Segmenting prostate from magnetic resonance imaging (MRI) is a critical procedure in prostate cancer staging and treatment planning. Considering the nature of labeled data scarcity for medical images, semi-supervised learning (SSL) becomes an appealing solution since it can simultaneously exploit limited labeled data and a large amount of unlabeled data. However, SSL relies on the assumption that the unlabeled images are abundant, which may not be satisfied when the local institute has limited image collection capabilities. An intuitive solution is to seek support from other centers to enrich the unlabeled image pool. However, this further introduces data heterogeneity, which can impede SSL that works under identical data distribution with certain model assumptions. Aiming at this under-explored yet valuable scenario, in this work, we propose a separated collaborative learning (SCL) framework for semi-supervised prostate segmentation with multi-site unlabeled MRI data. Specifically, on top of the teacher-student framework, SCL exploits multi-site unlabeled data by: (i) Local learning, which advocates local distribution fitting, including the pseudo label learning that reinforces confirmation of low-entropy easy regions and the cyclic propagated real label learning that leverages class prototypes to regularize the distribution of intra-class features; (ii) External multi-site learning, which aims to robustly mine informative clues from external data, mainly including the local-support category mutual dependence learning, which takes the spirit that mutual information can effectively measure the amount of information shared by two variables even from different domains, and the stability learning under strong adversarial perturbations to enhance robustness to heterogeneity. Extensive experiments on prostate MRI data from six different clinical centers show that our method can effectively generalize SSL on multi-site unlabeled data and significantly outperform other semi-supervised segmentation methods. Besides, we validate the extensibility of our method on the multi-class cardiac MRI segmentation task with data from four different clinical centers.

Recently, deep learning (DL)-based skin lesion segmentation in dermoscopic images has advanced the efficient diagnosis of skin diseases. Commonly, most of the DL-based methods require a large amount of training data and can only perform accurate predictions on pre-defined classes. However, there exist some rare skin diseases with very limited labeled samples, which poses great challenges to typical DL-based methods. Few-shot learning (FSL) technique, which aims to train models with abundant seen classes and then generalizes to related unseen classes, is promising in addressing a similar problem. Unfortunately, simply borrowing the typical FSL is infeasible since collecting such abundant seen-class data (common skin diseases), is also difficult. In this paper, we propose a cross-domain few-shot segmentation (CD-FSS) framework, which enables the model to leverage the learning ability obtained from the natural domain, to facilitate rare-disease skin lesion segmentation with limited data of common diseases. Specifically, the framework consists of two processes, i.e., specific learning and generic learning, which are alternately optimized in a meta-training manner. A specific learner and a generic learner are tailored to build relationships between both processes. Experimental results demonstrate that our framework significantly improves the generalization ability from natural domain to unseen medical domain.

Semi-supervised learning has substantially advanced medical image segmentation since it alleviates the heavy burden of acquiring the costly expert-examined annotations. Especially, the consistency-based approaches have attracted more attention for their superior performance, wherein the real labels are only utilized to supervise their paired images via supervised loss while the unlabeled images are exploited by enforcing the perturbation-based "unsupervised" consistency without explicit guidance from those real labels. However, intuitively, the expert-examined real labels contain more reliable supervision signals. Observing this, we ask an unexplored but interesting question: can we exploit the unlabeled data via explicit real label supervision for semi-supervised training? To this end, we discard the previous perturbation-based consistency but absorb the essence of non-parametric prototype learning. Based on the prototypical networks, we then propose a novel cyclic prototype consistency learning (CPCL) framework, which is constructed by a labeled-to-unlabeled (L2U) prototypical forward process and an unlabeled-to-labeled (U2L) backward process. Such two processes synergistically enhance the segmentation network by encouraging morediscriminative and compact features. In this way, our framework turns previous "unsupervised" consistency into new "supervised" consistency, obtaining the "all-around real label supervision" property of our method. Extensive experiments on brain tumor segmentation from MRI and kidney segmentation from CT images show that our CPCL can effectively exploit the unlabeled data and outperform other state-of-the-art semi-supervised medical image segmentation methods.

Manually segmenting medical images is expertise-demanding, time-consuming and laborious. Acquiring massive high-quality labeled data from experts is often infeasible. Unfortunately, without sufficient high-quality pixel-level labels, the usual data-driven learning-based segmentation methods often struggle with deficient training. As a result, we are often forced to collect additional labeled data from multiple sources with varying label qualities. However, directly introducing additional data with low-quality noisy labels may mislead the network training and undesirably offset the efficacy provided by those high-quality labels. To address this issue, we propose a Mean-Teacher-assisted Confident Learning (MTCL) framework constructed by a teacher-student architecture and a label self-denoising process to robustly learn segmentation from a small set of high-quality labeled data and plentiful low-quality noisy labeled data. Particularly, such a synergistic framework is capable of simultaneously and robustly exploiting (i) the additional dark knowledge inside the images of low-quality labeled set via perturbation-based unsupervised consistency, and (ii) the productive information of their low-quality noisy labels via explicit label refinement. Comprehensive experiments on left atrium segmentation with simulated noisy labels and hepatic and retinal vessel segmentation with real-world noisy labels demonstrate the superior segmentation performance of our approach as well as its effectiveness on label denoising.

Multimodal image registration (MIR) is a fundamental procedure in many image-guided therapies. Recently, unsupervised learning-based methods have demonstrated promising performance over accuracy and efficiency in deformable image registration. However, the estimated deformation fields of the existing methods fully rely on the to-be-registered image pair. It is difficult for the networks to be aware of the mismatched boundaries, resulting in unsatisfactory organ boundary alignment. In this paper, we propose a novel multimodal registration framework, which elegantly leverages the deformation fields estimated from both: (i) the original to-be-registered image pair, (ii) their corresponding gradient intensity maps, and adaptively fuses them with the proposed gated fusion module. With the help of auxiliary gradient-space guidance, the network can concentrate more on the spatial relationship of the organ boundary. Experimental results on two clinically acquired CT-MRI datasets demonstrate the effectiveness of our proposed approach.

We present a robust method to correct for motion and deformations in in-utero volumetric MRI time series. Spatio-temporal analysis of dynamic MRI requires robust alignment across time in the presence of substantial and unpredictable motion. We make a Markov assumption on the nature of deformations to take advantage of the temporal structure in the image data. Forward message passing in the corresponding hidden Markov model (HMM) yields an estimation algorithm that only has to account for relatively small motion between consecutive frames. We demonstrate the utility of the temporal model by showing that its use improves the accuracy of the segmentation propagation through temporal registration. Our results suggest that the proposed model captures accurately the temporal dynamics of deformations in in-utero MRI time series.