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Unsupervised anomaly detection in medical imaging using aggregated normative diffusion
Alexander Frotscher1, Jaivardhan Kapoor2, Thomas Wolfers1
1University Hospital Tübingen, Tübingen, 72074, Baden-Württemberg, Germany.
Medical Image Analysis
|December 20, 2025
Summary
A new unsupervised anomaly detection (UAD) method, Aggregated Normative Diffusion (ANDi), shows improved performance in identifying brain anomalies in MRI scans. ANDi surpasses existing methods, especially for detecting multiple sclerosis lesions.
Area of Science:
- Medical Imaging Analysis
- Artificial Intelligence in Healthcare
- Neuroscience Research
Background:
- Early detection of anomalies in brain magnetic resonance imaging (MRI) is crucial for medical diagnosis and treatment.
- Supervised machine learning for anomaly detection is limited by the need for extensive labeled data for specific pathologies.
- Unsupervised anomaly detection (UAD) offers a promising approach to identify a wider range of abnormalities by detecting deviations from normal patterns.
Purpose of the Study:
- To address the limitations of existing UAD methods in generalizing to diverse anomalies in multi-modal brain MRI data.
- To introduce and evaluate a novel UAD method named Aggregated Normative Diffusion (ANDi).
Main Methods:
- ANDi aggregates differences between predicted denoising steps and ground truth backwards transitions within Denoising Diffusion Probabilistic Models (DDPMs).
- The DDPMs used in ANDi are trained on pyramidal Gaussian noise.
- The proposed method was validated against four recent UAD baselines across three diverse brain MRI datasets.
Main Results:
- ANDi demonstrates substantial improvements over existing UAD baselines in detecting anomalies in brain MRI.
- The method exhibits increased robustness to various types of anomalies.
- Specifically, ANDi achieved up to a 44% improvement in Area Under the Precision-Recall Curve (AUPRC) for detecting multiple sclerosis (MS) lesions.
Conclusions:
- Aggregated Normative Diffusion (ANDi) represents a significant advancement in unsupervised anomaly detection for multi-modal brain MRI.
- The developed method offers enhanced accuracy and robustness, particularly beneficial for identifying neurological conditions like MS.
- ANDi has the potential to improve the early detection and diagnosis of a broader range of brain abnormalities.
Keywords:
BrainComputer-aided detection and diagnosisMachine learningMagnetic resonance imagingScore-based generative models
