# Hierarchical Diffusion Framework for Pseudo-Healthy Brain MRI Inpainting with Enhanced 3D Consistency

arXiv: https://arxiv.org/abs/2507.17911 · HTML: https://mlsanity.com/paper/2507.17911/

## 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 7 of its 31 references that are in the map.
- First posted on arXiv 23 Jul 2025.

## Placed in

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

## Builds on (most cited first, 7 of 7)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [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)
- [Diffusion Models Beat GANs on Image Synthesis](https://mlsanity.com/paper/2105.05233/) (2021)
- [Xception: Deep Learning with Depthwise Separable Convolutions](https://mlsanity.com/paper/1610.02357/) (2016)
- [Free-Form Image Inpainting with Gated Convolution](https://mlsanity.com/paper/1806.03589/) (2018)
- [Similarity and Quality Metrics for MR Image-To-Image Translation](https://mlsanity.com/paper/2405.08431/) (2024)

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

- [BrainNormalizer: Anatomy-Informed Pseudo-Healthy Brain Reconstruction from Tumor MRI via Edge-Guided ControlNet](https://mlsanity.com/paper/2511.12853/) (2025)
- [Diffusion Models in Medical Image Inpainting: Challenges, Solution Taxonomy, and Future Directions](https://mlsanity.com/paper/2607.21904/) (2026)

## Abstract (arXiv)

Pseudo-healthy image inpainting is an essential preprocessing step for analyzing pathological brain MRI scans. Most current inpainting methods favor slice-wise 2D models for their high in-plane fidelity, but their independence across slices produces discontinuities in the volume. Fully 3D models alleviate this issue, but their high model capacity demands extensive training data for reliable, high-fidelity synthesis -- often impractical in medical settings. We address these limitations with a hierarchical diffusion framework by replacing direct 3D modeling with two perpendicular coarse-to-fine 2D stages. An axial diffusion model first yields a coarse, globally consistent inpainting; a coronal diffusion model then refines anatomical details. By combining perpendicular spatial views with adaptive resampling, our method balances data efficiency and volumetric consistency. Our experiments show our approach outperforms state-of-the-art baselines in both realism and volumetric consistency, making it a promising solution for pseudo-healthy image inpainting. Code is available at https://github.com/dou0000/3dMRI-Consistent-Inpaint.