A Dual-Stage Semi-Supervised Pre-Training Approach for Medical Image Segmentation.

Deep neural networks have played a vital role in developing automated methods for addressing medical image segmentation. However, their reliance on labeled data impedes the practicability. Semi-supervised learning is gaining attention for its intrinsic ability to extract valuable information from labeled and unlabeled data with improved performance. Recently, consistency regularization methods have gained interest due to their efficient learning procedures. They are, however, confined to data or network-level perturbations, negating the benefit of having both forms in a single framework. In light of this, we ask an intriguing but unexplored question: can we have both network-level and data-level perturbation in the semi-supervised framework? To this end, we present a holistic approach that integrates data-level perturbation in the model pre-training stage, followed by implicit network-level perturbation in the fine-tuning stage. Furthermore, we incorporate networks with manifold learning paradigms throughout the training to facilitate the formation of robust data representations by ensuring local and global semantic affinities adhering to the theory of consensus. Notably, this may be the first attempt in the semi-supervised medical image segmentation archetype to use data and network-level perturbation with a model pre-training strategy. We extensively validated the efficacy of the proposed framework on three benchmark datasets, namely the Automated Cardiac Diagnosis Challenge, ISIC-2018, and Left Atrial Segmentation Challenge datasets, subjected to severely low-sampled labeled data. Notably, in ACDC (4%), ISIC-2018 (5%), and LA (6%) labeled cases, the proposed method outperforms the second-best method by 2.95%, 1.31%, and 0.71% in the Dice Similarity Metric.