# Harnessing EHRs for Diffusion-based Anomaly Detection on Chest X-rays

arXiv: https://arxiv.org/abs/2505.17311 · HTML: https://mlsanity.com/paper/2505.17311/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 21 of its 29 references that are in the map.
- First posted on arXiv 22 May 2025.

## Builds on (most cited first, 21 of 21)

- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [Denoising Diffusion Implicit Models](https://mlsanity.com/paper/2010.02502/) (2020)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Towards Total Recall in Industrial Anomaly Detection](https://mlsanity.com/paper/2106.08265/) (2021)
- [Revisiting Deep Learning Models for Tabular Data](https://mlsanity.com/paper/2106.11959/) (2021)
- [PaDiM: a Patch Distribution Modeling Framework for Anomaly Detection and Localization](https://mlsanity.com/paper/2011.08785/) (2020)
- [Unsupervised Anomaly Detection with Generative Adversarial Networks to Guide Marker Discovery](https://mlsanity.com/paper/1703.05921/) (2017)
- [Anomaly Detection via Reverse Distillation from One-Class Embedding](https://mlsanity.com/paper/2201.10703/) (2022)
- [GANomaly: Semi-Supervised Anomaly Detection via Adversarial Training](https://mlsanity.com/paper/1805.06725/) (2018)
- [Diffusion Models for Medical Anomaly Detection](https://mlsanity.com/paper/2203.04306/) (2022)
- [CFA: Coupled-hypersphere-based Feature Adaptation for Target-Oriented Anomaly Localization](https://mlsanity.com/paper/2206.04325/) (2022)
- [MambaAD: Exploring State Space Models for Multi-class Unsupervised Anomaly Detection](https://mlsanity.com/paper/2404.06564/) (2024)
- [BMAD: Benchmarks for Medical Anomaly Detection](https://mlsanity.com/paper/2306.11876/) (2023)
- [Anomaly Detection with Conditioned Denoising Diffusion Models](https://mlsanity.com/paper/2305.15956/) (2023)
- [DrFuse: Learning Disentangled Representation for Clinical Multi-Modal Fusion with Missing Modality and Modal Inconsistency](https://mlsanity.com/paper/2403.06197/) (2024)
- [RadFusion: Benchmarking Performance and Fairness for Multimodal Pulmonary Embolism Detection from CT and EHR](https://mlsanity.com/paper/2111.11665/) (2021)
- [Diffusion Models with Implicit Guidance for Medical Anomaly Detection](https://mlsanity.com/paper/2403.08464/) (2024)
- [Unsupervised Anomaly Detection in Medical Images Using Masked Diffusion Model](https://mlsanity.com/paper/2305.19867/) (2023)
- [Contrastive Diffusion Model with Auxiliary Guidance for Coarse-to-Fine PET Reconstruction](https://mlsanity.com/paper/2308.10157/) (2023)
- [MedSegFactory: Text-Guided Generation of Medical Image-Mask Pairs](https://mlsanity.com/paper/2504.06897/) (2025)
- [A Survey of Emerging Applications of Diffusion Probabilistic Models in MRI](https://mlsanity.com/paper/2311.11383/) (2023)

## Abstract (arXiv)

Unsupervised anomaly detection (UAD) in medical imaging is crucial for identifying pathological abnormalities without requiring extensive labeled data. However, existing diffusion-based UAD models rely solely on imaging features, limiting their ability to distinguish between normal anatomical variations and pathological anomalies. To address this, we propose Diff3M, a multi-modal diffusion-based framework that integrates chest X-rays and structured Electronic Health Records (EHRs) for enhanced anomaly detection. Specifically, we introduce a novel image-EHR cross-attention module to incorporate structured clinical context into the image generation process, improving the model's ability to differentiate normal from abnormal features. Additionally, we develop a static masking strategy to enhance the reconstruction of normal-like images from anomalies. Extensive evaluations on CheXpert and MIMIC-CXR/IV demonstrate that Diff3M achieves state-of-the-art performance, outperforming existing UAD methods in medical imaging. Our code is available at this http URL https://github.com/nth221/Diff3M