# Regression is all you need for medical image translation

arXiv: https://arxiv.org/abs/2505.02048 · HTML: https://mlsanity.com/paper/2505.02048/

## Key facts

- Cited by 8 papers in the map (data through 14 Oct 2026).
- Placed in Medical imaging and segmentation, one of 14 directions in Diffusion models.
- Builds on 56 of its 89 references that are in the map.
- First posted on arXiv 4 May 2025.

## Placed in

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

## Builds on (most cited first, 30 of 56)

- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [High-Resolution Image Synthesis with Latent Diffusion Models](https://mlsanity.com/paper/2112.10752/) (2021)
- [Denoising Diffusion Implicit Models](https://mlsanity.com/paper/2010.02502/) (2020)
- [Score-Based Generative Modeling through Stochastic Differential Equations](https://mlsanity.com/paper/2011.13456/) (2020)
- [Diffusion Models Beat GANs on Image Synthesis](https://mlsanity.com/paper/2105.05233/) (2021)
- [Deep Unsupervised Learning using Nonequilibrium Thermodynamics](https://mlsanity.com/paper/1503.03585/) (2015)
- [Flow Matching for Generative Modeling](https://mlsanity.com/paper/2210.02747/) (2022)
- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [Improved Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2102.09672/) (2021)
- [Analyzing and Improving the Image Quality of StyleGAN](https://mlsanity.com/paper/1912.04958/) (2019)
- [Elucidating the Design Space of Diffusion-Based Generative Models](https://mlsanity.com/paper/2206.00364/) (2022)
- [Photo-Realistic Single Image Super-Resolution Using a Generative Adversarial Network](https://mlsanity.com/paper/1609.04802/) (2016)
- [Image Super-Resolution via Iterative Refinement](https://mlsanity.com/paper/2104.07636/) (2021)
- [Palette: Image-to-Image Diffusion Models](https://mlsanity.com/paper/2111.05826/) (2021)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [The Perception-Distortion Tradeoff](https://mlsanity.com/paper/1711.06077/) (2017)
- [Noise2Noise: Learning Image Restoration without Clean Data](https://mlsanity.com/paper/1803.04189/) (2018)
- [The RSNA-ASNR-MICCAI BraTS 2021 Benchmark on Brain Tumor Segmentation and Radiogenomic Classification](https://mlsanity.com/paper/2107.02314/) (2021)
- [Novel View Synthesis with Diffusion Models](https://mlsanity.com/paper/2210.04628/) (2022)
- [Diffusion Models for Medical Image Analysis: A Comprehensive Survey](https://mlsanity.com/paper/2211.07804/) (2022)
- [Brain Imaging Generation with Latent Diffusion Models](https://mlsanity.com/paper/2209.07162/) (2022)
- [nnU-Net Revisited: A Call for Rigorous Validation in 3D Medical Image Segmentation](https://mlsanity.com/paper/2404.09556/) (2024)
- [SynthSeg: Segmentation of brain MRI scans of any contrast and resolution without retraining](https://mlsanity.com/paper/2107.09559/) (2021)
- [BBDM: Image-to-image Translation with Brownian Bridge Diffusion Models](https://mlsanity.com/paper/2205.07680/) (2022)
- [I2SB: Image-to-Image Schr"odinger Bridge](https://mlsanity.com/paper/2302.05872/) (2023)
- [Unsupervised Medical Image Translation with Adversarial Diffusion Models](https://mlsanity.com/paper/2207.08208/) (2022)
- [ResViT: Residual vision transformers for multi-modal medical image synthesis](https://mlsanity.com/paper/2106.16031/) (2021)
- [Image Synthesis in Multi-Contrast MRI with Conditional Generative Adversarial Networks](https://mlsanity.com/paper/1802.01221/) (2018)
- [Standardized Assessment of Automatic Segmentation of White Matter Hyperintensities and Results of the WMH Segmentation Challenge](https://mlsanity.com/paper/1904.00682/) (2019)
- [FastSurfer -- A fast and accurate deep learning based neuroimaging pipeline](https://mlsanity.com/paper/1910.03866/) (2019)

## Built on by (most cited first, 8 of 8)

- [Generative Drifting for Conditional Medical Image Generation](https://mlsanity.com/paper/2604.19736/) (2026)
- [Exploiting Completeness Perception with Diffusion Transformer for Unified 3D MRI Synthesis](https://mlsanity.com/paper/2602.18400/) (2026)
- [Unified Multimodal Model for Brain MRI Imputation and Understanding](https://mlsanity.com/paper/2606.16484/) (2026)
- [Do We Really Need Diffusion? A Fast U-Net for Paired Medical Image Translation](https://mlsanity.com/paper/2606.17675/) (2026)
- [Posterior Samplings are Missing Modalities Generators for Medical Image Translation](https://mlsanity.com/paper/2607.18763/) (2026)
- [Evaluating the Safety of Deep Learning-Based Brain MRI Reconstruction](https://mlsanity.com/paper/2608.28714/) (2026)
- [When Misalignment Becomes Supervision: Structured Label Noise in Supervised Synthetic CT Generation](https://mlsanity.com/paper/2609.29387/) (2026)
- [PredRA: Fast Medical Image Translation by Deterministic Component Extraction and Controlled Stochastic Refinement](https://mlsanity.com/paper/2609.31912/) (2026)

## Abstract (arXiv)

While Generative Adversarial Nets (GANs) and Diffusion Models (DMs) have achieved impressive results in natural image synthesis, their core strengths - creativity and realism - can be detrimental in medical applications, where accuracy and fidelity are paramount. These models instead risk introducing hallucinations and replication of unwanted acquisition noise. Here, we propose YODA (You Only Denoise once - or Average), a 2.5D diffusion-based framework for medical image translation (MIT). Consistent with DM theory, we find that conventional diffusion sampling stochastically replicates noise. To mitigate this, we draw and average multiple samples, akin to physical signal averaging. As this effectively approximates the DM's expected value, we term this Expectation-Approximation (ExpA) sampling. We additionally propose regression sampling YODA, which retains the initial DM prediction and omits iterative refinement to produce noise-free images in a single step. Across five diverse multi-modal datasets - including multi-contrast brain MRI and pelvic MRI-CT - we demonstrate that regression sampling is not only substantially more efficient but also matches or exceeds image quality of full diffusion sampling even with ExpA. Our results reveal that iterative refinement solely enhances perceptual realism without benefiting information translation, which we confirm in relevant downstream tasks. YODA outperforms eight state-of-the-art DMs and GANs and challenges the presumed superiority of DMs and GANs over computationally cheap regression models for high-quality MIT. Furthermore, we show that YODA-translated images are interchangeable with, or even superior to, physical acquisitions for several medical applications.