SLIM-Diff: Shared Latent Image-Mask Diffusion with Lp loss for Data-Scarce Epilepsy FLAIR MRI

Focal cortical dysplasia (FCD) lesions in epilepsy FLAIR MRI are subtle and scarce, making joint image--mask generative modeling prone to instability and memorization. We propose SLIM-Diff, a compact joint diffusion model whose main contributions are (i) a single shared-bottleneck U-Net that enforces tight coupling between anatomy and lesion geometry from a 2-channel image+mask representation, and (ii) loss-geometry tuning via a tunable L_p objective. As an internal baseline, we include the canonical DDPM-style objective (ε-prediction with L_2 loss) and isolate the effect of prediction parameterization and L_p geometry under a matched setup. Experiments show that x_0-prediction is consistently the strongest choice for joint synthesis, and that fractional sub-quadratic penalties (L_{1.5}) improve image fidelity while L_2 better preserves lesion mask morphology. Our code and model weights are available in https://github.com/MarioPasc/slim-diff