Semantic Iterative Reconstruction: One-Shot Universal Anomaly Detection

Anomaly detection is a critical task in computer vision with profound implications for medical imaging, where identifying pathologies early can directly impact patient outcomes. While recent unsupervised anomaly detection approaches show promise, they require substantial normal training data and struggle to generalize across anatomical contexts. We introduce D$^2$4FAD, a novel dual distillation framework for few-shot anomaly detection that identifies anomalies in previously unseen tasks using only a small number of normal reference images. Our approach leverages a pre-trained encoder as a teacher network to extract multi-scale features from both support and query images, while a student decoder learns to distill knowledge from the teacher on query images and self-distill on support images. We further propose a learn-to-weight mechanism that dynamically assesses the reference value of each support image conditioned on the query, optimizing anomaly detection performance. To evaluate our method, we curate a comprehensive benchmark dataset comprising 13,084 images across four organs, four imaging modalities, and five disease categories. Extensive experiments demonstrate that D$^2$4FAD significantly outperforms existing approaches, establishing a new state-of-the-art in few-shot medical anomaly detection. Code is available at https://github.com/ttttqz/D24FAD.

Unsupervised anomaly detection is vital in industrial fields, with reconstruction-based methods favored for their simplicity and effectiveness. However, reconstruction methods often encounter an identical shortcut issue, where both normal and anomalous regions can be well reconstructed and fail to identify outliers. The severity of this problem increases with the complexity of the normal data distribution. Consequently, existing methods may exhibit excellent detection performance in a specific scenario, but their performance sharply declines when transferred to another scenario. This paper focuses on establishing a universal model applicable to anomaly detection tasks across different settings, termed as universal anomaly detection. In this work, we introduce a novel, straightforward yet efficient framework for universal anomaly detection: \uline{F}eature \uline{S}huffling and \uline{R}estoration (FSR), which can alleviate the identical shortcut issue across different settings. First and foremost, FSR employs multi-scale features with rich semantic information as reconstruction targets, rather than raw image pixels. Subsequently, these multi-scale features are partitioned into non-overlapping feature blocks, which are randomly shuffled and then restored to their original state using a restoration network. This simple paradigm encourages the model to focus more on global contextual information. Additionally, we introduce a novel concept, the shuffling rate, to regulate the complexity of the FSR task, thereby alleviating the identical shortcut across different settings. Furthermore, we provide theoretical explanations for the effectiveness of FSR framework from two perspectives: network structure and mutual information. Extensive experimental results validate the superiority and efficiency of the FSR framework across different settings.Code is available at https://github.com/luow23/FSR.

Anomaly detection in medical images is challenging due to limited annotations and the domain gap. Existing reconstruction-based methods often rely on frozen pre-trained encoders, restricting adaptation to domain-specific patterns and degrading localization accuracy. Meanwhile, prototype-based learning offers interpretable representations but commonly suffers from prototype collapse, where a few prototypes dominate training and reduce diversity. To address these issues, we propose DNP-ConFormer, a unified framework that integrates a trainable encoder with prototype-guided reconstruction and a Diversity-Aware Alignment Loss. A momentum encoder enables stable domain-adaptive representation learning, while a lightweight Prototype Extractor discovers informative normal prototypes and injects them into the decoder via attention to guide reconstruction. The proposed alignment objective further encourages balanced feature-to-prototype assignments, effectively mitigating prototype collapse. Extensive experiments on multiple medical imaging benchmarks demonstrate improved representation quality and anomaly localization compared with prior methods. Visualization and prototype assignment analyses further validate the effectiveness and interpretability of our approach. The code is available at https://github.com/liluhu0/DNP-ConFormer.