Bidirectional Copy-Paste for Semi-Supervised Medical Image Segmentation

In semi-supervised medical image segmentation, there exist empirical mismatch problems between labeled and unlabeled data distribution. The knowledge learned from the labeled data may be largely discarded if treating labeled and unlabeled data separately or training labeled and unlabeled data in an inconsistent manner. We propose a straightforward method for alleviating the problem -- copy-pasting labeled and unlabeled data bidirectionally, in a simple Mean Teacher architecture. The method encourages unlabeled data to learn comprehensive common semantics from the labeled data in both inward and outward directions. More importantly, the consistent learning procedure for labeled and unlabeled data can largely reduce the empirical distribution gap. In detail, we copy-paste a random crop from a labeled image (foreground) onto an unlabeled image (background) and an unlabeled image (foreground) onto a labeled image (background), respectively. The two mixed images are fed into a Student network. It is trained by the generated supervisory signal via bidirectional copy-pasting between the predictions of the unlabeled images from the Teacher and the label maps of the labeled images. We explore several design choices of how to copy-paste to make it more effective for minimizing empirical distribution gaps between labeled and unlabeled data. We reveal that the simple mechanism of copy-pasting bidirectionally between labeled and unlabeled data is good enough and the experiments show solid gains (e.g., over 21% Dice improvement on ACDC dataset with 5% labeled data) compared with other state-of-the-arts on various semi-supervised medical image segmentation datasets.