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Segmentor-Guided Counterfactual Fine-Tuning for Locally Coherent and Targeted Image Synthesis

2025-09-29 · Tian Xia, Matthew Sinclair, Andreas Schuh, Fabio De Sousa Ribeiro, Raghav Mehta, Rajat Rasal, Esther Puyol-Antón, Samuel Gerber, Kersten Petersen, Michiel Schaap, Ben Glocker arxiv

Counterfactual image generation is a powerful tool for augmenting training data, de-biasing datasets, and modeling disease. Current approaches rely on external classifiers or regressors to increase the effectiveness of subject-level interventions (e.g., changing the patient's age). For structure-specific interventions (e.g., changing the area of the left lung in a chest radiograph), we show that this is insufficient, and can result in undesirable global effects across the image domain. Previous work used pixel-level label maps as guidance, requiring a user to provide hypothetical segmentations which are tedious and difficult to obtain. We propose Segmentor-guided Counterfactual Fine-Tuning (Seg-CFT), which preserves the simplicity of intervening on scalar-valued, structure-specific variables while producing locally coherent and effective counterfactuals. We demonstrate the capability of generating realistic chest radiographs, and we show promising results for modeling coronary artery disease. Code: https://github.com/biomedia-mira/seg-cft.

📄 PDF Abstract BibTeX arXiv:2509.24913

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Image Generation

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