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Paper · arXiv

CompDiff enables fair and zero shot medical image generation across demographic intersections through compositional diffusion

Medical image generators trained on imbalanced data can fail at demographic intersections absent from training. We introduce CompDiff, which encodes age, sex and race separately and composes supervised demographic tokens alongside clinical text. Across chest radiographs and fundus images, CompDiff improves overall and subgroup fidelity relative to prompt conditioning (RoentGen-v2) and loss reweighting (FairDiffusion). It generalises in zero-shot generation to 16 chest X-ray intersections excluded from training, achieving the lowest mean FID-RadImageNet in every intersection. In a blinded reader study of these unseen intersections, two radiologists gave CompDiff the highest mean scores amo...

AuthorsMahmoud K. Ibrahim, Bart Elen, Chang Sun et al.
Primary categorycs.CV
Published17 March 2026
Last updated at source28 September 2026
cs.CVcs.AI
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