# CPKD: Clinical Prior Knowledge-Constrained Diffusion Models for Surgical Phase Recognition in Endoscopic Submucosal Dissection

arXiv: https://arxiv.org/abs/2507.03295 · HTML: https://mlsanity.com/paper/2507.03295/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical imaging and segmentation, one of 14 directions in Diffusion models.
- Builds on 50 of its 70 references that are in the map.
- First posted on arXiv 4 Jul 2025.

## Placed in

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

## Builds on (most cited first, 30 of 50)

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- [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)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Denoising Diffusion Implicit Models](https://mlsanity.com/paper/2010.02502/) (2020)
- [Diffusion Models Beat GANs on Image Synthesis](https://mlsanity.com/paper/2105.05233/) (2021)
- [Generative Modeling by Estimating Gradients of the Data Distribution](https://mlsanity.com/paper/1907.05600/) (2019)
- [DPM-Solver: A Fast ODE Solver for Diffusion Probabilistic Model Sampling in Around 10 Steps](https://mlsanity.com/paper/2206.00927/) (2022)
- [Improved Techniques for Training Score-Based Generative Models](https://mlsanity.com/paper/2006.09011/) (2020)
- [Diffusion Models in Vision: A Survey](https://mlsanity.com/paper/2209.04747/) (2022)
- [Vector Quantized Diffusion Model for Text-to-Image Synthesis](https://mlsanity.com/paper/2111.14822/) (2021)
- [DiffusionCLIP: Text-Guided Diffusion Models for Robust Image Manipulation](https://mlsanity.com/paper/2110.02711/) (2021)
- [Label-Efficient Semantic Segmentation with Diffusion Models](https://mlsanity.com/paper/2112.03126/) (2021)
- [Diffusion Autoencoders: Toward a Meaningful and Decodable Representation](https://mlsanity.com/paper/2111.15640/) (2021)
- [MS-TCN: Multi-Stage Temporal Convolutional Network for Action Segmentation](https://mlsanity.com/paper/1903.01945/) (2019)
- [EndoNet: A Deep Architecture for Recognition Tasks on Laparoscopic Videos](https://mlsanity.com/paper/1602.03012/) (2016)
- [DiffusionDet: Diffusion Model for Object Detection](https://mlsanity.com/paper/2211.09788/) (2022)
- [Understanding Diffusion Models: A Unified Perspective](https://mlsanity.com/paper/2208.11970/) (2022)
- [SegDiff: Image Segmentation with Diffusion Probabilistic Models](https://mlsanity.com/paper/2112.00390/) (2021)
- [Diffusion Probabilistic Modeling for Video Generation](https://mlsanity.com/paper/2203.09481/) (2022)
- [Temporal Convolutional Networks: A Unified Approach to Action Segmentation](https://mlsanity.com/paper/1608.08242/) (2016)
- [ASFormer: Transformer for Action Segmentation](https://mlsanity.com/paper/2110.08568/) (2021)
- [TeCNO: Surgical Phase Recognition with Multi-Stage Temporal Convolutional Networks](https://mlsanity.com/paper/2003.10751/) (2020)
- [Diffusion Models for Video Prediction and Infilling](https://mlsanity.com/paper/2206.07696/) (2022)
- [Surgical Data Science: Enabling Next-Generation Surgery](https://mlsanity.com/paper/1701.06482/) (2017)
- [Trans-SVNet: Accurate Phase Recognition from Surgical Videos via Hybrid Embedding Aggregation Transformer](https://mlsanity.com/paper/2103.09712/) (2021)
- [Multi-Task Recurrent Convolutional Network with Correlation Loss for Surgical Video Analysis](https://mlsanity.com/paper/1907.06099/) (2019)
- [Latent Diffusion Energy-Based Model for Interpretable Text Modeling](https://mlsanity.com/paper/2206.05895/) (2022)
- [Temporal Memory Relation Network for Workflow Recognition from Surgical Video](https://mlsanity.com/paper/2103.16327/) (2021)

## Abstract (arXiv)

Gastrointestinal malignancies constitute a leading cause of cancer-related mortality worldwide, with advanced-stage prognosis remaining particularly dismal. Originating as a groundbreaking technique for early gastric cancer treatment, Endoscopic Submucosal Dissection has evolved into a versatile intervention for diverse gastrointestinal lesions. While computer-assisted systems significantly enhance procedural precision and safety in ESD, their clinical adoption faces a critical bottleneck: reliable surgical phase recognition within complex endoscopic workflows. Current state-of-the-art approaches predominantly rely on multi-stage refinement architectures that iteratively optimize temporal predictions. In this paper, we present Clinical Prior Knowledge-Constrained Diffusion (CPKD), a novel generative framework that reimagines phase recognition through denoising diffusion principles while preserving the core iterative refinement philosophy. This architecture progressively reconstructs phase sequences starting from random noise and conditioned on visual-temporal features. To better capture three domain-specific characteristics, including positional priors, boundary ambiguity, and relation dependency, we design a conditional masking strategy. Furthermore, we incorporate clinical prior knowledge into the model training to improve its ability to correct phase logical errors. Comprehensive evaluations on ESD820, Cholec80, and external multi-center demonstrate that our proposed CPKD achieves superior or comparable performance to state-of-the-art approaches, validating the effectiveness of diffusion-based generative paradigms for surgical phase recognition.