Class Incremental Medical Image Segmentation via Prototype-Guided Calibration and Dual-Aligned Distillation

Class incremental medical image segmentation (CIMIS) aims to preserve knowledge of previously learned classes while learning new ones without relying on old-class labels. However, existing methods 1) either adopt one-size-fits-all strategies that treat all spatial regions and feature channels equally, which may hinder the preservation of accurate old knowledge, 2) or focus solely on aligning local prototypes with global ones for old classes while overlooking their local representations in new data, leading to knowledge degradation. To mitigate the above issues, we propose Prototype-Guided Calibration Distillation (PGCD) and Dual-Aligned Prototype Distillation (DAPD) for CIMIS in this paper. Specifically, PGCD exploits prototype-to-feature similarity to calibrate class-specific distillation intensity in different spatial regions, effectively reinforcing reliable old knowledge and suppressing misleading information from old classes. Complementarily, DAPD aligns the local prototypes of old classes extracted from the current model with both global prototypes and local prototypes, further enhancing segmentation performance on old categories. Comprehensive evaluations on two widely used multi-organ segmentation benchmarks demonstrate that our method outperforms state-of-the-art methods, highlighting its robustness and generalization capabilities.

Exploiting Unlabeled Structures through Task Consistency Training for Versatile Medical Image Segmentation

Versatile medical image segmentation (VMIS) targets the segmentation of multiple classes, while obtaining full annotations for all classes is often impractical due to the time and labor required. Leveraging partially labeled datasets (PLDs) presents a promising alternative; however, current VMIS approaches face significant class imbalance due to the unequal category distribution in PLDs. Existing methods attempt to address this by generating pseudo-full labels. Nevertheless, these typically require additional models and often result in potential performance degradation from label noise. In this work, we introduce a Task Consistency Training (TCT) framework to address class imbalance without requiring extra models. TCT includes a backbone network with a main segmentation head (MSH) for multi-channel predictions and multiple auxiliary task heads (ATHs) for task-specific predictions. By enforcing a consistency constraint between the MSH and ATH predictions, TCT effectively utilizes unlabeled anatomical structures. To avoid error propagation from low-consistency, potentially noisy data, we propose a filtering strategy to exclude such data. Additionally, we introduce a unified auxiliary uncertainty-weighted loss (UAUWL) to mitigate segmentation quality declines caused by the dominance of specific tasks. Extensive experiments on eight abdominal datasets from diverse clinical sites demonstrate our approach's effectiveness.