# ImmunoDiff: A Diffusion Model for Immunotherapy Response Prediction in Lung Cancer

arXiv: https://arxiv.org/abs/2505.23675 · HTML: https://mlsanity.com/paper/2505.23675/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Placed in Medical imaging and segmentation, one of 14 directions in Diffusion models.
- Builds on 23 of its 49 references that are in the map.
- First posted on arXiv 29 May 2025.

## Placed in

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

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

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [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)
- [High-Resolution Image Synthesis with Latent Diffusion Models](https://mlsanity.com/paper/2112.10752/) (2021)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [Adding Conditional Control to Text-to-Image Diffusion Models](https://mlsanity.com/paper/2302.05543/) (2023)
- [RoFormer: Enhanced Transformer with Rotary Position Embedding](https://mlsanity.com/paper/2104.09864/) (2021)
- [GLIGEN: Open-Set Grounded Text-to-Image Generation](https://mlsanity.com/paper/2301.07093/) (2023)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [Uni-ControlNet: All-in-One Control to Text-to-Image Diffusion Models](https://mlsanity.com/paper/2305.16322/) (2023)
- [Your Diffusion Model is Secretly a Zero-Shot Classifier](https://mlsanity.com/paper/2303.16203/) (2023)
- [Composer: Creative and Controllable Image Synthesis with Composable Conditions](https://mlsanity.com/paper/2302.09778/) (2023)
- [Brain Imaging Generation with Latent Diffusion Models](https://mlsanity.com/paper/2209.07162/) (2022)
- [Diffusion Models for Medical Anomaly Detection](https://mlsanity.com/paper/2203.04306/) (2022)
- [UniControl: A Unified Diffusion Model for Controllable Visual Generation In the Wild](https://mlsanity.com/paper/2305.11147/) (2023)
- [RoentGen: Vision-Language Foundation Model for Chest X-ray Generation](https://mlsanity.com/paper/2211.12737/) (2022)
- [Adaptive Latent Diffusion Model for 3D Medical Image to Image Translation: Multi-modal Magnetic Resonance Imaging Study](https://mlsanity.com/paper/2311.00265/) (2023)
- [MedSyn: Text-guided Anatomy-aware Synthesis of High-Fidelity 3D CT Images](https://mlsanity.com/paper/2310.03559/) (2023)
- [Cross-conditioned Diffusion Model for Medical Image to Image Translation](https://mlsanity.com/paper/2409.08500/) (2024)
- [DiffBoost: Enhancing Medical Image Segmentation via Text-Guided Diffusion Model](https://mlsanity.com/paper/2310.12868/) (2023)
- [RadGazeGen: Radiomics and Gaze-guided Medical Image Generation using Diffusion Models](https://mlsanity.com/paper/2410.00307/) (2024)

## Built on by (most cited first, 2 of 2)

- [Anatomy-DT: A Cross-Diffusion Digital Twin for Anatomical Evolution](https://mlsanity.com/paper/2509.25280/) (2025)
- [SoC-DT: Standard-of-Care Aligned Digital Twins for Patient-Specific Tumor Dynamics](https://mlsanity.com/paper/2510.03287/) (2025)

## Abstract (arXiv)

Accurately predicting immunotherapy response in Non-Small Cell Lung Cancer (NSCLC) remains a critical unmet need. Existing radiomics and deep learning-based predictive models rely primarily on pre-treatment imaging to predict categorical response outcomes, limiting their ability to capture the complex morphological and textural transformations induced by immunotherapy. This study introduces ImmunoDiff, an anatomy-aware diffusion model designed to synthesize post-treatment CT scans from baseline imaging while incorporating clinically relevant constraints. The proposed framework integrates anatomical priors, specifically lobar and vascular structures, to enhance fidelity in CT synthesis. Additionally, we introduce a novel cbi-Adapter, a conditioning module that ensures pairwise-consistent multimodal integration of imaging and clinical data embeddings, to refine the generative process. Additionally, a clinical variable conditioning mechanism is introduced, leveraging demographic data, blood-based biomarkers, and PD-L1 expression to refine the generative process. Evaluations on an in-house NSCLC cohort treated with immune checkpoint inhibitors demonstrate a 21.24% improvement in balanced accuracy for response prediction and a 0.03 increase in c-index for survival prediction. Code will be released soon.