Semi-TMS: an efficient regularization-oriented triple-teacher semi-supervised medical image segmentation model.

Objective. Although convolutional neural networks (CNN) and Transformers have performed well in many medical image segmentation tasks, they rely on large amounts of labeled data for training. The annotation of medical image data is expensive and time-consuming, so it is common to use semi-supervised learning methods that use a small amount of labeled data and a large amount of unlabeled data to improve the performance of medical imaging segmentation.Approach. This work aims to enhance the segmentation performance of medical images using a triple-teacher cross-learning semi-supervised medical image segmentation with shape perception and multi-scale consistency regularization. To effectively leverage the information from unlabeled data, we design a multi-scale semi-supervised method for three-teacher cross-learning based on shape perception, called Semi-TMS. The three teacher models engage in cross-learning with each other, where Teacher A and Teacher C utilize a CNN architecture, while Teacher B employs a transformer model. The cross-learning module consisting of Teacher A and Teacher C captures local and global information, generates pseudo-labels, and performs cross-learning using prediction results. Multi-scale consistency regularization is applied separately to the CNN and Transformer to improve accuracy. Furthermore, the low uncertainty output probabilities from Teacher A or Teacher C are utilized as input to Teacher B, enhancing the utilization of prior knowledge and overall segmentation robustness.Main results. Experimental evaluations on two public datasets demonstrate that the proposed method outperforms some existing semi-segmentation models, implicitly capturing shape information and effectively improving the utilization and accuracy of unlabeled data through multi-scale consistency.Significance. With the widespread utilization of medical imaging in clinical diagnosis, our method is expected to be a potential auxiliary tool, assisting clinicians and medical researchers in their diagnoses.

Chen W ，Zhou S ，Liu X ，Chen Y ... -  《-》

Efficient Combination of CNN and Transformer for Dual-Teacher Uncertainty-guided Semi-supervised Medical Image Segmentation.

Deep learning-based methods for fast target segmentation of magnetic resonance imaging (MRI) have become increasingly popular in recent years. Generally, the success of deep learning methods in medical image segmentation tasks relies on a large amount of labeled data. The time-consuming and labor-intensive problem of data annotation is a major challenge in medical image segmentation tasks. The aim of this work is to enhance the segmentation of MR images using a semi-supervised learning-based method using a small amount of labeled data and a large amount of unlabeled data. To utilize the effective information of the unlabeled data, we designed the method of guiding the Student segmentation model simultaneously by the Dual-Teacher structure of CNN and transformer forming the subject network. Both Teacher A and Student models are CNNs, and the TA-S module they form is a mean teacher structure with added data noise. In the TB-S module formed by the combination of Student and Teacher B models, their backbone networks CNN and transformer capture the local and global information of the image at the same time, respectively, to create pseudo labels for each other and perform cross-supervision. The Dual-Teacher guides the Student through synchronous training and performs knowledge rectification and communication with each other through consistent regular constraints, which better utilizes the valid information in the unlabeled data. In addition, the segmentation predictions of Teacher A and Student and Teacher A and Teacher B are screened for uncertainty assessment during the training process to enhance the prediction accuracy and generalization of the model. This method uses the mechanism of simultaneous training of the synthetic structure composed of TA-S and TB-S modules to jointly guide the optimization of the Student model to obtain better segmentation ability. We evaluated the proposed method on a publicly available MRI dataset from a cardiac segmentation competition organized by MICCAI in 2017. Compared with several existing state-of-the-art semi-supervised segmentation methods, the method achieves better segmentation results in terms of Dice coefficient and HD distance evaluation metrics of 0.878 and 4.9 mm and 0.886 and 5.0 mm, respectively, using a training set containing only 10% and 20% of labeled data. This method fuses CNN and transformer to design a new Teacher-Student semi-supervised learning optimization strategy, which greatly improves the utilization of a large number of unlabeled medical images and the effectiveness of model segmentation results.

Xiao Z ，Su Y ，Deng Z ，Zhang W ... -  《-》

Uncertainty-guided cross learning via CNN and transformer for semi-supervised honeycomb lung lesion segmentation.

Objective. Deep learning networks such as convolutional neural networks (CNN) and Transformer have shown excellent performance on the task of medical image segmentation, however, the usual problem with medical images is the lack of large-scale, high-quality pixel-level annotations, which is a very time-consuming and laborious task, and its further leads to compromised the performance of medical image segmentation under limited annotation conditions.Approach. In this paper, we propose a new semi-supervised learning method, uncertainty-guided cross learning, which uses a limited number of annotated samples along with a large number of unlabeled images to train the network. Specifically, we use two networks with different learning paradigms, CNN and Transformer, for cross learning, and use the prediction of one of them as a pseudo label to supervise the other, so that they can learn from each other, fully extract the local and global features of the images, and combine explicit and implicit consistency regularization constraints with pseudo label methods. On the other hand, we use epistemic uncertainty as a guiding message to encourage the model to learn high-certainty pixel information in high-confidence regions, and minimize the impact of erroneous pseudo labels on the overall learning process to improve the performance of semi-supervised segmentation methods.Main results. We conducted honeycomb lung lesion segmentation experiments using a honeycomb lung CT image dataset, and designed several sets of comparison experiments and ablation experiments to validate the effectiveness of our method. The final experimental results show that the Dice coefficient of our proposed method reaches 88.49% on the test set, and our method achieves state-of-the-art performance in honeycomb lung lesion segmentation compared to other semi-supervised learning methods.Significance. Our proposed method can effectively improve the accuracy of segmentation of honeycomb lung lesions, which provides an important reference for physicians in the diagnosis and treatment of this disease.

Zi-An Z ，Xiu-Fang F ，Xiao-Qiang R ，Yun-Yun D ... -  《-》

A modality-collaborative convolution and transformer hybrid network for unpaired multi-modal medical image segmentation with limited annotations.

Multi-modal learning is widely adopted to learn the latent complementary information between different modalities in multi-modal medical image segmentation tasks. Nevertheless, the traditional multi-modal learning methods require spatially well-aligned and paired multi-modal images for supervised training, which cannot leverage unpaired multi-modal images with spatial misalignment and modality discrepancy. For training accurate multi-modal segmentation networks using easily accessible and low-cost unpaired multi-modal images in clinical practice, unpaired multi-modal learning has received comprehensive attention recently. Existing unpaired multi-modal learning methods usually focus on the intensity distribution gap but ignore the scale variation problem between different modalities. Besides, within existing methods, shared convolutional kernels are frequently employed to capture common patterns in all modalities, but they are typically inefficient at learning global contextual information. On the other hand, existing methods highly rely on a large number of labeled unpaired multi-modal scans for training, which ignores the practical scenario when labeled data is limited. To solve the above problems, we propose a modality-collaborative convolution and transformer hybrid network (MCTHNet) using semi-supervised learning for unpaired multi-modal segmentation with limited annotations, which not only collaboratively learns modality-specific and modality-invariant representations, but also could automatically leverage extensive unlabeled scans for improving performance. We make three main contributions to the proposed method. First, to alleviate the intensity distribution gap and scale variation problems across modalities, we develop a modality-specific scale-aware convolution (MSSC) module that can adaptively adjust the receptive field sizes and feature normalization parameters according to the input. Secondly, we propose a modality-invariant vision transformer (MIViT) module as the shared bottleneck layer for all modalities, which implicitly incorporates convolution-like local operations with the global processing of transformers for learning generalizable modality-invariant representations. Third, we design a multi-modal cross pseudo supervision (MCPS) method for semi-supervised learning, which enforces the consistency between the pseudo segmentation maps generated by two perturbed networks to acquire abundant annotation information from unlabeled unpaired multi-modal scans. Extensive experiments are performed on two unpaired CT and MR segmentation datasets, including a cardiac substructure dataset derived from the MMWHS-2017 dataset and an abdominal multi-organ dataset consisting of the BTCV and CHAOS datasets. Experiment results show that our proposed method significantly outperforms other existing state-of-the-art methods under various labeling ratios, and achieves a comparable segmentation performance close to single-modal methods with fully labeled data by only leveraging a small portion of labeled data. Specifically, when the labeling ratio is 25%, our proposed method achieves overall mean DSC values of 78.56% and 76.18% in cardiac and abdominal segmentation, respectively, which significantly improves the average DSC value of two tasks by 12.84% compared to single-modal U-Net models. Our proposed method is beneficial for reducing the annotation burden of unpaired multi-modal medical images in clinical applications.

Liu H ，Zhuang Y ，Song E ，Xu X ，Ma G ，Cetinkaya C ，Hung CC ... -  《-》

Semi-supervised medical image segmentation via uncertainty rectified pyramid consistency.

Despite that Convolutional Neural Networks (CNNs) have achieved promising performance in many medical image segmentation tasks, they rely on a large set of labeled images for training, which is expensive and time-consuming to acquire. Semi-supervised learning has shown the potential to alleviate this challenge by learning from a large set of unlabeled images and limited labeled samples. In this work, we present a simple yet efficient consistency regularization approach for semi-supervised medical image segmentation, called Uncertainty Rectified Pyramid Consistency (URPC). Inspired by the pyramid feature network, we chose a pyramid-prediction network that obtains a set of segmentation predictions at different scales. For semi-supervised learning, URPC learns from unlabeled data by minimizing the discrepancy between each of the pyramid predictions and their average. We further present multi-scale uncertainty rectification to boost the pyramid consistency regularization, where the rectification seeks to temper the consistency loss at outlier pixels that may have substantially different predictions than the average, potentially due to upsampling errors or lack of enough labeled data. Experiments on two public datasets and an in-house clinical dataset showed that: 1) URPC can achieve large performance improvement by utilizing unlabeled data and 2) Compared with five existing semi-supervised methods, URPC achieved better or comparable results with a simpler pipeline. Furthermore, we build a semi-supervised medical image segmentation codebase to boost research on this topic: https://github.com/HiLab-git/SSL4MIS.

Luo X ，Wang G ，Liao W ，Chen J ，Song T ，Chen Y ，Zhang S ，Metaxas DN ，Zhang S ... -  《-》