Unsupervised Brain Anomaly Detection as a Bayesian Inverse Problem with Diffusion Prior

Unsupervised medical anomaly detection learns normal anatomical patterns from healthy training images and identifies deviations at test time. Reconstruction-based and diffusion-based methods commonly use the difference between an input image and its reconstruction as anomaly evidence. However, this residual can be ambiguous. Expressive models may preserve pathological structures, while benign anatomical variation, imaging noise, and acquisition differences may also produce large reconstruction errors. We propose discriminative mask-guided diffusion (DMD), a medical anomaly detection framework that complements residual-based localization with reconstruction-shift discrimination. DMD first learns a compact quantized latent representation of normal images. Localized masks then perturb selected latent regions, and a latent diffusion model reconstructs the perturbed representations. The resulting reconstructions are paired with their original normal images to define a self-supervised classification task. At inference, the classifier provides a learned image-level anomaly score, while the residual between the input and its diffusion-based reconstruction yields a pixel-level anomaly map. Experiments on five datasets spanning brain MRI, breast ultrasound, and chest radiography show that DMD achieves the best overall performance among the state-of-the-art baseline methods.

Diffusion models have achieved outstanding performance in unsupervised industrial anomaly detection (uIAD) by learning a manifold of normal data under the common assumption that off-manifold anomalies are harder to generate, resulting in larger reconstruction errors in data space or lower probability densities in the tractable latent space. However, their iterative denoising and noising nature leads to slow inference. In this paper, we propose OSD-IRF, a novel one-step diffusion with inverse residual fields, to address this limitation for uIAD task. We first train a deep diffusion probabilistic model (DDPM) on normal data without any conditioning. Then, for a test sample, we predict its inverse residual fields (IRF) based on the noise estimated by the well-trained parametric noise function of the DDPM. Finally, uIAD is performed by evaluating the probability density of the IRF under a Gaussian distribution and comparing it with a threshold. Our key observation is that anomalies become distinguishable in this IRF space, a finding that has seldom been reported in prior works. Moreover, OSD-IRF requires only single step diffusion for uIAD, thanks to the property that IRF holds for any neighboring time step in the denoising process. Extensive experiments on three widely used uIAD benchmarks show that our model achieves SOTA or competitive performance across six metrics, along with roughly a 2X inference speedup without distillation.

Anomaly detection aims to identify samples that deviate from the nominal data distribution and is central to many safety-critical applications. However, developing effective anomaly detection methods for categorical, mixed-type, and discrete sequence data remains challenging and relatively underexplored. Masked diffusion models provide a natural way to model such data by learning to recover masked values from the remaining visible context. In this paper, we propose Masked Diffusion for Anomaly Detection (MaskDiff-AD), a forward-only method based on masked diffusion models trained only on nominal data. Given a test sample, MaskDiff-AD constructs anomaly scores from the difficulty of reconstructing randomly masked coordinates, yielding a content-sensitive score that operates directly on discrete state spaces while avoiding reverse-time sampling. We also develop a non-parametric variant of MaskDiff-AD and provide theoretical guarantees by characterizing Type-I and Type-II errors under a fixed detection threshold. Experiments on fourteen categorical and mixed-type tabular datasets from ADBench and UADAD, as well as four text anomaly detection datasets from NLP-ADBench, show that MaskDiff-AD achieves competitive performance against classical, diffusion-based, and recent tabular/text anomaly detection baselines. Notably, MaskDiff-AD achieves the best overall average rank, outperforming all twelve tabular baseline methods.