Weakly supervised medical image segmentation (MIS) using generative models is crucial for clinical diagnosis. However, the accuracy of the segmentation results is often limited by insufficient supervision and the complex nature of medical imaging. Existing models also only provide a single outcome, which does not allow for the measurement of uncertainty. In this paper, we introduce DiffSeg, a segmentation model for skin lesions based on diffusion difference which exploits diffusion model principles to ex-tract noise-based features from images with diverse semantic information. By discerning difference between these noise features, the model identifies diseased areas. Moreover, its multi-output capability mimics doctors' annotation behavior, facilitating the visualization of segmentation result consistency and ambiguity. Additionally, it quantifies output uncertainty using Generalized Energy Distance (GED), aiding interpretability and decision-making for physicians. Finally, the model integrates outputs through the Dense Conditional Random Field (DenseCRF) algorithm to refine the segmentation boundaries by considering inter-pixel correlations, which improves the accuracy and optimizes the segmentation results. We demonstrate the effectiveness of DiffSeg on the ISIC 2018 Challenge dataset, outperforming state-of-the-art U-Net-based methods.

DiffSeg基于扩散差异原理，利用扩散模型从具有多样的语义信息的图像中提取基于噪声的特征，识别出疾病区域，同时通过模拟医生的注释行为，可视化分割结果的一致性和模糊性，并使用广义能量距离（GED）量化输出不确定性，帮助医生解释和决策。最后，通过密集条件随机场（DenseCRF）算法整合输出，考虑像素之间的相关性，改善准确度并优化分割结果。我们在ISIC 2018 Challenge数据集中展示了DiffSeg的有效性，优于现有基于U-Net的方法。

DiffSeg：一种基于扩散差异的皮肤病变分割模型