Synthetic Diffusion Tensor Imaging Maps Generated by 2D and 3D Probabilistic Diffusion Models: Evaluation and Applications

Diffusion tensor imaging (DTI) is a key neuroimaging modality for assessing brain tissue microstructure, yet high-quality acquisitions are costly, time-intensive, and prone to artifacts. To address data scarcity and privacy concerns – and to augment the available data for training deep learning methods – synthetic DTI generation has gained interest. Specifically, denoising diffusion probabilistic models (DDPMs) have emerged as a promising approach due to their superior fidelity, diversity, controllability, and stability compared to generative adversarial networks (GANs) and variational autoencoders (VAEs). In this work, we evaluate the quality, fidelity and added value for downstream applications of synthetic DTI mean diffusivity (MD) maps generated by 2D slice-wise and 3D volume-wise DDPMs. We evaluate their computational efficiency and utility for data augmentation in two downstream tasks: sex classification and dementia classification using 2D and 3D convolutional neural networks (CNNs). Our findings show that 3D synthesis outperforms 2D slice-wise generation in downstream tasks. We present a benchmark analysis of synthetic diffusion-weighted imaging approaches, highlighting key trade-offs in image quality, diversity, efficiency, and downstream performance.