Medical image classification is a fundamental task in medical image analysis and underpins a wide range of clinical applications, including dermatological screening, retinal disease assessment, and malignant tissue detection. In recent years, diffusion models have demonstrated promising potential for medical image classification owing to their strong representation learning capability. However, existing diffusion-based classification methods often rely on oversimplified prior modeling strategies, which fail to adequately capture the intrinsic multi-scale semantic information and contextual dependencies inherent in medical images. As a result, the discriminative power and stability of feature representations are constrained in complex scenarios. In addition, fixed noise injection strategies neglect variations in sample-level prediction confidence, leading to uniform perturbations being imposed on samples with different levels of semantic reliability during the diffusion process, which in turn limits the model’s discriminative performance and generalization ability. To address these challenges, this paper proposes a Confidence-Guided Adaptive Diffusion Network (CGAD-Net) for medical image classification. Specifically, a hybrid prior modeling framework is introduced, consisting of a Hierarchical Pyramid Context Modeling (HPCM) module and an Intra-Scale Dilated Convolution Refinement (IDCR) module. These two components jointly enable the diffusion-based feature modeling process to effectively capture fine-grained structural details and global contextual semantic information. Furthermore, a Confidence-Guided Adaptive Noise Injection (CG-ANI) strategy is designed to dynamically regulate noise intensity during the diffusion process according to sample-level prediction confidence. Without altering the underlying discriminative objective, CG-ANI stabilizes model training and enhances robust representation learning for semantically ambiguous samples.Experimental results on multiple public medical image classification benchmarks, including HAM10000, APTOS2019, and Chaoyang, demonstrate that CGAD-Net achieves competitive performance in terms of classification accuracy, robustness, and training stability. These results validate the effectiveness and application potential of confidence-guided diffusion modeling for two-dimensional medical image classification tasks, and provide valuable insights for further research on diffusion models in the field of medical image analysis.
Yan et al. (Sat,) studied this question.