Uncertainty-aware Cross-training for Semi-supervised Medical Image Segmentation

Semi-supervised learning has gained considerable popularity in medical image segmentation tasks due to its capability to reduce reliance on expert-examined annotations. Several mean-teacher (MT) based semi-supervised methods utilize consistency regularization to effectively leverage valuable information from unlabeled data. However, these methods often heavily rely on the student model and overlook the potential impact of cognitive biases within the model. Furthermore, some methods employ co-training using pseudo-labels derived from different inputs, yet generating high-confidence pseudo-labels from perturbed inputs during training remains a significant challenge. In this paper, we propose an Uncertainty-aware Cross-training framework for semi-supervised medical image Segmentation (UC-Seg). Our UC-Seg framework incorporates two distinct subnets to effectively explore and leverage the correlation between them, thereby mitigating cognitive biases within the model. Specifically, we present a Cross-subnet Consistency Preservation (CCP) strategy to enhance feature representation capability and ensure feature consistency across the two subnets. This strategy enables each subnet to correct its own biases and learn shared semantics from both labeled and unlabeled data. Additionally, we propose an Uncertainty-aware Pseudo-label Generation (UPG) component that leverages segmentation results and corresponding uncertainty maps from both subnets to generate high-confidence pseudo-labels. We extensively evaluate the proposed UC-Seg on various medical image segmentation tasks involving different modality images, such as MRI, CT, ultrasound, colonoscopy, and so on. The results demonstrate that our method achieves superior segmentation accuracy and generalization performance compared to other state-of-the-art semi-supervised methods. Our code will be released at https://github.com/taozh2017/UCSeg.

Boosting Generic Semi-Supervised Medical Image Segmentation via Diverse Teaching and Label Propagation

Both limited annotation and domain shift are significant challenges frequently encountered in medical image segmentation, leading to derivative scenarios like semi-supervised medical (SSMIS), semi-supervised medical domain generalization (Semi-MDG) and unsupervised medical domain adaptation (UMDA). Conventional methods are generally tailored to specific tasks in isolation, the error accumulation hinders the effective utilization of unlabeled data and limits further improvements, resulting in suboptimal performance when these issues occur. In this paper, we aim to develop a generic framework that masters all three tasks. We found that the key to solving the problem lies in how to generate reliable pseudo labels for the unlabeled data in the presence of domain shift with labeled data and increasing the diversity of the model. To tackle this issue, we employ a Diverse Teaching and Label Propagation Network (DTLP-Net) to boosting the Generic Semi-Supervised Medical Image Segmentation. Our DTLP-Net involves a single student model and two diverse teacher models, which can generate reliable pseudo-labels for the student model. The first teacher model decouple the training process with labeled and unlabeled data, The second teacher is momentum-updated periodically, thus generating reliable yet divers pseudo-labels. To fully utilize the information within the data, we adopt inter-sample and intra-sample data augmentation to learn the global and local knowledge. In addition, to further capture the voxel-level correlations, we propose label propagation to enhance the model robust. We evaluate our proposed framework on five benchmark datasets for SSMIS, UMDA, and Semi-MDG tasks. The results showcase notable improvements compared to state-of-the-art methods across all five settings, indicating the potential of our framework to tackle more challenging SSL scenarios.

Enhancing Small-Scale Dataset Expansion with Triplet-Connection-based Sample Re-Weighting

The performance of computer vision models in certain real-world applications, such as medical diagnosis, is often limited by the scarcity of available images. Expanding datasets using pre-trained generative models is an effective solution. However, due to the uncontrollable generation process and the ambiguity of natural language, noisy images may be generated. Re-weighting is an effective way to address this issue by assigning low weights to such noisy images. We first theoretically analyze three types of supervision for the generated images. Based on the theoretical analysis, we develop TriReWeight, a triplet-connection-based sample re-weighting method to enhance generative data augmentation. Theoretically, TriReWeight can be integrated with any generative data augmentation methods and never downgrade their performance. Moreover, its generalization approaches the optimal in the order $O(\sqrt{d\ln (n)/n})$. Our experiments validate the correctness of the theoretical analysis and demonstrate that our method outperforms the existing SOTA methods by $7.9\%$ on average over six natural image datasets and by $3.4\%$ on average over three medical datasets. We also experimentally validate that our method can enhance the performance of different generative data augmentation methods.

Towards Human-AI Collaboration System for the Detection of Invasive Ductal Carcinoma in Histopathology Images

Invasive ductal carcinoma (IDC) is the most prevalent form of breast cancer, and early, accurate diagnosis is critical to improving patient survival rates by guiding treatment decisions. Combining medical expertise with artificial intelligence (AI) holds significant promise for enhancing the precision and efficiency of IDC detection. In this work, we propose a human-in-the-loop (HITL) deep learning system designed to detect IDC in histopathology images. The system begins with an initial diagnosis provided by a high-performance EfficientNetV2S model, offering feedback from AI to the human expert. Medical professionals then review the AI-generated results, correct any misclassified images, and integrate the revised labels into the training dataset, forming a feedback loop from the human back to the AI. This iterative process refines the model's performance over time. The EfficientNetV2S model itself achieves state-of-the-art performance compared to existing methods in the literature, with an overall accuracy of 93.65\%. Incorporating the human-in-the-loop system further improves the model's accuracy using four experimental groups with misclassified images. These results demonstrate the potential of this collaborative approach to enhance AI performance in diagnostic systems. This work contributes to advancing automated, efficient, and highly accurate methods for IDC detection through human-AI collaboration, offering a promising direction for future AI-assisted medical diagnostics.

NeeCo: Image Synthesis of Novel Instrument States Based on Dynamic and Deformable 3D Gaussian Reconstruction

Computer vision-based technologies significantly enhance surgical automation by advancing tool tracking, detection, and localization. However, Current data-driven approaches are data-voracious, requiring large, high-quality labeled image datasets, which limits their application in surgical data science. Our Work introduces a novel dynamic Gaussian Splatting technique to address the data scarcity in surgical image datasets. We propose a dynamic Gaussian model to represent dynamic surgical scenes, enabling the rendering of surgical instruments from unseen viewpoints and deformations with real tissue backgrounds. We utilize a dynamic training adjustment strategy to address challenges posed by poorly calibrated camera poses from real-world scenarios. Additionally, we propose a method based on dynamic Gaussians for automatically generating annotations for our synthetic data. For evaluation, we constructed a new dataset featuring seven scenes with 14,000 frames of tool and camera motion and tool jaw articulation, with a background of an ex-vivo porcine model. Using this dataset, we synthetically replicate the scene deformation from the ground truth data, allowing direct comparisons of synthetic image quality. Experimental results illustrate that our method generates photo-realistic labeled image datasets with the highest values in Peak-Signal-to-Noise Ratio (29.87). We further evaluate the performance of medical-specific neural networks trained on real and synthetic images using an unseen real-world image dataset. Our results show that the performance of models trained on synthetic images generated by the proposed method outperforms those trained with state-of-the-art standard data augmentation by 10%, leading to an overall improvement in model performances by nearly 15%.

Perceptual Evaluation of GANs and Diffusion Models for Generating X-rays

Generative image models have achieved remarkable progress in both natural and medical imaging. In the medical context, these techniques offer a potential solution to data scarcity-especially for low-prevalence anomalies that impair the performance of AI-driven diagnostic and segmentation tools. However, questions remain regarding the fidelity and clinical utility of synthetic images, since poor generation quality can undermine model generalizability and trust. In this study, we evaluate the effectiveness of state-of-the-art generative models-Generative Adversarial Networks (GANs) and Diffusion Models (DMs)-for synthesizing chest X-rays conditioned on four abnormalities: Atelectasis (AT), Lung Opacity (LO), Pleural Effusion (PE), and Enlarged Cardiac Silhouette (ECS). Using a benchmark composed of real images from the MIMIC-CXR dataset and synthetic images from both GANs and DMs, we conducted a reader study with three radiologists of varied experience. Participants were asked to distinguish real from synthetic images and assess the consistency between visual features and the target abnormality. Our results show that while DMs generate more visually realistic images overall, GANs can report better accuracy for specific conditions, such as absence of ECS. We further identify visual cues radiologists use to detect synthetic images, offering insights into the perceptual gaps in current models. These findings underscore the complementary strengths of GANs and DMs and point to the need for further refinement to ensure generative models can reliably augment training datasets for AI diagnostic systems.

Trustworthy Medical Imaging with Large Language Models: A Study of Hallucinations Across Modalities

Large Language Models (LLMs) are increasingly applied to medical imaging tasks, including image interpretation and synthetic image generation. However, these models often produce hallucinations, which are confident but incorrect outputs that can mislead clinical decisions. This study examines hallucinations in two directions: image to text, where LLMs generate reports from X-ray, CT, or MRI scans, and text to image, where models create medical images from clinical prompts. We analyze errors such as factual inconsistencies and anatomical inaccuracies, evaluating outputs using expert informed criteria across imaging modalities. Our findings reveal common patterns of hallucination in both interpretive and generative tasks, with implications for clinical reliability. We also discuss factors contributing to these failures, including model architecture and training data. By systematically studying both image understanding and generation, this work provides insights into improving the safety and trustworthiness of LLM driven medical imaging systems.

SynMatch: Rethinking Consistency in Medical Image Segmentation with Sparse Annotations

Label scarcity remains a major challenge in deep learning-based medical image segmentation. Recent studies use strong-weak pseudo supervision to leverage unlabeled data. However, performance is often hindered by inconsistencies between pseudo labels and their corresponding unlabeled images. In this work, we propose \textbf{SynMatch}, a novel framework that sidesteps the need for improving pseudo labels by synthesizing images to match them instead. Specifically, SynMatch synthesizes images using texture and shape features extracted from the same segmentation model that generates the corresponding pseudo labels for unlabeled images. This design enables the generation of highly consistent synthesized-image-pseudo-label pairs without requiring any training parameters for image synthesis. We extensively evaluate SynMatch across diverse medical image segmentation tasks under semi-supervised learning (SSL), weakly-supervised learning (WSL), and barely-supervised learning (BSL) settings with increasingly limited annotations. The results demonstrate that SynMatch achieves superior performance, especially in the most challenging BSL setting. For example, it outperforms the recent strong-weak pseudo supervision-based method by 29.71\% and 10.05\% on the polyp segmentation task with 5\% and 10\% scribble annotations, respectively. The code will be released at https://github.com/Senyh/SynMatch.

ASM-UNet: Adaptive Scan Mamba Integrating Group Commonalities and Individual Variations for Fine-Grained Segmentation

Precise lesion resection depends on accurately identifying fine-grained anatomical structures. While many coarse-grained segmentation (CGS) methods have been successful in large-scale segmentation (e.g., organs), they fall short in clinical scenarios requiring fine-grained segmentation (FGS), which remains challenging due to frequent individual variations in small-scale anatomical structures. Although recent Mamba-based models have advanced medical image segmentation, they often rely on fixed manually-defined scanning orders, which limit their adaptability to individual variations in FGS. To address this, we propose ASM-UNet, a novel Mamba-based architecture for FGS. It introduces adaptive scan scores to dynamically guide the scanning order, generated by combining group-level commonalities and individual-level variations. Experiments on two public datasets (ACDC and Synapse) and a newly proposed challenging biliary tract FGS dataset, namely BTMS, demonstrate that ASM-UNet achieves superior performance in both CGS and FGS tasks. Our code and dataset are available at https://github.com/YqunYang/ASM-UNet.

Improving Diagnostic Accuracy for Oral Cancer with inpainting Synthesis Lesions Generated Using Diffusion Models

In oral cancer diagnostics, the limited availability of annotated datasets frequently constrains the performance of diagnostic models, particularly due to the variability and insufficiency of training data. To address these challenges, this study proposed a novel approach to enhance diagnostic accuracy by synthesizing realistic oral cancer lesions using an inpainting technique with a fine-tuned diffusion model. We compiled a comprehensive dataset from multiple sources, featuring a variety of oral cancer images. Our method generated synthetic lesions that exhibit a high degree of visual fidelity to actual lesions, thereby significantly enhancing the performance of diagnostic algorithms. The results show that our classification model achieved a diagnostic accuracy of 0.97 in differentiating between cancerous and non-cancerous tissues, while our detection model accurately identified lesion locations with 0.85 accuracy. This method validates the potential for synthetic image generation in medical diagnostics and paves the way for further research into extending these methods to other types of cancer diagnostics.