Deep learning-based medical image segmentation models suffer from performance degradation when deployed to a new healthcare center. To address this issue, unsupervised domain adaptation and multi-source domain generalization methods have been proposed, which, however, are less favorable for clinical practice due to the cost of acquiring target-domain data and the privacy concerns associated with redistributing the data from multiple source domains. In this paper, we propose a \textbf{C}hannel-level \textbf{C}ontrastive \textbf{S}ingle \textbf{D}omain \textbf{G}eneralization (\textbf{C$^2$SDG}) model for medical image segmentation. In C$^2$SDG, the shallower features of each image and its style-augmented counterpart are extracted and used for contrastive training, resulting in the disentangled style representations and structure representations. The segmentation is performed based solely on the structure representations. Our method is novel in the contrastive perspective that enables channel-wise feature disentanglement using a single source domain. We evaluated C$^2$SDG against six SDG methods on a multi-domain joint optic cup and optic disc segmentation benchmark. Our results suggest the effectiveness of each module in C$^2$SDG and also indicate that C$^2$SDG outperforms the baseline and all competing methods with a large margin. The code will be available at \url{https://github.com/ShishuaiHu/CCSDG}.
Biomedical image segmentation plays a significant role in computer-aided diagnosis. However, existing CNN based methods rely heavily on massive manual annotations, which are very expensive and require huge human resources. In this work, we adopt a coarse-to-fine strategy and propose a self-supervised correction learning paradigm for semi-supervised biomedical image segmentation. Specifically, we design a dual-task network, including a shared encoder and two independent decoders for segmentation and lesion region inpainting, respectively. In the first phase, only the segmentation branch is used to obtain a relatively rough segmentation result. In the second step, we mask the detected lesion regions on the original image based on the initial segmentation map, and send it together with the original image into the network again to simultaneously perform inpainting and segmentation separately. For labeled data, this process is supervised by the segmentation annotations, and for unlabeled data, it is guided by the inpainting loss of masked lesion regions. Since the two tasks rely on similar feature information, the unlabeled data effectively enhances the representation of the network to the lesion regions and further improves the segmentation performance. Moreover, a gated feature fusion (GFF) module is designed to incorporate the complementary features from the two tasks. Experiments on three medical image segmentation datasets for different tasks including polyp, skin lesion and fundus optic disc segmentation well demonstrate the outstanding performance of our method compared with other semi-supervised approaches. The code is available at https://github.com/ReaFly/SemiMedSeg.
The domain gap caused mainly by variable medical image quality renders a major obstacle on the path between training a segmentation model in the lab and applying the trained model to unseen clinical data. To address this issue, domain generalization methods have been proposed, which however usually use static convolutions and are less flexible. In this paper, we propose a multi-source domain generalization model based on the domain and content adaptive convolution (DCAC) for the segmentation of medical images across different modalities. Specifically, we design the domain adaptive convolution (DAC) module and content adaptive convolution (CAC) module and incorporate both into an encoder-decoder backbone. In the DAC module, a dynamic convolutional head is conditioned on the predicted domain code of the input to make our model adapt to the unseen target domain. In the CAC module, a dynamic convolutional head is conditioned on the global image features to make our model adapt to the test image. We evaluated the DCAC model against the baseline and four state-of-the-art domain generalization methods on the prostate segmentation, COVID-19 lesion segmentation, and optic cup/optic disc segmentation tasks. Our results not only indicate that the proposed DCAC model outperforms all competing methods on each segmentation task but also demonstrate the effectiveness of the DAC and CAC modules. Code is available at \url{https://git.io/DCAC}.
Medical image segmentation is important for computer-aided diagnosis. Good segmentation demands the model to see the big picture and fine details simultaneously, i.e., to learn image features that incorporate large context while keep high spatial resolutions. To approach this goal, the most widely used methods -- U-Net and variants, extract and fuse multi-scale features. However, the fused features still have small "effective receptive fields" with a focus on local image cues, limiting their performance. In this work, we propose Segtran, an alternative segmentation framework based on transformers, which have unlimited "effective receptive fields" even at high feature resolutions. The core of Segtran is a novel Squeeze-and-Expansion transformer: a squeezed attention block regularizes the self attention of transformers, and an expansion block learns diversified representations. Additionally, we propose a new positional encoding scheme for transformers, imposing a continuity inductive bias for images. Experiments were performed on 2D and 3D medical image segmentation tasks: optic disc/cup segmentation in fundus images (REFUGE'20 challenge), polyp segmentation in colonoscopy images, and brain tumor segmentation in MRI scans (BraTS'19 challenge). Compared with representative existing methods, Segtran consistently achieved the highest segmentation accuracy, and exhibited good cross-domain generalization capabilities. The source code of Segtran is released at https://github.com/askerlee/segtran.
Deep learning models, which are increasingly being used in the field of medical image analysis, come with a major security risk, namely, their vulnerability to adversarial examples. Adversarial examples are carefully crafted samples that force machine learning models to make mistakes during testing time. These malicious samples have been shown to be highly effective in misguiding classification tasks. However, research on the influence of adversarial examples on segmentation is significantly lacking. Given that a large portion of medical imaging problems are effectively segmentation problems, we analyze the impact of adversarial examples on deep learning-based image segmentation models. Specifically, we expose the vulnerability of these models to adversarial examples by proposing the Adaptive Segmentation Mask Attack (ASMA). This novel algorithm makes it possible to craft targeted adversarial examples that come with (1) high intersection-over-union rates between the target adversarial mask and the prediction and (2) with perturbation that is, for the most part, invisible to the bare eye. We lay out experimental and visual evidence by showing results obtained for the ISIC skin lesion segmentation challenge and the problem of glaucoma optic disc segmentation. An implementation of this algorithm and additional examples can be found at https://github.com/utkuozbulak/adaptive-segmentation-mask-attack.
Medical image segmentation is an important step in medical image analysis. With the rapid development of convolutional neural network in image processing, deep learning has been used for medical image segmentation, such as optic disc segmentation, blood vessel detection, lung segmentation, cell segmentation, etc. Previously, U-net based approaches have been proposed. However, the consecutive pooling and strided convolutional operations lead to the loss of some spatial information. In this paper, we propose a context encoder network (referred to as CE-Net) to capture more high-level information and preserve spatial information for 2D medical image segmentation. CE-Net mainly contains three major components: a feature encoder module, a context extractor and a feature decoder module. We use pretrained ResNet block as the fixed feature extractor. The context extractor module is formed by a newly proposed dense atrous convolution (DAC) block and residual multi-kernel pooling (RMP) block. We applied the proposed CE-Net to different 2D medical image segmentation tasks. Comprehensive results show that the proposed method outperforms the original U-Net method and other state-of-the-art methods for optic disc segmentation, vessel detection, lung segmentation, cell contour segmentation and retinal optical coherence tomography layer segmentation.