LeFusion: Synthesizing Myocardial Pathology on Cardiac MRI via Lesion-Focus Diffusion Models

Data generated in clinical practice often exhibits biases, such as long-tail imbalance and algorithmic unfairness. This study aims to mitigate these challenges through data synthesis. Previous efforts in medical imaging synthesis have struggled with separating lesion information from background context, leading to difficulties in generating high-quality backgrounds and limited control over the synthetic output. Inspired by diffusion-based image inpainting, we propose LeFusion, lesion-focused diffusion models. By redesigning the diffusion learning objectives to concentrate on lesion areas, it simplifies the model learning process and enhance the controllability of the synthetic output, while preserving background by integrating forward-diffused background contexts into the reverse diffusion process. Furthermore, we generalize it to jointly handle multi-class lesions, and further introduce a generative model for lesion masks to increase synthesis diversity. Validated on the DE-MRI cardiac lesion segmentation dataset (Emidec), our methodology employs the popular nnUNet to demonstrate that the synthetic data make it possible to effectively enhance a state-of-the-art model. Code and model are available at https://github.com/M3DV/LeFusion.