TABNet: A Triplet Augmentation Self-Recovery Framework with Boundary-Aware Pseudo-Labels for Medical Image Segmentation

Background and objective: Medical image segmentation is a core task in various clinical applications. However, acquiring large-scale, fully annotated medical image datasets is both time-consuming and costly. Scribble annotations, as a form of sparse labeling, provide an efficient and cost-effective alternative for medical image segmentation. However, the sparsity of scribble annotations limits the feature learning of the target region and lacks sufficient boundary supervision, which poses significant challenges for training segmentation networks. Methods: We propose TAB Net, a novel weakly-supervised medical image segmentation framework, consisting of two key components: the triplet augmentation self-recovery (TAS) module and the boundary-aware pseudo-label supervision (BAP) module. The TAS module enhances feature learning through three complementary augmentation strategies: intensity transformation improves the model's sensitivity to texture and contrast variations, cutout forces the network to capture local anatomical structures by masking key regions, and jigsaw augmentation strengthens the modeling of global anatomical layout by disrupting spatial continuity. By guiding the network to recover complete masks from diverse augmented inputs, TAS promotes a deeper semantic understanding of medical images under sparse supervision. The BAP module enhances pseudo-supervision accuracy and boundary modeling by fusing dual-branch predictions into a loss-weighted pseudo-label and introducing a boundary-aware loss for fine-grained contour refinement. Results: Experimental evaluations on two public datasets, ACDC and MSCMR seg, demonstrate that TAB Net significantly outperforms state-of-the-art methods for scribble-based weakly supervised segmentation. Moreover, it achieves performance comparable to that of fully supervised methods.

HELPNet: Hierarchical Perturbations Consistency and Entropy-guided Ensemble for Scribble Supervised Medical Image Segmentation

Creating fully annotated labels for medical image segmentation is prohibitively time-intensive and costly, emphasizing the necessity for innovative approaches that minimize reliance on detailed annotations. Scribble annotations offer a more cost-effective alternative, significantly reducing the expenses associated with full annotations. However, scribble annotations offer limited and imprecise information, failing to capture the detailed structural and boundary characteristics necessary for accurate organ delineation. To address these challenges, we propose HELPNet, a novel scribble-based weakly supervised segmentation framework, designed to bridge the gap between annotation efficiency and segmentation performance. HELPNet integrates three modules. The Hierarchical perturbations consistency (HPC) module enhances feature learning by employing density-controlled jigsaw perturbations across global, local, and focal views, enabling robust modeling of multi-scale structural representations. Building on this, the Entropy-guided pseudo-label (EGPL) module evaluates the confidence of segmentation predictions using entropy, generating high-quality pseudo-labels. Finally, the structural prior refinement (SPR) module incorporates connectivity and bounded priors to enhance the precision and reliability and pseudo-labels. Experimental results on three public datasets ACDC, MSCMRseg, and CHAOS show that HELPNet significantly outperforms state-of-the-art methods for scribble-based weakly supervised segmentation and achieves performance comparable to fully supervised methods. The code is available at https://github.com/IPMI-NWU/HELPNet.

Gaze-directed Vision GNN for Mitigating Shortcut Learning in Medical Image

Deep neural networks have demonstrated remarkable performance in medical image analysis. However, its susceptibility to spurious correlations due to shortcut learning raises concerns about network interpretability and reliability. Furthermore, shortcut learning is exacerbated in medical contexts where disease indicators are often subtle and sparse. In this paper, we propose a novel gaze-directed Vision GNN (called GD-ViG) to leverage the visual patterns of radiologists from gaze as expert knowledge, directing the network toward disease-relevant regions, and thereby mitigating shortcut learning. GD-ViG consists of a gaze map generator (GMG) and a gaze-directed classifier (GDC). Combining the global modelling ability of GNNs with the locality of CNNs, GMG generates the gaze map based on radiologists' visual patterns. Notably, it eliminates the need for real gaze data during inference, enhancing the network's practical applicability. Utilizing gaze as the expert knowledge, the GDC directs the construction of graph structures by incorporating both feature distances and gaze distances, enabling the network to focus on disease-relevant foregrounds. Thereby avoiding shortcut learning and improving the network's interpretability. The experiments on two public medical image datasets demonstrate that GD-ViG outperforms the state-of-the-art methods, and effectively mitigates shortcut learning. Our code is available at https://github.com/SX-SS/GD-ViG.