Guotai Wang

Jianghao Wu, Guotai Wang, Ran Gu et al.

Domain Adaptation (DA) is important for deep learning-based medical image segmentation models to deal with testing images from a new target domain. As the source-domain data are usually unavailable when a trained model is deployed at a new center, Source-Free Domain Adaptation (SFDA) is appealing for data and annotation-efficient adaptation to the target domain. However, existing SFDA methods have a limited performance due to lack of sufficient supervision with source-domain images unavailable and target-domain images unlabeled. We propose a novel Uncertainty-aware Pseudo Label guided (UPL) SFDA method for medical image segmentation. Specifically, we propose Target Domain Growing (TDG) to enhance the diversity of predictions in the target domain by duplicating the pre-trained model's prediction head multiple times with perturbations. The different predictions in these duplicated heads are used to obtain pseudo labels for unlabeled target-domain images and their uncertainty to identify reliable pseudo labels. We also propose a Twice Forward pass Supervision (TFS) strategy that uses reliable pseudo labels obtained in one forward pass to supervise predictions in the next forward pass. The adaptation is further regularized by a mean prediction-based entropy minimization term that encourages confident and consistent results in different prediction heads. UPL-SFDA was validated with a multi-site heart MRI segmentation dataset, a cross-modality fetal brain segmentation dataset, and a 3D fetal tissue segmentation dataset. It improved the average Dice by 5.54, 5.01 and 6.89 percentage points for the three tasks compared with the baseline, respectively, and outperformed several state-of-the-art SFDA methods.

Weiren Zhao, Lanfeng Zhong, Xin Liao et al.

Semi-Supervised Learning (SSL) is important for reducing the annotation cost for medical image segmentation models. State-of-the-art SSL methods such as Mean Teacher, FixMatch and Cross Pseudo Supervision (CPS) are mainly based on consistency regularization or pseudo-label supervision between a reference prediction and a supervised prediction. Despite the effectiveness, they have overlooked the potential noise in the labeled data, and mainly focus on strategies to generate the reference prediction, while ignoring the heterogeneous values of different unlabeled pixels. We argue that effectively mining the rich information contained by the two predictions in the loss function, instead of the specific strategy to obtain a reference prediction, is more essential for SSL, and propose a universal framework MetaSSL based on a spatially heterogeneous loss that assigns different weights to pixels by simultaneously leveraging the uncertainty and consistency information between the reference and supervised predictions. Specifically, we split the predictions on unlabeled data into four regions with decreasing weights in the loss: Unanimous and Confident (UC), Unanimous and Suspicious (US), Discrepant and Confident (DC), and Discrepant and Suspicious (DS), where an adaptive threshold is proposed to distinguish confident predictions from suspicious ones. The heterogeneous loss is also applied to labeled images for robust learning considering the potential annotation noise. Our method is plug-and-play and general to most existing SSL methods. The experimental results showed that it improved the segmentation performance significantly when integrated with existing SSL frameworks on different datasets. Code is available at https://github.com/HiLab-git/MetaSSL.

Zihao Luo, Zijun Gao, Wenjun Liao et al.

Accurate lymph node (LN) segmentation is critical in radiotherapy treatment and prognosis analysis, but is limited by the need for large annotated datasets. While deep learning-based segmentation foundation models show potential in developing high-performing models with fewer samples, their medical adaptation faces LN domain-specific prior deficiencies and inefficient few-shot fine-tuning for complex clinical practices, highlighting the necessity of an LN segmentation foundation model. In this work, we annotated 36,106 visible LNs from 3,346 publicly available head-and-neck CT scans to establish a robust LN segmentation model (nnUNetv2). Building on this, we propose Dynamic Gradient Sparsification Training (DGST), a few-shot fine-tuning approach that preserves foundational knowledge while dynamically updating the most critical parameters of the LN segmentation model with few annotations. We validate it on two publicly available LN segmentation datasets: SegRap2023 and LNQ2023. The results show that DGST outperforms existing few-shot fine-tuning methods, achieving satisfactory performance with limited labeled data. We release the dataset, models and all implementations to facilitate relevant research: https://github.com/Zihaoluoh/LN-Seg-FM.

Zihao Luo, Shaohao Rui, Zhenyu Tang et al.

Continual self-supervised learning (CSSL) in medical imaging trains a foundation model sequentially, alleviating the need for collecting multi-modal images for joint training and offering promising improvements in downstream performance while preserving data privacy. However, most existing methods still rely on replaying data from previous stages to prevent catastrophic forgetting, which compromises privacy and limits their applicability in real-world scenarios where data transfer across sites is often restricted. In this work, we propose InvCoSS, an inversion-driven continual self-supervised learning framework for medical multi-modal image pre-training. Specifically, after training on a previous task, InvCoSS inverts the pre-trained self-supervised model to generate synthetic images that approximate the original training distribution. These synthetic images are then combined with data from the new task for joint optimization, which effectively mitigates catastrophic forgetting while strictly adhering to the constraint of no access to previous real data. Furthermore, to improve the fidelity of synthetic images, we introduce a novel InvUNet with a multi-scale fusion architecture to restore both high- and low-frequency components of the inverted images. To enhance diversity and prevent mode collapse, we design a repulsive representation-learning mechanism that encourages a diverse feature space for synthetic images without class guidance. Extensive experiments across nine downstream tasks validate the effectiveness of InvCoSS, achieving performance comparable to or even superior to prior data-replay methods while significantly reducing storage requirements and eliminating data privacy constraints.

Xiaochuan Ma, Jia Fu, Wenjun Liao et al.

Brain tumor segmentation is important for diagnosis of the tumor, and current deep-learning methods rely on a large set of annotated images for training, with high annotation costs. Unsupervised segmentation is promising to avoid human annotations while the performance is often limited. In this study, we present a novel unsupervised segmentation approach that leverages the capabilities of foundation models, and it consists of three main steps: (1) A vision-language model (i.e., CLIP) is employed to obtain image-level pseudo-labels for training a classification network. Class Activation Mapping (CAM) is then employed to extract Regions of Interest (ROIs), where an adaptive masking-based data augmentation is used to enhance ROI identification.(2) The ROIs are used to generate bounding box and point prompts for the Segment Anything Model (SAM) to obtain segmentation pseudo-labels. (3) A 3D segmentation network is trained with the SAM-derived pseudo-labels, where low-quality pseudo-labels are filtered out in a self-learning process based on the similarity between the SAM's output and the network's prediction. Evaluation on the BraTS2020 dataset demonstrates that our approach obtained an average Dice Similarity Score (DSC) of 85.60%, outperforming five state-of-the-art unsupervised segmentation methods by more than 10 percentage points. Besides, our approach outperforms directly using SAM for zero-shot inference, and its performance is close to fully supervised learning.

Tao Song, Yicheng Wu, Minhao Hu et al.

Accelerated MRI reconstruction plays a vital role in reducing scan time while preserving image quality. While most existing methods rely on complex-valued image-space or k-space data, these formats are often inaccessible in clinical practice due to proprietary reconstruction pipelines, leaving only magnitude images stored in DICOM files. To address this gap, we focus on the underexplored task of magnitude-image-based MRI reconstruction. Recent advancements in diffusion models, particularly denoising diffusion probabilistic models (DDPMs), have demonstrated strong capabilities in modeling image priors. However, their task-agnostic denoising nature limits performance in source-to-target image translation tasks, such as MRI reconstruction. In this work, we propose a novel Self-Consistent Nested Diffusion Bridge (SC-NDB) framework that models accelerated MRI reconstruction as a bi-directional image translation process between under-sampled and fully-sampled magnitude MRI images. SC-NDB introduces a nested diffusion architecture with a self-consistency constraint and reverse bridge diffusion pathways to improve intermediate prediction fidelity and better capture the explicit priors of source images. Furthermore, we incorporate a Contour Decomposition Embedding Module (CDEM) to inject structural and textural knowledge by leveraging Laplacian pyramids and directional filter banks. Extensive experiments on the fastMRI and IXI datasets demonstrate that our method achieves state-of-the-art performance compared to both magnitude-based and non-magnitude-based diffusion models, confirming the effectiveness and clinical relevance of SC-NDB.