Vision Transformer has recently gained tremendous popularity in medical image segmentation task due to its superior capability in capturing long-range dependencies. However, transformer requires a large amount of labeled data to be effective, which hinders its applicability in annotation scarce semi-supervised learning scenario where only limited labeled data is available. State-of-the-art semi-supervised learning methods propose combinatorial CNN-Transformer learning to cross teach a transformer with a convolutional neural network, which achieves promising results. However, it remains a challenging task to effectively train the transformer with limited labeled data. In this paper, we propose an adversarial masked image modeling method to fully unleash the potential of transformer for semi-supervised medical image segmentation. The key challenge in semi-supervised learning with transformer lies in the lack of sufficient supervision signal. To this end, we propose to construct an auxiliary masked domain from original domain with masked image modeling and train the transformer to predict the entire segmentation mask with masked inputs to increase supervision signal. We leverage the original labels from labeled data and pseudo-labels from unlabeled data to learn the masked domain. To further benefit the original domain from masked domain, we provide a theoretical analysis of our method from a multi-domain learning perspective and devise a novel adversarial training loss to reduce the domain gap between the original and masked domain, which boosts semi-supervised learning performance. We also extend adversarial masked image modeling to CNN network. Extensive experiments on three public medical image segmentation datasets demonstrate the effectiveness of our method, where our method outperforms existing methods significantly. Our code is publicly available at https://github.com/zlheui/AdvMIM.
For the immanent challenge of insufficiently annotated samples in the medical field, semi-supervised medical image segmentation (SSMIS) offers a promising solution. Despite achieving impressive results in delineating primary target areas, most current methodologies struggle to precisely capture the subtle details of boundaries. This deficiency often leads to significant diagnostic inaccuracies. To tackle this issue, we introduce C3S3, a novel semi-supervised segmentation model that synergistically integrates complementary competition and contrastive selection. This design significantly sharpens boundary delineation and enhances overall precision. Specifically, we develop an Outcome-Driven Contrastive Learning module dedicated to refining boundary localization. Additionally, we incorporate a Dynamic Complementary Competition module that leverages two high-performing sub-networks to generate pseudo-labels, thereby further improving segmentation quality. The proposed C3S3 undergoes rigorous validation on two publicly accessible datasets, encompassing the practices of both MRI and CT scans. The results demonstrate that our method achieves superior performance compared to previous cutting-edge competitors. Especially, on the 95HD and ASD metrics, our approach achieves a notable improvement of at least 6%, highlighting the significant advancements. The code is available at https://github.com/Y-TARL/C3S3.
In the era of information explosion, efficiently leveraging large-scale unlabeled data while minimizing the reliance on high-quality pixel-level annotations remains a critical challenge in the field of medical imaging. Semi-supervised learning (SSL) enhances the utilization of unlabeled data by facilitating knowledge transfer, significantly improving the performance of fully supervised models and emerging as a highly promising research direction in medical image analysis. Inspired by the ability of Vision Foundation Models (e.g., SAM-2) to provide rich prior knowledge, we propose SSS (Semi-Supervised SAM-2), a novel approach that leverages SAM-2's robust feature extraction capabilities to uncover latent knowledge in unlabeled medical images, thus effectively enhancing feature support for fully supervised medical image segmentation. Specifically, building upon the single-stream "weak-to-strong" consistency regularization framework, this paper introduces a Discriminative Feature Enhancement (DFE) mechanism to further explore the feature discrepancies introduced by various data augmentation strategies across multiple views. By leveraging feature similarity and dissimilarity across multi-scale augmentation techniques, the method reconstructs and models the features, thereby effectively optimizing the salient regions. Furthermore, a prompt generator is developed that integrates Physical Constraints with a Sliding Window (PCSW) mechanism to generate input prompts for unlabeled data, fulfilling SAM-2's requirement for additional prompts. Extensive experiments demonstrate the superiority of the proposed method for semi-supervised medical image segmentation on two multi-label datasets, i.e., ACDC and BHSD. Notably, SSS achieves an average Dice score of 53.15 on BHSD, surpassing the previous state-of-the-art method by +3.65 Dice. Code will be available at https://github.com/AIGeeksGroup/SSS.
Confronting the critical challenge of insufficiently annotated samples in medical domain, semi-supervised medical image segmentation (SSMIS) emerges as a promising solution. Specifically, most methodologies following the Mean Teacher (MT) or Dual Students (DS) architecture have achieved commendable results. However, to date, these approaches face a performance bottleneck due to two inherent limitations, \textit{e.g.}, the over-coupling problem within MT structure owing to the employment of exponential moving average (EMA) mechanism, as well as the severe cognitive bias between two students of DS structure, both of which potentially lead to reduced efficacy, or even model collapse eventually. To mitigate these issues, a Decoupled Competitive Framework (DCF) is elaborated in this work, which utilizes a straightforward competition mechanism for the update of EMA, effectively decoupling students and teachers in a dynamical manner. In addition, the seamless exchange of invaluable and precise insights is facilitated among students, guaranteeing a better learning paradigm. The DCF introduced undergoes rigorous validation on three publicly accessible datasets, which encompass both 2D and 3D datasets. The results demonstrate the superiority of our method over previous cutting-edge competitors. Code will be available at https://github.com/JiaheChen2002/DCF.
Both limited annotation and domain shift are prevalent challenges in medical image segmentation. Traditional semi-supervised segmentation and unsupervised domain adaptation methods address one of these issues separately. However, the coexistence of limited annotation and domain shift is quite common, which motivates us to introduce a novel and challenging scenario: Mixed Domain Semi-supervised medical image Segmentation (MiDSS), where limited labeled data from a single domain and a large amount of unlabeled data from multiple domains. To tackle this issue, we propose the UST-RUN framework, which fully leverages intermediate domain information to facilitate knowledge transfer. We employ Unified Copy-paste (UCP) to construct intermediate domains, and propose a Symmetric GuiDance training strategy (SymGD) to supervise unlabeled data by merging pseudo-labels from intermediate samples. Subsequently, we introduce a Training Process aware Random Amplitude MixUp (TP-RAM) to progressively incorporate style-transition components into intermediate samples. To generate more diverse intermediate samples, we further select reliable samples with high-quality pseudo-labels, which are then mixed with other unlabeled data. Additionally, we generate sophisticated intermediate samples with high-quality pseudo-labels for unreliable samples, ensuring effective knowledge transfer for them. Extensive experiments on four public datasets demonstrate the superiority of UST-RUN. Notably, UST-RUN achieves a 12.94% improvement in Dice score on the Prostate dataset. Our code is available at https://github.com/MQinghe/UST-RUN
Semi-supervised medical image segmentation (SSMIS) leverages unlabeled data to reduce reliance on manually annotated images. However, current SOTA approaches predominantly focus on foreground-oriented modeling (i.e., segmenting only the foreground region) and have largely overlooked the potential benefits of explicitly modeling the background region. Our study theoretically and empirically demonstrates that highly certain predictions in background modeling enhance the confidence of corresponding foreground modeling. Building on this insight, we propose the Cross-view Bidirectional Modeling (CVBM) framework, which introduces a novel perspective by incorporating background modeling to improve foreground modeling performance. Within CVBM, background modeling serves as an auxiliary perspective, providing complementary supervisory signals to enhance the confidence of the foreground model. Additionally, CVBM introduces an innovative bidirectional consistency mechanism, which ensures mutual alignment between foreground predictions and background-guided predictions. Extensive experiments demonstrate that our approach achieves SOTA performance on the LA, Pancreas, ACDC, and HRF datasets. Notably, on the Pancreas dataset, CVBM outperforms fully supervised methods (i.e., DSC: 84.57% vs. 83.89%) while utilizing only 20% of the labeled data. Our code is publicly available at https://github.com/caoluyang0830/CVBM.git.
Perturbation with diverse unlabeled data has proven beneficial for semi-supervised medical image segmentation (SSMIS). While many works have successfully used various perturbation techniques, a deeper understanding of learning perturbations is needed. Excessive or inappropriate perturbation can have negative effects, so we aim to address two challenges: how to use perturbation mechanisms to guide the learning of unlabeled data through labeled data, and how to ensure accurate predictions in boundary regions. Inspired by human progressive and periodic learning, we propose a progressive and periodic perturbation mechanism (P3M) and a boundary-focused loss. P3M enables dynamic adjustment of perturbations, allowing the model to gradually learn them. Our boundary-focused loss encourages the model to concentrate on boundary regions, enhancing sensitivity to intricate details and ensuring accurate predictions. Experimental results demonstrate that our method achieves state-of-the-art performance on two 2D and 3D datasets. Moreover, P3M is extendable to other methods, and the proposed loss serves as a universal tool for improving existing methods, highlighting the scalability and applicability of our approach.
Recently, prototype learning has emerged in semi-supervised medical image segmentation and achieved remarkable performance. However, the scarcity of labeled data limits the expressiveness of prototypes in previous methods, potentially hindering the complete representation of prototypes for class embedding. To overcome this issue, we propose an efficient prototype consistency learning via joint uncertainty quantification and data augmentation (EPCL-JUDA) to enhance the semantic expression of prototypes based on the framework of Mean-Teacher. The concatenation of original and augmented labeled data is fed into student network to generate expressive prototypes. Then, a joint uncertainty quantification method is devised to optimize pseudo-labels and generate reliable prototypes for original and augmented unlabeled data separately. High-quality global prototypes for each class are formed by fusing labeled and unlabeled prototypes, which are utilized to generate prototype-to-features to conduct consistency learning. Notably, a prototype network is proposed to reduce high memory requirements brought by the introduction of augmented data. Extensive experiments on Left Atrium, Pancreas-NIH, Type B Aortic Dissection datasets demonstrate EPCL-JUDA's superiority over previous state-of-the-art approaches, confirming the effectiveness of our framework. The code will be released soon.
Semi-supervised learning (SSL) has achieved significant progress in medical image segmentation (SSMIS) through effective utilization of limited labeled data. While current SSL methods for medical images predominantly rely on consistency regularization and pseudo-labeling, they often overlook transferable semantic relationships across different clinical domains and imaging modalities. To address this, we propose TransMedSeg, a novel transferable semantic framework for semi-supervised medical image segmentation. Our approach introduces a Transferable Semantic Augmentation (TSA) module, which implicitly enhances feature representations by aligning domain-invariant semantics through cross-domain distribution matching and intra-domain structural preservation. Specifically, TransMedSeg constructs a unified feature space where teacher network features are adaptively augmented towards student network semantics via a lightweight memory module, enabling implicit semantic transformation without explicit data generation. Interestingly, this augmentation is implicitly realized through an expected transferable cross-entropy loss computed over the augmented teacher distribution. An upper bound of the expected loss is theoretically derived and minimized during training, incurring negligible computational overhead. Extensive experiments on medical image datasets demonstrate that TransMedSeg outperforms existing semi-supervised methods, establishing a new direction for transferable representation learning in medical image analysis.
Semi-supervised medical image segmentation has attracted significant attention due to its potential to reduce manual annotation costs. The mean teacher (MT) strategy, commonly understood as introducing smoothed, temporally lagged consistency regularization, has demonstrated strong performance across various tasks in this field. In this work, we reinterpret the MT strategy on supervised data as a form of self-paced learning, regulated by the output agreement between the temporally lagged teacher model and the ground truth labels. This idea is further extended to incorporate agreement between a temporally lagged model and a cross-architectural model, which offers greater flexibility in regulating the learning pace and enables application to unlabeled data. Specifically, we propose dual teacher-student learning (DTSL), a framework that introduces two groups of teacher-student models with different architectures. The output agreement between the cross-group teacher and student models is used as pseudo-labels, generated via a Jensen-Shannon divergence-based consensus label generator (CLG). Extensive experiments on popular datasets demonstrate that the proposed method consistently outperforms existing state-of-the-art approaches. Ablation studies further validate the effectiveness of the proposed modules.
Semi-supervised medical image segmentation (SSMIS) shows promise in reducing reliance on scarce labeled medical data. However, SSMIS field confronts challenges such as distribution mismatches between labeled and unlabeled data, artificial perturbations causing training biases, and inadequate use of raw image information, especially low-frequency (LF) and high-frequency (HF) components.To address these challenges, we propose a Wavelet Transform based Bidirectional Copy-Paste SSMIS framework, named WT-BCP, which improves upon the Mean Teacher approach. Our method enhances unlabeled data understanding by copying random crops between labeled and unlabeled images and employs WT to extract LF and HF details.We propose a multi-input and multi-output model named XNet-Plus, to receive the fused information after WT. Moreover, consistency training among multiple outputs helps to mitigate learning biases introduced by artificial perturbations. During consistency training, the mixed images resulting from WT are fed into both models, with the student model's output being supervised by pseudo-labels and ground-truth. Extensive experiments conducted on 2D and 3D datasets confirm the effectiveness of our model.Code: https://github.com/simzhangbest/WT-BCP.
Despite the promising performance achieved by current semi-supervised models in segmenting individual medical targets, many of these models suffer a notable decrease in performance when tasked with the simultaneous segmentation of multiple targets. A vital factor could be attributed to the imbalanced scales among different targets: during simultaneously segmenting multiple targets, large targets dominate the loss, leading to small targets being misclassified as larger ones. To this end, we propose a novel method, which consists of a Collaborative Generalist and several Specialists, termed CGS. It is centered around the idea of employing a specialist for each target class, thus avoiding the dominance of larger targets. The generalist performs conventional multi-target segmentation, while each specialist is dedicated to distinguishing a specific target class from the remaining target classes and the background. Based on a theoretical insight, we demonstrate that CGS can achieve a more balanced training. Moreover, we develop cross-consistency losses to foster collaborative learning between the generalist and the specialists. Lastly, regarding their intrinsic relation that the target class of any specialized head should belong to the remaining classes of the other heads, we introduce an inter-head error detection module to further enhance the quality of pseudo-labels. Experimental results on three popular benchmarks showcase its superior performance compared to state-of-the-art methods.
Semi-supervised medical image segmentation aims to leverage minimal expert annotations, yet remains confronted by challenges in maintaining high-quality consistency learning. Excessive perturbations can degrade alignment and hinder precise decision boundaries, especially in regions with uncertain predictions. In this paper, we introduce Confidence-Aware Adaptive Displacement (CAD), a framework that selectively identifies and replaces the largest low-confidence regions with high-confidence patches. By dynamically adjusting both the maximum allowable replacement size and the confidence threshold throughout training, CAD progressively refines the segmentation quality without overwhelming the learning process. Experimental results on public medical datasets demonstrate that CAD effectively enhances segmentation quality, establishing new state-of-the-art accuracy in this field. The source code will be released after the paper is published.
Large pretrained visual foundation models exhibit impressive general capabilities. However, the extensive prior knowledge inherent in these models can sometimes be a double-edged sword when adapting them to downstream tasks in specific domains. In the context of semi-supervised medical image segmentation with domain shift, foundation models like MedSAM tend to make overconfident predictions, some of which are incorrect. The error accumulation hinders the effective utilization of unlabeled data and limits further improvements. In this paper, we introduce a Synergistic training framework for Foundation and Conventional models (SynFoC) to address the issue. We observe that a conventional model trained from scratch has the ability to correct the high-confidence mispredictions of the foundation model, while the foundation model can supervise it with high-quality pseudo-labels in the early training stages. Furthermore, to enhance the collaborative training effectiveness of both models and promote reliable convergence towards optimization, the consensus-divergence consistency regularization is proposed. We demonstrate the superiority of our method across four public multi-domain datasets. In particular, our method improves the Dice score by 10.31\% on the Prostate dataset. Our code is available at https://github.com/MQinghe/SynFoC .
Deep learning-based medical image segmentation has shown remarkable success; however, it typically requires extensive pixel-level annotations, which are both expensive and time-intensive. Semi-supervised medical image segmentation (SSMIS) offers a viable alternative, driven by advancements in CNNs and ViTs. However, these networks often rely on single fixed activation functions and linear modeling patterns, limiting their ability to effectively learn robust representations. Given the limited availability of labeled date, achieving robust representation learning becomes crucial. Inspired by Kolmogorov-Arnold Networks (KANs), we propose Semi-KAN, which leverages the untapped potential of KANs to enhance backbone architectures for representation learning in SSMIS. Our findings indicate that: (1) compared to networks with fixed activation functions, KANs exhibit superior representation learning capabilities with fewer parameters, and (2) KANs excel in high-semantic feature spaces. Building on these insights, we integrate KANs into tokenized intermediate representations, applying them selectively at the encoder's bottleneck and the decoder's top layers within a U-Net pipeline to extract high-level semantic features. Although learnable activation functions improve feature expansion, they introduce significant computational overhead with only marginal performance gains. To mitigate this, we reduce the feature dimensions and employ horizontal scaling to capture multiple pattern representations. Furthermore, we design a multi-branch U-Net architecture with uncertainty estimation to effectively learn diverse pattern representations. Extensive experiments on four public datasets demonstrate that Semi-KAN surpasses baseline networks, utilizing fewer KAN layers and lower computational cost, thereby underscoring the potential of KANs as a promising approach for SSMIS.
Semi-supervised learning is of great significance in medical image segmentation by exploiting unlabeled data. Among its strategies, the co-training framework is prominent. However, previous co-training studies predominantly concentrate on network initialization variances and pseudo-label generation, while overlooking the equilibrium between information interchange and model diversity preservation. In this paper, we propose the Masked Image Consistency and Discrepancy Learning (MICD) framework with three key modules. The Masked Cross Pseudo Consistency (MCPC) module enriches context perception and small sample learning via pseudo-labeling across masked-input branches. The Cross Feature Consistency (CFC) module fortifies information exchange and model robustness by ensuring decoder feature consistency. The Cross Model Discrepancy (CMD) module utilizes EMA teacher networks to oversee outputs and preserve branch diversity. Together, these modules address existing limitations by focusing on fine-grained local information and maintaining diversity in a heterogeneous framework. Experiments on two public medical image datasets, AMOS and Synapse, demonstrate that our approach outperforms state-of-the-art methods.
Medical image segmentation aims to identify anatomical structures at the voxel-level. Segmentation accuracy relies on distinguishing voxel differences. Compared to advancements achieved in studies of the inter-class variance, the intra-class variance receives less attention. Moreover, traditional linear classifiers, limited by a single learnable weight per class, struggle to capture this finer distinction. To address the above challenges, we propose a Multi-Prototype-based Embedding Refinement method for semi-supervised medical image segmentation. Specifically, we design a multi-prototype-based classification strategy, rethinking the segmentation from the perspective of structural relationships between voxel embeddings. The intra-class variations are explored by clustering voxels along the distribution of multiple prototypes in each class. Next, we introduce a consistency constraint to alleviate the limitation of linear classifiers. This constraint integrates different classification granularities from a linear classifier and the proposed prototype-based classifier. In the thorough evaluation on two popular benchmarks, our method achieves superior performance compared with state-of-the-art methods. Code is available at https://github.com/Briley-byl123/MPER.
Medical ultrasound imaging is ubiquitous, but manual analysis struggles to keep pace. Automated segmentation can help but requires large labeled datasets, which are scarce. Semi-supervised learning leveraging both unlabeled and limited labeled data is a promising approach. State-of-the-art methods use consistency regularization or pseudo-labeling but grow increasingly complex. Without sufficient labels, these models often latch onto artifacts or allow anatomically implausible segmentations. In this paper, we present a simple yet effective pseudo-labeling method with an adversarially learned shape prior to regularize segmentations. Specifically, we devise an encoder-twin-decoder network where the shape prior acts as an implicit shape model, penalizing anatomically implausible but not ground-truth-deviating predictions. Without bells and whistles, our simple approach achieves state-of-the-art performance on two benchmarks under different partition protocols. We provide a strong baseline for future semi-supervised medical image segmentation. Code is available at https://github.com/WUTCM-Lab/Shape-Prior-Semi-Seg.
Semi-supervised learning utilizes insights from unlabeled data to improve model generalization, thereby reducing reliance on large labeled datasets. Most existing studies focus on limited samples and fail to capture the overall data distribution. We contend that combining distributional information with detailed information is crucial for achieving more robust and accurate segmentation results. On the one hand, with its robust generative capabilities, diffusion models (DM) learn data distribution effectively. However, it struggles with fine detail capture, leading to generated images with misleading details. Combining DM with convolutional neural networks (CNNs) enables the former to learn data distribution while the latter corrects fine details. While capturing complete high-frequency details by CNNs requires substantial computational resources and is susceptible to local noise. On the other hand, given that both labeled and unlabeled data come from the same distribution, we believe that regions in unlabeled data similar to overall class semantics to labeled data are likely to belong to the same class, while regions with minimal similarity are less likely to. This work introduces a semi-supervised medical image segmentation framework from the distribution perspective (Diff-CL). Firstly, we propose a cross-pseudo-supervision learning mechanism between diffusion and convolution segmentation networks. Secondly, we design a high-frequency mamba module to capture boundary and detail information globally. Finally, we apply contrastive learning for label propagation from labeled to unlabeled data. Our method achieves state-of-the-art (SOTA) performance across three datasets, including left atrium, brain tumor, and NIH pancreas datasets.
Semi-supervised learning enhances medical image segmentation by leveraging unlabeled data, reducing reliance on extensive labeled datasets. On the one hand, the distribution discrepancy between limited labeled data and abundant unlabeled data can hinder model generalization. Most existing methods rely on local similarity matching, which may introduce bias. In contrast, Mamba effectively models global context with linear complexity, learning more comprehensive data representations. On the other hand, medical images usually exhibit consistent anatomical structures defined by geometric features. Most existing methods fail to fully utilize global geometric priors, such as volumes, moments etc. In this work, we introduce a global information interaction and geometric priors focus framework (GIGP). Firstly, we present a Global Information Interaction Mamba module to reduce distribution discrepancy between labeled and unlabeled data. Secondly, we propose a Geometric Moment Attention Mechanism to extract richer global geometric features. Finally, we propose Global Geometric Perturbation Consistency to simulate organ dynamics and geometric variations, enhancing the ability of the model to learn generalized features. The superior performance on the NIH Pancreas and Left Atrium datasets demonstrates the effectiveness of our approach.