CTGDiff: A Conditional Diffusion Model for Cardiotocography Signal Synthesis

The analysis of Cardiotocography (CTG) signals is often hindered by challenges such as limited data availability and label imbalance, which can undermine the performance of deep learning models. To address these issues, we present CTGDiff, a novel conditional diffusion model designed for generating synthetic Fetal Heart Rate (FHR) and Uterine Contraction (UC) signals. CTGDiff leverages both Phase-Rectified Signal Averaging (PRSA) spectrograms and UC as conditioning inputs for FHR, and integrates time encoding, condition generation from PRSA features, and residual blocks with dilated convolutions to capture both temporal dynamics and long-range dependencies. Extensive experiments, both qualitative and quantitative, demonstrate the model’s ability to synthesize high-quality CTG signals. In comparison with GANs and image-based diffusion models, CTGDiff achieves superior signal fidelity and distribution similarity for FHR, as indicated by metrics such as a 0.004 maximum mean deviation (MMD), 0.646 percent root mean square difference (PRD), 3.951 relative entropy (RE), and 0.291 Frechet distance (FD). Expert evaluations confirm that the model can generate both normal and abnormal CTG signals with high accuracy, conditioned on specific input data. These results underscore the potential of diffusion models for a wide range of applications in biomedical time series analysis, including signal synthesis, imputation, and noise reduction.