FIESTA: Fourier-Based Semantic Augmentation with Uncertainty Guidance for Enhanced Domain Generalizability in Medical Image Segmentation

Single-source domain generalization (SDG) in medical image segmentation (MIS) aims to generalize a model using data from only one source domain to segment data from an unseen target domain. Despite substantial advances in SDG with data augmentation, existing methods often fail to fully consider the details and uncertain areas prevalent in MIS, leading to mis-segmentation. This paper proposes a Fourier-based semantic augmentation method called FIESTA using uncertainty guidance to enhance the fundamental goals of MIS in an SDG context by manipulating the amplitude and phase components in the frequency domain. The proposed Fourier augmentative transformer addresses semantic amplitude modulation based on meaningful angular points to induce pertinent variations and harnesses the phase spectrum to ensure structural coherence. Moreover, FIESTA employs epistemic uncertainty to fine-tune the augmentation process, improving the ability of the model to adapt to diverse augmented data and concentrate on areas with higher ambiguity. Extensive experiments across three cross-domain scenarios demonstrate that FIESTA surpasses recent state-of-the-art SDG approaches in segmentation performance and significantly contributes to boosting the applicability of the model in medical imaging modalities.

Domain Generalization for Medical Image Analysis: A Survey

Medical Image Analysis (MedIA) has become an essential tool in medicine and healthcare, aiding in disease diagnosis, prognosis, and treatment planning, and recent successes in deep learning (DL) have made significant contributions to its advances. However, DL models for MedIA remain challenging to deploy in real-world situations, failing for generalization under the distributional gap between training and testing samples, known as a distribution shift problem. Researchers have dedicated their efforts to developing various DL methods to adapt and perform robustly on unknown and out-of-distribution data distributions. This paper comprehensively reviews domain generalization studies specifically tailored for MedIA. We provide a holistic view of how domain generalization techniques interact within the broader MedIA system, going beyond methodologies to consider the operational implications on the entire MedIA workflow. Specifically, we categorize domain generalization methods into data-level, feature-level, model-level, and analysis-level methods. We show how those methods can be used in various stages of the MedIA workflow with DL equipped from data acquisition to model prediction and analysis. Furthermore, we include benchmark datasets and applications used to evaluate these approaches and analyze the strengths and weaknesses of various methods, unveiling future research opportunities.