped variant of the LIDC-IDRI dataset that is better suited for uncertainty in image segmentation. Our model also achieves SOTA in this harder setting.