# Scalable next-scale autoregression for medical image generation across anatomical regions

arXiv: https://arxiv.org/abs/2602.14512 · HTML: https://mlsanity.com/paper/2602.14512/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 28 of its 46 references that are in the map.
- First posted on arXiv 16 Feb 2026.

## Builds on (most cited first, 28 of 28)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (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)
- [The Unreasonable Effectiveness of Deep Features as a Perceptual Metric](https://mlsanity.com/paper/1801.03924/) (2018)
- [Scaling Laws for Neural Language Models](https://mlsanity.com/paper/2001.08361/) (2020)
- [Scalable Diffusion Models with Transformers](https://mlsanity.com/paper/2212.09748/) (2022)
- [Membership Inference Attacks against Machine Learning Models](https://mlsanity.com/paper/1610.05820/) (2016)
- [Demystifying MMD GANs](https://mlsanity.com/paper/1801.01401/) (2018)
- [Alias-Free Generative Adversarial Networks](https://mlsanity.com/paper/2106.12423/) (2021)
- [MaskGIT: Masked Generative Image Transformer](https://mlsanity.com/paper/2202.04200/) (2022)
- [Visual Autoregressive Modeling: Scalable Image Generation via Next-Scale Prediction](https://mlsanity.com/paper/2404.02905/) (2024)
- [Membership Inference Attacks From First Principles](https://mlsanity.com/paper/2112.03570/) (2021)
- [Autoregressive Image Generation using Residual Quantization](https://mlsanity.com/paper/2203.01941/) (2022)
- [Rethinking FID: Towards a Better Evaluation Metric for Image Generation](https://mlsanity.com/paper/2401.09603/) (2023)
- [Classification Accuracy Score for Conditional Generative Models](https://mlsanity.com/paper/1905.10887/) (2019)
- [Medical Image Synthesis with Context-Aware Generative Adversarial Networks](https://mlsanity.com/paper/1612.05362/) (2016)
- [MAISI: Medical AI for Synthetic Imaging](https://mlsanity.com/paper/2409.11169/) (2024)
- [Hierarchical Amortized Training for Memory-efficient High Resolution 3D GAN](https://mlsanity.com/paper/2008.01910/) (2020)
- [WDM: 3D Wavelet Diffusion Models for High-Resolution Medical Image Synthesis](https://mlsanity.com/paper/2402.19043/) (2024)
- [3D MedDiffusion: A 3D Medical Latent Diffusion Model for Controllable and High-quality Medical Image Generation](https://mlsanity.com/paper/2412.13059/) (2024)
- [Flow Matching for Medical Image Synthesis: Bridging the Gap Between Speed and Quality](https://mlsanity.com/paper/2503.00266/) (2025)
- [Feature Extraction for Generative Medical Imaging Evaluation: New Evidence Against an Evolving Trend](https://mlsanity.com/paper/2311.13717/) (2023)
- [Context-Aware Membership Inference Attacks against Pre-trained Large Language Models](https://mlsanity.com/paper/2409.13745/) (2024)
- [MedM2G: Unifying Medical Multi-Modal Generation via Cross-Guided Diffusion with Visual Invariant](https://mlsanity.com/paper/2403.04290/) (2024)
- [Privacy Attacks on Image AutoRegressive Models](https://mlsanity.com/paper/2502.02514/) (2025)
- [Generative AI Enables Medical Image Segmentation in Ultra Low-Data Regimes](https://mlsanity.com/paper/2408.17421/) (2024)
- [MedDiff-FM: A Diffusion-based Foundation Model for Versatile Medical Image Applications](https://mlsanity.com/paper/2410.15432/) (2024)
- [Generative Autoregressive Transformers for Model-Agnostic Federated MRI Reconstruction](https://mlsanity.com/paper/2502.04521/) (2025)

## Built on by (most cited first, 3 of 3)

- [Next-Acceleration-Scale Prediction for Autoregressive MRI Reconstruction](https://mlsanity.com/paper/2605.19354/) (2026)
- [Next-Dense-Stride Prediction for Multimodal Autoregressive Visual Modeling](https://mlsanity.com/paper/2607.09892/) (2026)
- [What Makes a Good Medical Image Tokenizer? Rethinking Reconstruction and Generation in Medical Image Tokenization](https://mlsanity.com/paper/2609.24691/) (2026)

## Abstract (arXiv)

Autoregressive pretraining has been key to the scalability of large language models, yet medical generative foundation models remain predominantly based on diffusion. Here we introduce MedVAR, the first foundation model for all-round medical image generation through autoregressive training, and find it offers improved generation quality and efficiency, stronger scalability, and broader adaptability to downstream clinical tasks than diffusion-based models. A tokenizer trained on medical images and separate semantic and structural controls enable generation across six anatomical regions in computed tomography and magnetic resonance imaging. Trained on 438,905 slices from 40 datasets, including seven internal clinical centres, MedVAR generates images 12-19 times faster than 100-step diffusion baselines. Generation quality improves with model size. Pretraining on generated images improves seven-centre hepatocellular carcinoma segmentation Dice from 0.615 to 0.632, while reconstruction using MedVAR images approaches the volumetric segmentation performance of fully sampled volumes. Membership inference reaches 3.54% sensitivity at a 1% false-positive rate, while copy detection performs near chance. These findings establish next-scale autoregression as a scalable and versatile approach to medical image generation and downstream analysis.