FairDiff: Fair Segmentation with Point-Image Diffusion

Fairness is an important topic for medical image analysis, driven by the challenge of unbalanced training data among diverse target groups and the societal demand for equitable medical quality. In response to this issue, our research adopts a data-driven strategy-enhancing data balance by integrating synthetic images. However, in terms of generating synthetic images, previous works either lack paired labels or fail to precisely control the boundaries of synthetic images to be aligned with those labels. To address this, we formulate the problem in a joint optimization manner, in which three networks are optimized towards the goal of empirical risk minimization and fairness maximization. On the implementation side, our solution features an innovative Point-Image Diffusion architecture, which leverages 3D point clouds for improved control over mask boundaries through a point-mask-image synthesis pipeline. This method outperforms significantly existing techniques in synthesizing scanning laser ophthalmoscopy (SLO) fundus images. By combining synthetic data with real data during the training phase using a proposed Equal Scale approach, our model achieves superior fairness segmentation performance compared to the state-of-the-art fairness learning models. Code is available at https://github.com/wenyi-li/FairDiff.