Medical image segmentation is a critical yet challenging task, primarily due to the difficulty of obtaining extensive datasets of high-quality, expert-annotated images. Contrastive learning presents a potential but still problematic solution to this issue. Because most existing methods focus on extracting instance-level or pixel-to-pixel representation, which ignores the characteristics between intra-image similar pixel groups. Moreover, when considering contrastive pairs generation, most SOTA methods mainly rely on manually setting thresholds, which requires a large number of gradient experiments and lacks efficiency and generalization. To address these issues, we propose a novel contrastive learning approach named SuperCL for medical image segmentation pre-training. Specifically, our SuperCL exploits the structural prior and pixel correlation of images by introducing two novel contrastive pairs generation strategies: Intra-image Local Contrastive Pairs (ILCP) Generation and Inter-image Global Contrastive Pairs (IGCP) Generation. Considering superpixel cluster aligns well with the concept of contrastive pairs generation, we utilize the superpixel map to generate pseudo masks for both ILCP and IGCP to guide supervised contrastive learning. Moreover, we also propose two modules named Average SuperPixel Feature Map Generation (ASP) and Connected Components Label Generation (CCL) to better exploit the prior structural information for IGCP. Finally, experiments on 8 medical image datasets indicate our SuperCL outperforms existing 12 methods. i.e. Our SuperCL achieves a superior performance with more precise predictions from visualization figures and 3.15%, 5.44%, 7.89% DSC higher than the previous best results on MMWHS, CHAOS, Spleen with 10% annotations. Our code is released at https://github.com/stevezs315/SuperCL.

Concept Bottleneck Models (CBMs) offer inherent interpretability by initially translating images into human-comprehensible concepts, followed by a linear combination of these concepts for classification. However, the annotation of concepts for visual recognition tasks requires extensive expert knowledge and labor, constraining the broad adoption of CBMs. Recent approaches have leveraged the knowledge of large language models to construct concept bottlenecks, with multimodal models like CLIP subsequently mapping image features into the concept feature space for classification. Despite this, the concepts produced by language models can be verbose and may introduce non-visual attributes, which hurts accuracy and interpretability. In this study, we investigate to avoid these issues by constructing CBMs directly from multimodal models. To this end, we adopt common words as base concept vocabulary and leverage auxiliary unlabeled images to construct a Vision-to-Concept (V2C) tokenizer that can explicitly quantize images into their most relevant visual concepts, thus creating a vision-oriented concept bottleneck tightly coupled with the multimodal model. This leads to our V2C-CBM which is training efficient and interpretable with high accuracy. Our V2C-CBM has matched or outperformed LLM-supervised CBMs on various visual classification benchmarks, validating the efficacy of our approach.

The performance of fully supervised methods for fundus vessel segmentation highly relies on a large number of full labels which are laborious and time-consuming to obtain. Although weak annotations relax the requirement for pixel-wise labeling, they pose challenges in learning comprehensive information about the target. Some methods use pseudo labels generated from network predictions for extra supervision, but false positive predictions in these labels may harm training. In this paper, to tackle this problem and to balance the annotation cost and supervision information, we introduce point annotations to fundus vessel segmentation and propose a novel method, called Points-based Vessel segmentation Network (PVN), to enhance the segmentation accuracy. In PVN, to avoid noise in pseudo labels, by combining proposed Point Activation Maps, shape priors of vessels are learned and used as soft supervision. Additionally, to further leverage the annotated vessel and background points, we design a novel contrastive learning method in a pixels-and-regions-mixed manner, which helps learn discriminative features by distinguishing between pixel and region samples of vessels and background. The performance of PVN is evaluated on laser speckle contrast imaging fundus images, 548 nm fundus images, and three public datasets, where PVN outperforms other point-supervised methods. Even with only 1% annotated pixels, PVN still achieves excellent performance. Our method is also flexible and easy to be combined with other frameworks. To the best of our knowledge, we are the first to propose and demonstrate the effectiveness of point annotations for fundus vessel segmentation. Our code is available at: https://github.com/kaiwenli325/PVN.

End-to-end weakly supervised semantic segmentation (E2E-WSSS) aims at optimizing a segmentation model in a single-stage training process based on only image annotations. Existing methods adopt an online-trained classification branch to provide pseudo annotations for supervising the segmentation branch. However, this strategy makes the classification branch dominate the whole concurrent training process, hindering these two branches from assisting each other. In our work, we treat these two branches equally by viewing them as diverse ways to generate the segmentation map, and add interactions on both their supervision and operation to achieve mutual promotion. For this purpose, a bidirectional supervision mechanism is elaborated to force the consistency between the outputs of these two branches. Thus, the segmentation branch can also give feedback to the classification branch to enhance the quality of localization seeds. Moreover, our method also designs interaction operations between these two branches to exchange their knowledge to assist each other. Experiments indicate our work outperforms existing end-to-end weakly supervised segmentation methods. Codes are available at https://github.com/zh460045050/BMP-WSSS.

Scribble-based weakly-supervised semantic segmentation using sparse scribble supervision is gaining traction as it reduces annotation costs when compared to fully annotated alternatives. Existing methods primarily generate pseudo-labels by diffusing labeled pixels to unlabeled ones with local cues for supervision. However, this diffusion process fails to exploit global semantics and class-specific cues, which are important for semantic segmentation. In this study, we propose a class-driven scribble promotion network, which utilizes both scribble annotations and pseudo-labels informed by image-level classes and global semantics for supervision. Directly adopting pseudo-labels might misguide the segmentation model, thus we design a localization rectification module to correct foreground representations in the feature space. To further combine the advantages of both supervisions, we also introduce a distance entropy loss for uncertainty reduction, which adapts per-pixel confidence weights according to the reliable region determined by the scribble and pseudo-label's boundary. Experiments on the ScribbleSup dataset with different qualities of scribble annotations outperform all the previous methods, demonstrating the superiority and robustness of our method. The code is available at https://github.com/Zxl19990529/Class-driven-Scribble-Promotion-Network.

Adversarial Training (AT), which adversarially perturb the input samples during training, has been acknowledged as one of the most effective defenses against adversarial attacks, yet suffers from inevitably decreased clean accuracy. Instead of perturbing the samples, Sharpness-Aware Minimization (SAM) perturbs the model weights during training to find a more flat loss landscape and improve generalization. However, as SAM is designed for better clean accuracy, its effectiveness in enhancing adversarial robustness remains unexplored. In this work, considering the duality between SAM and AT, we investigate the adversarial robustness derived from SAM. Intriguingly, we find that using SAM alone can improve adversarial robustness. To understand this unexpected property of SAM, we first provide empirical and theoretical insights into how SAM can implicitly learn more robust features, and conduct comprehensive experiments to show that SAM can improve adversarial robustness notably without sacrificing any clean accuracy, shedding light on the potential of SAM to be a substitute for AT when accuracy comes at a higher priority. Code is available at https://github.com/weizeming/SAM_AT.