Francesca Pia Panaccione

Eugenio Lomurno, Filippo Balzarini, Francesco Benelle et al.

Diffusion-based generators set the current state of the art for synthetic tabular data. These methods approach but rarely exceed real-data utility, and closing this synthetic-real gap has so far been pursued exclusively at training time, via architectural advances, scaling, and retraining of monolithic generators. The inference-time alternative, i.e., refining the outputs of a pre-trained backbone with parameters left untouched, has remained largely unexplored for tabular synthesis. We introduce TARDIS (Tabular generation through Refinement, Distillation, and Inference-time Sampling), an inference-time refinement framework that operates on a frozen pre-trained backbone, configured per dataset by a Tree-structured Parzen Estimator search over score-level guidance during reverse diffusion, with each trial's objective set by an inner grid search over post-hoc sample selectors and an optional soft-label distillation step. The search space encodes a single mathematical pattern we name Bidirectional Chamfer Refinement (BCR): the symmetric Chamfer functional between synthetic and real samples is minimized both continuously, via a score-level gradient, and discretely, via batch-ranking post-generation. The per-dataset search recovers BCR-aligned configurations on most datasets, evidence for BCR as the dominant refinement pattern. Across 15 binary, multiclass, and regression benchmarks TARDIS achieves a median +8.6% downstream-task improvement over models trained on real data (95% CI [+3.3, +16.4], Wilcoxon p=0.016, 11/15 strict wins) and improves over the TabDiff backbone on all 15 datasets (mean +12.9%, p<10^-4), matching the backbone on manifold fidelity, diversity, and sample-level privacy. Inference-time refinement of a pre-trained tabular diffusion backbone reaches and exceeds real-data utility in 1 to 80 minutes on a single consumer-grade GPU.

Francesca Pia Panaccione, Carlo Sgaravatti, Pietro Pinoli

Biomedical research increasingly relies on integrating diverse data modalities, including gene expression profiles, medical images, and clinical metadata. While medical images and clinical metadata are routinely collected in clinical practice, gene expression data presents unique challenges for widespread research use, mainly due to stringent privacy regulations and costly laboratory experiments. To address these limitations, we present GeMM-GAN, a novel Generative Adversarial Network conditioned on histopathology tissue slides and clinical metadata, designed to synthesize realistic gene expression profiles. GeMM-GAN combines a Transformer Encoder for image patches with a final Cross Attention mechanism between patches and text tokens, producing a conditioning vector to guide a generative model in generating biologically coherent gene expression profiles. We evaluate our approach on the TCGA dataset and demonstrate that our framework outperforms standard generative models and generates more realistic and functionally meaningful gene expression profiles, improving by more than 11\% the accuracy on downstream disease type prediction compared to current state-of-the-art generative models. Code will be available at: https://github.com/francescapia/GeMM-GAN

Francesca Pia Panaccione, Eugenio Lomurno, Francesca Fati et al.

Ovarian cancer is frequently diagnosed at an advanced stage, making preoperative contrast-enhanced computed tomography (CT) central to staging and surgical planning; yet the scarcity of annotated imaging data, compounded by privacy regulations, limits the development of generalizable computational models in this domain. Text-conditioned 3D CT synthesis has shown promise, but existing pipelines depend on paired radiology reports and have been evaluated only on chest CT. We propose OvESyn (Ovarian Evidence-based Synthesis), a framework that constructs standardized Findings and Impression sections directly from CT-derived imaging descriptors and routine clinical metadata, without any original radiology report, and uses them to condition a latent diffusion model adapted to 493 high-grade serous ovarian carcinoma patients. This is the first text-conditioned 3D CT synthesis framework adapted to an abdomino-pelvic oncologic setting. A systematic ablation over two adaptation axes, vision-language encoder alignment and generator fine-tuning, identifies generator domain adaptation as the operative mechanism for crossing the domain gap and establishing the target anatomy: without it, synthesis remains anchored to the thoracic pretraining domain, with Precision and Recall collapsing to zero and FID2.5D exceeding 140, regardless of encoder alignment. Encoder alignment instead refines intensity and fine detail. The full OvESyn attains the best distributional and intensity fidelity (FID2.5D 29.35, Precision 0.671, Wasserstein-1 0.044), while the generator-only variant maximizes coverage (Recall 0.645), reflecting a fidelity/coverage trade-off governed by encoder adaptation. Requiring only automatic segmentations and routine preoperative metadata, OvESyn supports transferability to report-scarce settings and provides a foundation for synthetic cohort generation in abdomino-pelvic oncologic imaging.