Medical Image Analysis (MedIA) has emerged as a crucial tool in computer-aided diagnosis systems, particularly with the advancement of deep learning (DL) in recent years. However, well-trained deep models often experience significant performance degradation when deployed in different medical sites, modalities, and sequences, known as a domain shift issue. In light of this, Domain Generalization (DG) for MedIA aims to address the domain shift challenge by generalizing effectively and performing robustly across unknown data distributions. This paper presents the a comprehensive review of substantial developments in this area. First, we provide a formal definition of domain shift and domain generalization in medical field, and discuss several related settings. Subsequently, we summarize the recent methods from three viewpoints: data manipulation level, feature representation level, and model training level, and present some algorithms in detail for each viewpoints. Furthermore, we introduce the commonly used datasets. Finally, we summarize existing literature and present some potential research topics for the future. For this survey, we also created a GitHub project by collecting the supporting resources, at the link: https://github.com/Ziwei-Niu/DG_for_MedIA
Though U-Net has achieved tremendous success in medical image segmentation tasks, it lacks the ability to explicitly model long-range dependencies. Therefore, Vision Transformers have emerged as alternative segmentation structures recently, for their innate ability of capturing long-range correlations through Self-Attention (SA). However, Transformers usually rely on large-scale pre-training and have high computational complexity. Furthermore, SA can only model self-affinities within a single sample, ignoring the potential correlations of the overall dataset. To address these problems, we propose a novel Transformer module named Mixed Transformer Module (MTM) for simultaneous inter- and intra- affinities learning. MTM first calculates self-affinities efficiently through our well-designed Local-Global Gaussian-Weighted Self-Attention (LGG-SA). Then, it mines inter-connections between data samples through External Attention (EA). By using MTM, we construct a U-shaped model named Mixed Transformer U-Net (MT-UNet) for accurate medical image segmentation. We test our method on two different public datasets, and the experimental results show that the proposed method achieves better performance over other state-of-the-art methods. The code is available at: https://github.com/Dootmaan/MT-UNet.