Semi-supervised medical image segmentation is an effective method for addressing scenarios with limited labeled data. Existing methods mainly rely on frameworks such as mean teacher and dual-stream consistency learning. These approaches often face issues like error accumulation and model structural complexity, while also neglecting the interaction between labeled and unlabeled data streams. To overcome these challenges, we propose a Bidirectional Channel-selective Semantic Interaction (BCSI) framework for semi-supervised medical image segmentation. First, we propose a Semantic-Spatial Perturbation (SSP) mechanism, which disturbs the data using two strong augmentation operations and leverages unsupervised learning with pseudo-labels from weak augmentations. Additionally, we employ consistency on the predictions from the two strong augmentations to further improve model stability and robustness. Second, to reduce noise during the interaction between labeled and unlabeled data, we propose a Channel-selective Router (CR) component, which dynamically selects the most relevant channels for information exchange. This mechanism ensures that only highly relevant features are activated, minimizing unnecessary interference. Finally, the Bidirectional Channel-wise Interaction (BCI) strategy is employed to supplement additional semantic information and enhance the representation of important channels. Experimental results on multiple benchmarking 3D medical datasets demonstrate that the proposed method outperforms existing semi-supervised approaches.

Few-Shot Learning (FSL) has garnered increasing attention for data-scarce scenarios, particularly in medical segmentation tasks where only a few labeled data points are available. Existing few-shot segmentation methods typically learn prototypes from support images and employ nearest-neighbor searching to segment query images. Despite notable progress, effectively learning prototypes for each class remains a challenging task to achieve promising results. In this paper, we propose an Uncertainty-guided Prototype Reliability Enhancement Network (UPRE-Net) for few-shot medical image segmentation. Specifically, we present a dual-support branch to maximize the extraction of information from support images through augmentation techniques. To enhance the reliability of prototypes, we propose an Uncertainty-guided Prototype Generation (UPG) module. Within the UPG module, we first extract both global and local prototypes for each class and then apply uncertainty measures to select the most informative prototypes. Additionally, to effectively combine the prediction results from the dual-support branch, we present a Reliable Dynamic Fusion (RDF) module. This module dynamically integrates the two prediction results to generate a more reliable output. Furthermore, we present an Uncertainty-induced Weighted Loss (UWL) to ensure that the model pays more attention to these regions with high uncertainty. Experiments on four benchmark medical image datasets demonstrate that our proposed model significantly outperforms state-of-the-art methods. The code will be released at https://github.com/taozh2017/UPRENet.

Semi-supervised learning has gained considerable popularity in medical image segmentation tasks due to its capability to reduce reliance on expert-examined annotations. Several mean-teacher (MT) based semi-supervised methods utilize consistency regularization to effectively leverage valuable information from unlabeled data. However, these methods often heavily rely on the student model and overlook the potential impact of cognitive biases within the model. Furthermore, some methods employ co-training using pseudo-labels derived from different inputs, yet generating high-confidence pseudo-labels from perturbed inputs during training remains a significant challenge. In this paper, we propose an Uncertainty-aware Cross-training framework for semi-supervised medical image Segmentation (UC-Seg). Our UC-Seg framework incorporates two distinct subnets to effectively explore and leverage the correlation between them, thereby mitigating cognitive biases within the model. Specifically, we present a Cross-subnet Consistency Preservation (CCP) strategy to enhance feature representation capability and ensure feature consistency across the two subnets. This strategy enables each subnet to correct its own biases and learn shared semantics from both labeled and unlabeled data. Additionally, we propose an Uncertainty-aware Pseudo-label Generation (UPG) component that leverages segmentation results and corresponding uncertainty maps from both subnets to generate high-confidence pseudo-labels. We extensively evaluate the proposed UC-Seg on various medical image segmentation tasks involving different modality images, such as MRI, CT, ultrasound, colonoscopy, and so on. The results demonstrate that our method achieves superior segmentation accuracy and generalization performance compared to other state-of-the-art semi-supervised methods. Our code and segmentation maps will be released at https://github.com/taozh2017/UCSeg.

The limited availability of labeled data has driven advancements in semi-supervised learning for medical image segmentation. Modern large-scale models tailored for general segmentation, such as the Segment Anything Model (SAM), have revealed robust generalization capabilities. However, applying these models directly to medical image segmentation still exposes performance degradation. In this paper, we propose a learnable prompting SAM-induced Knowledge distillation framework (KnowSAM) for semi-supervised medical image segmentation. Firstly, we propose a Multi-view Co-training (MC) strategy that employs two distinct sub-networks to employ a co-teaching paradigm, resulting in more robust outcomes. Secondly, we present a Learnable Prompt Strategy (LPS) to dynamically produce dense prompts and integrate an adapter to fine-tune SAM specifically for medical image segmentation tasks. Moreover, we propose SAM-induced Knowledge Distillation (SKD) to transfer useful knowledge from SAM to two sub-networks, enabling them to learn from SAM's predictions and alleviate the effects of incorrect pseudo-labels during training. Notably, the predictions generated by our subnets are used to produce mask prompts for SAM, facilitating effective inter-module information exchange. Extensive experimental results on various medical segmentation tasks demonstrate that our model outperforms the state-of-the-art semi-supervised segmentation approaches. Crucially, our SAM distillation framework can be seamlessly integrated into other semi-supervised segmentation methods to enhance performance. The code will be released upon acceptance of this manuscript at https://github.com/taozh2017/KnowSAM.