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PCaPaint: Prostate Cancer Inpainting by Mitigating Shortcut Learning

2026-09-29 12:16:36
Levente Lippenszky, Hongxu Yang, Marcell D\"om\"ot\"or, Krisztian Koos, L\'aszl\'o Rusk\'o

Abstract

The development of AI systems for tumor-specific applications is limited by the scarcity of labeled data. Synthetic tumor inpainting offers a promising approach but faces challenges for prostate cancer MRI which contains high-resolution multi-sequence data. Although methods leveraging latent diffusion models (LDMs) enable large-volume synthesis, they are prone to shortcut learning, simply reproducing the condition image created by masking the lesion region. In this work, we introduce PCaPaint, a prostate cancer inpainting method based on LDMs that explicitly addresses this failure mode. To overcome shortcut learning that compromises synthetic tumor texture, we propose a simple yet efficient conditioning strategy in which the condition image is filled with Gaussian noise, and we provide theoretical justification. In addition, we propose a novel training objective for LDM that emphasizes the error within the lesion region. Furthermore, we introduce a multi-sequence latent design, in which T2w scans and DWI&ADC scans are compressed using two separate autoencoders to preserve their distinct frequency characteristics. Extensive experiments demonstrate that the generated synthetic data improves downstream performance in prostate lesion segmentation, patient-level classification and lesion-level detection. Furthermore, our method significantly outperforms a recent state-of-the-art LDM-based tumor inpainting method both in downstream performance and in synthetic image quality.

Abstract (translated)

URL

https://arxiv.org/abs/2609.37350

PDF

https://arxiv.org/pdf/2609.37350.pdf


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