# MedFedPure: A Medical Federated Framework with MAE-based Detection and Diffusion Purification for Inference-Time Attacks

arXiv: https://arxiv.org/abs/2511.11625 · HTML: https://mlsanity.com/paper/2511.11625/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 30 of its 62 references that are in the map.
- First posted on arXiv 7 Nov 2025.

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

- [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)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Communication-Efficient Learning of Deep Networks from Decentralized Data](https://mlsanity.com/paper/1602.05629/) (2016)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Towards Deep Learning Models Resistant to Adversarial Attacks](https://mlsanity.com/paper/1706.06083/) (2017)
- [MobileNetV2: Inverted Residuals and Linear Bottlenecks](https://mlsanity.com/paper/1801.04381/) (2018)
- [Federated Multi-Task Learning](https://mlsanity.com/paper/1705.10467/) (2017)
- [The Future of Digital Health with Federated Learning](https://mlsanity.com/paper/2003.08119/) (2020)
- [FedBN: Federated Learning on Non-IID Features via Local Batch Normalization](https://mlsanity.com/paper/2102.07623/) (2021)
- [Federated Learning with Personalization Layers](https://mlsanity.com/paper/1912.00818/) (2019)
- [An Efficient Framework for Clustered Federated Learning](https://mlsanity.com/paper/2006.04088/) (2020)
- [Diffusion Models for Adversarial Purification](https://mlsanity.com/paper/2205.07460/) (2022)
- [STRIP: A Defence Against Trojan Attacks on Deep Neural Networks](https://mlsanity.com/paper/1902.06531/) (2019)
- [FedProto: Federated Prototype Learning across Heterogeneous Clients](https://mlsanity.com/paper/2105.00243/) (2021)
- [Three Approaches for Personalization with Applications to Federated Learning](https://mlsanity.com/paper/2002.10619/) (2020)
- [Personalized Federated Learning: A Meta-Learning Approach](https://mlsanity.com/paper/2002.07948/) (2020)
- [Federated Multi-Task Learning under a Mixture of Distributions](https://mlsanity.com/paper/2108.10252/) (2021)
- [Privacy and Robustness in Federated Learning: Attacks and Defenses](https://mlsanity.com/paper/2012.06337/) (2020)
- [Layer-wised Model Aggregation for Personalized Federated Learning](https://mlsanity.com/paper/2205.03993/) (2022)
- [Federated Learning Enables Big Data for Rare Cancer Boundary Detection](https://mlsanity.com/paper/2204.10836/) (2022)
- [Personalized and Private Peer-to-Peer Machine Learning](https://mlsanity.com/paper/1705.08435/) (2017)
- [Detecting Backdoors During the Inference Stage Based on Corruption Robustness Consistency](https://mlsanity.com/paper/2303.18191/) (2023)
- [Black-box Backdoor Defense via Zero-shot Image Purification](https://mlsanity.com/paper/2303.12175/) (2023)
- [Attacks in Adversarial Machine Learning: A Systematic Survey from the Life-cycle Perspective](https://mlsanity.com/paper/2302.09457/) (2023)
- [Distributed Federated Learning-Based Deep Learning Model for Privacy MRI Brain Tumor Detection](https://mlsanity.com/paper/2404.10026/) (2024)
- [Test-time Detection and Repair of Adversarial Samples via Masked Autoencoder](https://mlsanity.com/paper/2303.12848/) (2023)
- [You Can Backdoor Personalized Federated Learning](https://mlsanity.com/paper/2307.15971/) (2023)
- [Comparative Analysis of Resource-Efficient CNN Architectures for Brain Tumor Classification](https://mlsanity.com/paper/2411.15596/) (2024)
- [Characterizing Internal Evasion Attacks in Federated Learning](https://mlsanity.com/paper/2209.08412/) (2022)

## Abstract (arXiv)

Artificial intelligence (AI) has shown great potential in medical imaging, particularly for brain tumor detection using Magnetic Resonance Imaging (MRI). However, the models remain vulnerable at inference time when they are trained collaboratively through Federated Learning (FL), an approach adopted to protect patient privacy. Adversarial attacks can subtly alter medical scans in ways invisible to the human eye yet powerful enough to mislead AI models, potentially causing serious misdiagnoses. Existing defenses often assume centralized data and struggle to cope with the decentralized and diverse nature of federated medical settings. In this work, we present MedFedPure, a personalized federated learning defense framework designed to protect diagnostic AI models at inference time without compromising privacy or accuracy. MedFedPure combines three key elements: (1) a personalized FL model that adapts to the unique data distribution of each institution; (2) a Masked Autoencoder (MAE) that detects suspicious inputs by exposing hidden perturbations; and (3) an adaptive diffusion-based purification module that selectively cleans only the flagged scans before classification. Together, these steps offer robust protection while preserving the integrity of normal, benign images. We evaluated MedFedPure on the Br35H brain MRI dataset. The results show a significant gain in adversarial robustness, improving performance from 49.50% to 87.33% under strong attacks, while maintaining a high clean accuracy of 97.67%. By operating locally and in real time during diagnosis, our framework provides a practical path to deploying secure, trustworthy, and privacy-preserving AI tools in clinical workflows. Index Terms: cancer, tumor detection, federated learning, masked autoencoder, diffusion, privacy