The teacher-student paradigm has emerged as a canonical framework in semi-supervised learning. When applied to medical image segmentation, the paradigm faces challenges due to inherent image ambiguities, making it particularly vulnerable to erroneous supervision. Crucially, the student's iterative reconfirmation of these errors leads to self-reinforcing bias. While some studies attempt to mitigate this bias, they often rely on external modifications to the conventional teacher-student framework, overlooking its intrinsic potential for error correction. In response, this work introduces a feedback mechanism into the teacher-student framework to counteract error reconfirmations. Here, the student provides feedback on the changes induced by the teacher's pseudo-labels, enabling the teacher to refine these labels accordingly. We specify that this interaction hinges on two key components: the feedback attributor, which designates pseudo-labels triggering the student's update, and the feedback receiver, which determines where to apply this feedback. Building on this, a dual-teacher feedback model is further proposed, which allows more dynamics in the feedback loop and fosters more gains by resolving disagreements through cross-teacher supervision while avoiding consistent errors. Comprehensive evaluations on three medical image benchmarks demonstrate the method's effectiveness in addressing error propagation in semi-supervised medical image segmentation.

Domain generalization (DG) methods traditionally rely on multiple source domains to achieve the robust performance across unseen target domains. However, single-DG (SDG) presents a more practical paradigm by learning from a single source domain, addressing scenarios where access to multiple domains is limited. While existing SDG approaches primarily focus on data augmentation and style transfer techniques to enhance the model robustness, these methods often incur substantial computational overhead and may inadequately capture the complexity of real-world domain shifts. In this article, we propose path flatness-aware optimization (PFO), an optimization framework that addresses the fundamental challenges of SDG. Unlike conventional approaches that rely on the synthetic data generation, PFO identifies and exploits regions of flat minima within the optimization landscape of deep neural networks. The framework employs an iterative optimization strategy to construct a path through the parameter space along which an ensemble of candidate models achieves the minimal empirical risk. The initialization of this optimization path is achieved through the strategic interconnection of model instances, each originating from carefully selected anchor points that are computationally determined through the systematic analysis of classification decision manifolds. This optimization path serves as a mechanism for implicit distribution alignment between source and target domains within the loss landscape, consequently enhancing the model's capacity for cross-DG. Empirical evaluation on multiple benchmark datasets demonstrates significant performance improvements in cross-DG, validating the efficacy of our approach.

Medical image segmentation provides detailed understanding and aids in diagnosis, treatment planning, and monitoring of diseases. Due to the high cost of acquiring labeled data in the field of medical image analysis, semi-supervised segmentation methods have garnered increasing attention. Benefiting from their simplicity and effectiveness, consistency regularization-based methods have emerged as a significant research focus by utilizing perturbations. However, existing methods typically consider perturbation strategies from only a single perspective: either instance perturbation or model perturbation, thus ignoring the potential benefit of effectively combining both. In response, we propose a unified perturbation framework named GapMatch, which bridges instance and model perturbations to broaden the perturbation space and employs dual perturbation to impose consistency regularization on the model. Specifically, GapMatch involves using instance perturbation to update the decision boundary and model perturbation to further optimize it. These two steps mutually reinforce each other in an iterative manner, effectively pushing the decision boundary towards low-density regions while maximizing the class margin. Extensive experimental results on two popular medical image benchmarks demonstrate the effectiveness and generality of the proposed method.

Out-of-distribution (OOD) problems commonly occur when models process data with a distribution significantly deviates from the in-distribution (InD) training data. In this paper, we hypothesize that a $\textit{field}$ or $\textit{potential}$ more essential than features exists, and features are not the ultimate essence of the data but rather manifestations of them during training. we investigate OOD problems from the perspective of collective behavior dynamics. With this in mind, we first treat the output of the feature extractor as charged particles and investigate their collective behavior dynamics within a self-consistent electric field. Then, to characterize the relationship between OOD problems and dynamical equations, we introduce the $\textit{basin of attraction}$ and prove that its boundary can be represented as the zero level set of a differentiable function of the potential, $\textit{i.e.}$, the spatial integral of field. We further demonstrate that: $\textit{i)}$ InD and OOD inputs can be effectively separated based on whether they are steady state solutions for specific field conditions, enabling robust OOD detection and outperforming prior methods over three benchmarks. $\textit{ii)}$ the generalization capability correlates positively with the basin of attraction. By analyzing the dynamics of perturbations, we propose that the potential is well-characterized by a Fourier-domain form of the Poisson equation. Evaluated on six benchmark datasets, our method rivals the SoTA approaches for OOD generalization and can be seamlessly integrated with them to deliver additional gains.

Domain generalization (DG) aims to learn a model on one or multiple observed source domains that can generalize to unseen target test domains. Previous approaches have focused on extracting domain-invariant information from multiple source domains, but domain-specific information is also closely tied to semantics in individual domains and is not well-suited for generalization to the target domain. In this article, we propose a novel DG method called continuous disentangled joint space learning (CJSL), which leverages both domain-invariant and domain-specific information for more effective DG. The key idea behind CJSL is to formulate and learn a continuous joint space (CJS) for domain-specific representations from source domains through iterative feature disentanglement. This learned CJS can then be used to simulate domain-specific representations for test samples from a mixture of multiple domains via Monte Carlo sampling during the inference stage. Unlike existing approaches, which exploit domain-invariant feature vectors only or aim to learn a universal domain-specific feature extractor, we simulate domain-specific representations via sampling the latent vectors in the learned CJS for the test sample to fully use the power of multiple domain-specific classifiers for robust prediction. Empirical results demonstrate that CJSL outperforms 19 state-of-the-art (SOTA) methods on seven benchmarks, indicating the effectiveness of our proposed method.

Deep neural networks have demonstrated impressive results in medical image analysis, but designing suitable architectures for each specific task is expertise-dependent and time-consuming. Neural architecture search (NAS) offers an effective means of discovering architectures. It has been highly successful in numerous applications, particularly in natural image classification. Yet, medical images possess unique characteristics, such as small regions and a wide variety of lesion sizes, that differentiate them from natural images. Furthermore, most current NAS methods struggle with high computational costs, especially when dealing with high-resolution image datasets. In this paper, we present a novel evolutionary neural architecture search method called Multi-Scale Training-Free Neural Architecture Search to address these challenges. Specifically, to accommodate the broad range of lesion region sizes in disease diagnosis, we develop a new reduction cell search space that enables the search algorithm to explicitly identify the optimal scale combination for multi-scale feature extraction. To overcome the issue of high computational costs, we utilize training-free indicators as performance measures for candidate architectures, which allows us to search for the optimal architecture more efficiently. More specifically, by considering the capability and simplicity of various networks, we formulate a multi-objective optimization problem that involves two training-free indicators and model complexity for candidate architectures. Extensive experiments on a large medical image benchmark and a publicly available breast cancer detection dataset are conducted. The empirical results demonstrate that our MSTF-NAS outperforms both human-designed architectures and current state-of-the-art NAS algorithms on both datasets, indicating the effectiveness of our proposed method.

Medical image segmentation is a fundamental task in many clinical applications, yet current automated segmentation methods rely heavily on manual annotations, which are inherently subjective and prone to annotation bias. Recently, modeling annotator preference has garnered great interest, and several methods have been proposed in the past two years. However, the existing methods completely ignore the potential correlation between annotations, such as complementary and discriminative information. In this work, the Adaptive annotation CorrelaTion based multI-annOtation LearNing (ACTION) method is proposed for calibrated medical image segmentation. ACTION employs consensus feature learning and dynamic adaptive weighting to leverage complementary information across annotations and emphasize discriminative information within each annotation based on their correlations, respectively. Meanwhile, memory accumulation-replay is proposed to accumulate the prior knowledge and integrate it into the model to enable the model to accommodate the multi-annotation setting. Two medical image benchmarks with different modalities are utilized to evaluate the performance of ACTION, and extensive experimental results demonstrate that it achieves superior performance compared to several state-of-the-art methods.

Due to the exorbitant expense of obtaining labeled data in the field of medical image analysis, semi-supervised learning has emerged as a favorable method for the segmentation of anatomical structures. Although semi-supervised learning techniques have shown great potential in this field, existing methods only utilize image-level spatial consistency to impose unsupervised regularization on data in label space. Considering that anatomical structures often possess inherent anatomical properties that have not been focused on in previous works, this study introduces the inherent consistency into semi-supervised anatomical structure segmentation. First, the prediction and the ground-truth are projected into an embedding space to obtain latent representations that encapsulate the inherent anatomical properties of the structures. Then, two inherent consistency constraints are designed to leverage these inherent properties by aligning these latent representations. The proposed method is plug-and-play and can be seamlessly integrated with existing methods, thereby collaborating to improve segmentation performance and enhance the anatomical plausibility of the results. To evaluate the effectiveness of the proposed method, experiments are conducted on three public datasets (ACDC, LA, and Pancreas). Extensive experimental results demonstrate that the proposed method exhibits good generalizability and outperforms several state-of-the-art methods.

Color fundus photography (CFP) and Optical coherence tomography (OCT) images are two of the most widely used modalities in the clinical diagnosis and management of retinal diseases. Despite the widespread use of multimodal imaging in clinical practice, few methods for automated diagnosis of eye diseases utilize correlated and complementary information from multiple modalities effectively. This paper explores how to leverage the information from CFP and OCT images to improve the automated diagnosis of retinal diseases. We propose a novel multimodal learning method, named geometric correspondence-based multimodal learning network (GeCoM-Net), to achieve the fusion of CFP and OCT images. Specifically, inspired by clinical observations, we consider the geometric correspondence between the OCT slice and the CFP region to learn the correlated features of the two modalities for robust fusion. Furthermore, we design a new feature selection strategy to extract discriminative OCT representations by automatically selecting the important feature maps from OCT slices. Unlike the existing multimodal learning methods, GeCoM-Net is the first method that formulates the geometric relationships between the OCT slice and the corresponding region of the CFP image explicitly for CFP and OCT fusion. Experiments have been conducted on a large-scale private dataset and a publicly available dataset to evaluate the effectiveness of GeCoM-Net for diagnosing diabetic macular edema (DME), impaired visual acuity (VA) and glaucoma. The empirical results show that our method outperforms the current state-of-the-art multimodal learning methods by improving the AUROC score 0.4%, 1.9% and 2.9% for DME, VA and glaucoma detection, respectively.

Deep neural network has shown a powerful performance in the medical image analysis of a variety of diseases. However, a number of studies over the past few years have demonstrated that these deep learning systems can be vulnerable to well-designed adversarial attacks, with minor disruptions added to the input. Since both the public and academia have focused on deep learning in the health information economy, these adversarial attacks would prove more important and raise security concerns. In this article, adversarial attacks on deep learning systems in medicine are analyzed from two different points of view: 1) white box and 2) black box. A fast adversarial sample generation method, Feature Space-Restricted Attention Attack is proposed to explore more confusing adversarial samples. It is based on a generative adversarial network with bound classification space to generate perturbations to achieve attacks. Meanwhile, it can employ an attention mechanism to focus this perturbation on the lesion region. This enables the perturbation closely associated with the classification information making the attack more efficient and invisible. The performance and specificity of the proposed attack method are demonstrated by conducting extensive experiments on three different types of medical images. Finally, it is expected that this work can assist practitioners become being of current weaknesses in the deployment of deep learning systems in clinical settings. And, it further investigates domain-specific features of medical deep learning systems to enhance model generalization and resistance to attacks.

Semi-supervised learning reduces overfitting and facilitates medical image segmentation by regularizing the learning of limited well-annotated data with the knowledge provided by a large amount of unlabeled data. However, there are many misuses and underutilization of data in conventional semi-supervised methods. On the one hand, the model will deviate from the empirical distribution under the training of numerous unlabeled data. On the other hand, the model treats labeled and unlabeled data differently and does not consider inter-data information. In this paper, a semi-supervised method is proposed to exploit unlabeled data to further narrow the gap between the semi-supervised model and its fully-supervised counterpart. Specifically, the architecture of the proposed method is based on the mean-teacher framework, and the uncertainty estimation module is improved to impose constraints of consistency and guide the selection of feature representation vectors. Notably, a voxel-level supervised contrastive learning module is devised to establish a contrastive relationship between feature representation vectors, whether from labeled or unlabeled data. The supervised manner ensures that the network learns the correct knowledge, and the dense contrastive relationship further extracts information from unlabeled data. The above overcomes data misuse and underutilization in semi-supervised frameworks. Moreover, it favors the feature representation with intra-class compactness and inter-class separability and gains extra performance. Extensive experimental results on the left atrium dataset from Atrial Segmentation Challenge demonstrate that the proposed method has superior performance over the state-of-the-art methods.

The early detection and timely treatment of breast cancer can save lives. Mammography is one of the most efficient approaches to screening early breast cancer. An automatic mammographic image classification method could improve the work efficiency of radiologists. Current deep learning-based methods typically use the traditional softmax loss to optimize the feature extraction part, which aims to learn the features of mammographic images. However, previous studies have shown that the feature extraction part cannot learn discriminative features from complex data using the standard softmax loss. In this paper, we design a new architecture and propose respective loss functions. Specifically, we develop a double-classifier network architecture that constrains the extracted features' distribution by changing the classifiers' decision boundaries. Then, we propose the double-classifier constraint loss function to constrain the decision boundaries so that the feature extraction part can learn discriminative features. Furthermore, by taking advantage of the architecture of two classifiers, the neural network can detect the difficult-to-classify samples. We propose a weighted double-classifier constraint method to make the feature extract part pay more attention to learning difficult-to-classify samples' features. Our proposed method can be easily applied to an existing convolutional neural network to improve mammographic image classification performance. We conducted extensive experiments to evaluate our methods on three public benchmark mammographic image datasets. The results showed that our methods outperformed many other similar methods and state-of-the-art methods on the three public medical benchmarks. Our code and weights can be found on GitHub.

Breast cancer is one of the most frequently diagnosed solid cancers. Mammography is the most commonly used screening technology for detecting breast cancer. Traditional machine learning methods of mammographic image classification or segmentation using manual features require a great quantity of manual segmentation annotation data to train the model and test the results. But manual labeling is expensive, time-consuming, and laborious, and greatly increases the cost of system construction. To reduce this cost and the workload of radiologists, an end-to-end full-image mammogram classification method based on deep neural networks was proposed for classifier building, which can be constructed without bounding boxes or mask ground truth label of training data. The only label required in this method is the classification of mammographic images, which can be relatively easy to collect from diagnostic reports. Because breast lesions usually take up a fraction of the total area visualized in the mammographic image, we propose different pooling structures for convolutional neural networks(CNNs) instead of the common pooling methods, which divide the image into regions and select the few with high probability of malignancy as the representation of the whole mammographic image. The proposed pooling structures can be applied on most CNN-based models, which may greatly improve the models' performance on mammographic image data with the same input. Experimental results on the publicly available INbreast dataset and CBIS dataset indicate that the proposed pooling structures perform satisfactorily on mammographic image data compared with previous state-of-the-art mammographic image classifiers and detection algorithm using segmentation annotations.

Cooperative transmission is considered as an efficient way to combat multipath fading and to increase the system capacity. Combining with effective coding scheme, the diversity and coding gain can be obtained. The concept of coded cooperation which employs distributed linear dispersion codes (LDC) for two-hop non-regenerative (NR) relay scenario is introduced and analyzed in terms of capacity gains over the system with the traditional coding scheme. Taking the maximum end-to-end data rate as the optimal criterion, an adaptive resource allocation (RA) scheme under the transmit power constraint is proposed to distribute appropriate resource to each hop based on the channel state information (CSI) and certain conditions for optimizing the performance of the distributed LDC. Theoretic analysis and numeric results indicate that with the adaptive scheme, the proposed coded cooperation system will obtain higher capacity benefits than the system with direct transmission and traditional uniform RA.

The idea of distributed space-time codes which is being applied to wireless relay network, seems to be a promising approach to reduce the total radiated power and to insure the delivery of the information with desired quality of service. In this paper, we propose a feasible coding scheme based on distributed linear dispersion codes (LDC) for two-hop regenerative multi-relay scenario, and further analyze the advantage of the proposed case in terms of capacity gains over the system with orthogonal transmission. Moreover, we show how to effectively allocate the limited resource among the source and relay terminals in order to maximize the performance of the proposed system. Numerical results indicate that with the adaptive scheme, the proposed system not only achieves higher capacity gains than the system with direct transmission and traditional uniform PA, but also performs very close to the optimum relay system.

As existing wireless network, system, and standards evolve to beyond 3G capability, the ability to roam between heterogeneous wireless networks becomes increasingly desirable. However, when attempt is made to achieve the vision of seamless handover between heterogeneous wireless networks, a number of formidable barriers appear due to unreasonable roaming strategy. In this paper, we propose a novel roaming solution which takes into account the call activity rates and moving speed of users, and analyze the impact of the different parameters on the rate of inter-networking handover and the fraction of calls undergoing call setup delay. Theoretic analysis and numeric results demonstrate that the proposed scheme can obtain better performance than traditional roaming strategy, in terms of improving the capability of inter-networking roaming and reducing the signaling cost of handover.

With the increasing requirement on QoS of data service, the long term evolution (LTE) of 3G is being researched and standardized to provide higher bit rates with lower latency, lower cost and improved coverage. In this paper, a novel network topology optimization of UMTS access networks combining mobility management and improved authentication schemes is proposed to support these requirements. The architecture presents a concept of URA (UMTS terrestrial radio access network registration area) self-control system in control plane (C-plane) of access network, so that the handover process of C-plane can be independent of that of user plane (U-plane), which significantly reduces the handover latency. Moreover, a novel layered tunnels topology method is proposed in U-plane to achieve load equilibrium in access gateway (AGW). Based on the proposed network architecture, we give examples of signaling sequence combining fast handover process and proposed authentication scheme, and shows that their performance is generally superior to current 3G network architecture, in terms of reducing handover latency and increasing data security and integrity