Pixels Under Pressure: Exploring Fine-Tuning Paradigms for Foundation Models in High-Resolution Medical Imaging

Advancements in diffusion-based foundation models have improved text-to-image generation, yet most efforts have been limited to low-resolution settings. As high-resolution image synthesis becomes increasingly essential for various applications, particularly in medical imaging domains, fine-tuning emerges as a crucial mechanism for adapting these powerful pre-trained models to task-specific requirements and data distributions. In this work, we present a systematic study, examining the impact of various fine-tuning techniques on image generation quality when scaling to high resolution 512x512 pixels. We benchmark a diverse set of fine-tuning methods, including full fine-tuning strategies and parameter-efficient fine-tuning (PEFT). We dissect how different fine-tuning methods influence key quality metrics, including Fr\'echet Inception Distance (FID), Vendi score, and prompt-image alignment. We also evaluate the utility of generated images in a downstream classification task under data-scarce conditions, demonstrating that specific fine-tuning strategies improve both generation fidelity and downstream performance when synthetic images are used for classifier training and evaluation on real images. Our code is accessible through the project website - https://tehraninasab.github.io/PixelUPressure/.

Language-Guided Trajectory Traversal in Disentangled Stable Diffusion Latent Space for Factorized Medical Image Generation

Text-to-image diffusion models have demonstrated a remarkable ability to generate photorealistic images from natural language prompts. These high-resolution, language-guided synthesized images are essential for the explainability of disease or exploring causal relationships. However, their potential for disentangling and controlling latent factors of variation in specialized domains like medical imaging remains under-explored. In this work, we present the first investigation of the power of pre-trained vision-language foundation models, once fine-tuned on medical image datasets, to perform latent disentanglement for factorized medical image generation and interpolation. Through extensive experiments on chest X-ray and skin datasets, we illustrate that fine-tuned, language-guided Stable Diffusion inherently learns to factorize key attributes for image generation, such as the patient's anatomical structures or disease diagnostic features. We devise a framework to identify, isolate, and manipulate key attributes through latent space trajectory traversal of generative models, facilitating precise control over medical image synthesis.

RL4Med-DDPO: Reinforcement Learning for Controlled Guidance Towards Diverse Medical Image Generation using Vision-Language Foundation Models

Vision-Language Foundation Models (VLFM) have shown a tremendous increase in performance in terms of generating high-resolution, photorealistic natural images. While VLFMs show a rich understanding of semantic content across modalities, they often struggle with fine-grained alignment tasks that require precise correspondence between image regions and textual descriptions a limitation in medical imaging, where accurate localization and detection of clinical features are essential for diagnosis and analysis. To address this issue, we propose a multi-stage architecture where a pre-trained VLFM provides a cursory semantic understanding, while a reinforcement learning (RL) algorithm refines the alignment through an iterative process that optimizes for understanding semantic context. The reward signal is designed to align the semantic information of the text with synthesized images. We demonstrate the effectiveness of our method on a medical imaging skin dataset where the generated images exhibit improved generation quality and alignment with prompt over the fine-tuned Stable Diffusion. We also show that the synthesized samples could be used to improve disease classifier performance for underrepresented subgroups through augmentation.