# Can Diffusion Models Bridge the Domain Gap in Cardiac MR Imaging?

arXiv: https://arxiv.org/abs/2508.06327 · HTML: https://mlsanity.com/paper/2508.06327/

## 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 37 references that are in the map.
- First posted on arXiv 8 Aug 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)

- [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)
- [Improved Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2102.09672/) (2021)
- [Generalizing to Unseen Domains: A Survey on Domain Generalization](https://mlsanity.com/paper/2103.03097/) (2021)
- [ILVR: Conditioning Method for Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2108.02938/) (2021)
- [A Comprehensive Survey on Test-Time Adaptation under Distribution Shifts](https://mlsanity.com/paper/2303.15361/) (2023)
- [Domain Adaptation for Medical Image Analysis: A Survey](https://mlsanity.com/paper/2102.09508/) (2021)
- [nnU-Net Revisited: A Call for Rigorous Validation in 3D Medical Image Segmentation](https://mlsanity.com/paper/2404.09556/) (2024)
- [On Fast Sampling of Diffusion Probabilistic Models](https://mlsanity.com/paper/2106.00132/) (2021)
- [FSDR: Frequency Space Domain Randomization for Domain Generalization](https://mlsanity.com/paper/2103.02370/) (2021)
- [Deep learning for cardiac image segmentation: A review](https://mlsanity.com/paper/1911.03723/) (2019)
- [Back to the Source: Diffusion-Driven Test-Time Adaptation](https://mlsanity.com/paper/2207.03442/) (2022)
- [Towards a Guideline for Evaluation Metrics in Medical Image Segmentation](https://mlsanity.com/paper/2202.05273/) (2022)
- [Domain Generalization for Medical Image Analysis: A Review](https://mlsanity.com/paper/2310.08598/) (2023)
- [Studying Robustness of Semantic Segmentation under Domain Shift in cardiac MRI](https://mlsanity.com/paper/2011.07592/) (2020)
- [Unsupervised Domain Adaptation with Variational Approximation for Cardiac Segmentation](https://mlsanity.com/paper/2106.08752/) (2021)
- [Generalization by Adaptation: Diffusion-Based Domain Extension for Domain-Generalized Semantic Segmentation](https://mlsanity.com/paper/2312.01850/) (2023)
- [Beware of diffusion models for synthesizing medical images -- A comparison with GANs in terms of memorizing brain MRI and chest x-ray images](https://mlsanity.com/paper/2305.07644/) (2023)
- [Brain tumor segmentation using synthetic MR images -- A comparison of GANs and diffusion models](https://mlsanity.com/paper/2306.02986/) (2023)
- [Controllable cardiac synthesis via disentangled anatomy arithmetic](https://mlsanity.com/paper/2107.01748/) (2021)
- [Fairness-Aware Data Augmentation for Cardiac MRI using Text-Conditioned Diffusion Models](https://mlsanity.com/paper/2403.19508/) (2024)
- [Enhancing Sample Generation of Diffusion Models using Noise Level Correction](https://mlsanity.com/paper/2412.05488/) (2024)
- [The Impact of Domain Shift on Left and Right Ventricle Segmentation in Short Axis Cardiac MR Images](https://mlsanity.com/paper/2109.13230/) (2021)

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

- [Balancing Fidelity, Utility, and Privacy in Synthetic Cardiac MRI Generation: A Comparative Study](https://mlsanity.com/paper/2603.04340/) (2026)
- [Synthetic Cardiac MRI Image Generation using Deep Generative Models](https://mlsanity.com/paper/2603.24764/) (2026)

## Abstract (arXiv)

Magnetic resonance (MR) imaging, including cardiac MR, is prone to domain shift due to variations in imaging devices and acquisition protocols. This challenge limits the deployment of trained AI models in real-world scenarios, where performance degrades on unseen domains. Traditional solutions involve increasing the size of the dataset through ad-hoc image augmentation or additional online training/transfer learning, which have several limitations. Synthetic data offers a promising alternative, but anatomical/structural consistency constraints limit the effectiveness of generative models in creating image-label pairs. To address this, we propose a diffusion model (DM) trained on a source domain that generates synthetic cardiac MR images that resemble a given reference. The synthetic data maintains spatial and structural fidelity, ensuring similarity to the source domain and compatibility with the segmentation mask. We assess the utility of our generative approach in multi-centre cardiac MR segmentation, using the 2D nnU-Net, 3D nnU-Net and vanilla U-Net segmentation networks. We explore domain generalisation, where, domain-invariant segmentation models are trained on synthetic source domain data, and domain adaptation, where, we shift target domain data towards the source domain using the DM. Both strategies significantly improved segmentation performance on data from an unseen target domain, in terms of surface-based metrics (Welch's t-test, p < 0.01), compared to training segmentation models on real data alone. The proposed method ameliorates the need for transfer learning or online training to address domain shift challenges in cardiac MR image analysis, especially useful in data-scarce settings.