# MedDiME: Efficient Latent Diffusion with Adaptive Masking for Medical Counterfactual Generation

arXiv: https://arxiv.org/abs/2609.15647 · HTML: https://mlsanity.com/paper/2609.15647/

## 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 24 of its 27 references that are in the map.
- First posted on arXiv 14 Sep 2026.

## Placed in

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

## Builds on (most cited first, 24 of 24)

- [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)
- [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)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [Exploring Simple Siamese Representation Learning](https://mlsanity.com/paper/2011.10566/) (2020)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Skin Lesion Analysis Toward Melanoma Detection 2018: A Challenge Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1902.03368/) (2019)
- [Diffusion Visual Counterfactual Explanations](https://mlsanity.com/paper/2210.11841/) (2022)
- [Diffusion Models for Counterfactual Explanations](https://mlsanity.com/paper/2203.15636/) (2022)
- [Explanation by Progressive Exaggeration](https://mlsanity.com/paper/1911.00483/) (2019)
- [Adversarial Counterfactual Visual Explanations](https://mlsanity.com/paper/2303.09962/) (2023)
- [Fast Diffusion-Based Counterfactuals for Shortcut Removal and Generation](https://mlsanity.com/paper/2312.14223/) (2023)
- [Equitable modelling of brain imaging by counterfactual augmentation with morphologically constrained 3D deep generative models](https://mlsanity.com/paper/2111.14923/) (2021)
- [Cycle-Consistent Counterfactuals by Latent Transformations](https://mlsanity.com/paper/2203.15064/) (2022)
- [Text-to-Image Models for Counterfactual Explanations: a Black-Box Approach](https://mlsanity.com/paper/2309.07944/) (2023)
- [Benchmarking Counterfactual Image Generation](https://mlsanity.com/paper/2403.20287/) (2024)
- [Reveal to Revise: An Explainable AI Life Cycle for Iterative Bias Correction of Deep Models](https://mlsanity.com/paper/2303.12641/) (2023)
- [Rethinking Visual Counterfactual Explanations Through Region Constraint](https://mlsanity.com/paper/2410.12591/) (2024)
- [Latent Drifting in Diffusion Models for Counterfactual Medical Image Synthesis](https://mlsanity.com/paper/2412.20651/) (2024)
- [Diffusion-based Visual Counterfactual Explanations -- Towards Systematic Quantitative Evaluation](https://mlsanity.com/paper/2308.06100/) (2023)
- [The Gaussian Discriminant Variational Autoencoder (GdVAE): A Self-Explainable Model with Counterfactual Explanations](https://mlsanity.com/paper/2409.12952/) (2024)
- [From Visual Explanations to Counterfactual Explanations with Latent Diffusion](https://mlsanity.com/paper/2504.09202/) (2025)
- [MaskDiME: Adaptive Masked Diffusion for Precise and Efficient Visual Counterfactual Explanations](https://mlsanity.com/paper/2602.18792/) (2026)

## Abstract (arXiv)

Medical counterfactual generation modifies images to change model predictions for interpretability. However, existing diffusion-based approaches are often prohibitively slow and memory-intensive, making them difficult to apply in high-resolution settings. Moreover, existing masking strategies are tightly coupled with pixel-space representations, making them incompatible with latent-space diffusion editing. To address these challenges, we propose MedDiME, a latent-space classifier-guided diffusion framework that reduces computational and memory overhead while introducing a latent-compatible, gradient-driven adaptive masking mechanism for spatially precise medical counterfactual generation. Extensive experiments demonstrate that MedDiME achieves high-quality counterfactual generation with significant efficiency gains compared to prior classifier-guided diffusion baselines, achieving up to 40 times faster inference and 13 times lower peak GPU memory usage.