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Apr 14

MedSteer: Counterfactual Endoscopic Synthesis via Training-Free Activation Steering

Generative diffusion models are increasingly used for medical imaging data augmentation, but text prompting cannot produce causal training data. Re-prompting rerolls the entire generation trajectory, altering anatomy, texture, and background. Inversion-based editing methods introduce reconstruction error that causes structural drift. We propose MedSteer, a training-free activation-steering framework for endoscopic synthesis. MedSteer identifies a pathology vector for each contrastive prompt pair in the cross-attention layers of a diffusion transformer. At inference time, it steers image activations along this vector, generating counterfactual pairs from scratch where the only difference is the steered concept. All other structure is preserved by construction. We evaluate MedSteer across three experiments on Kvasir v3 and HyperKvasir. On counterfactual generation across three clinical concept pairs, MedSteer achieves flip rates of 0.800, 0.925, and 0.950, outperforming the best inversion-based baseline in both concept flip rate and structural preservation. On dye disentanglement, MedSteer achieves 75% dye removal against 20% (PnP) and 10% (h-Edit). On downstream polyp detection, augmenting with MedSteer counterfactual pairs achieves ViT AUC of 0.9755 versus 0.9083 for quantity-matched re-prompting, confirming that counterfactual structure drives the gain. Code is at link https://github.com/phamtrongthang123/medsteer

  • 5 authors
·
Mar 7 3

DCI: Dual-Conditional Inversion for Boosting Diffusion-Based Image Editing

Diffusion models have achieved remarkable success in image generation and editing tasks. Inversion within these models aims to recover the latent noise representation for a real or generated image, enabling reconstruction, editing, and other downstream tasks. However, to date, most inversion approaches suffer from an intrinsic trade-off between reconstruction accuracy and editing flexibility. This limitation arises from the difficulty of maintaining both semantic alignment and structural consistency during the inversion process. In this work, we introduce Dual-Conditional Inversion (DCI), a novel framework that jointly conditions on the source prompt and reference image to guide the inversion process. Specifically, DCI formulates the inversion process as a dual-condition fixed-point optimization problem, minimizing both the latent noise gap and the reconstruction error under the joint guidance. This design anchors the inversion trajectory in both semantic and visual space, leading to more accurate and editable latent representations. Our novel setup brings new understanding to the inversion process. Extensive experiments demonstrate that DCI achieves state-of-the-art performance across multiple editing tasks, significantly improving both reconstruction quality and editing precision. Furthermore, we also demonstrate that our method achieves strong results in reconstruction tasks, implying a degree of robustness and generalizability approaching the ultimate goal of the inversion process.

  • 6 authors
·
Jun 3, 2025