# Exploring Smoothness and Class-Separation for Semi-supervised Medical Image Segmentation

arXiv: https://arxiv.org/abs/2203.01324 · HTML: https://mlsanity.com/paper/2203.01324/

## Key facts

- Cited by 93 papers in the map (data through 14 Oct 2026).
- Builds on 22 of its 33 references that are in the map.
- First posted on arXiv 2 Mar 2022.

## Builds on (most cited first, 22 of 22)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [FixMatch: Simplifying Semi-Supervised Learning with Consistency and Confidence](https://mlsanity.com/paper/2001.07685/) (2020)
- [Temporal Ensembling for Semi-Supervised Learning](https://mlsanity.com/paper/1610.02242/) (2016)
- [Virtual Adversarial Training: A Regularization Method for Supervised and Semi-Supervised Learning](https://mlsanity.com/paper/1704.03976/) (2017)
- [Uncertainty-aware Self-ensembling Model for Semi-supervised 3D Left Atrium Segmentation](https://mlsanity.com/paper/1907.07034/) (2019)
- [Semi-Supervised Semantic Segmentation with Cross-Consistency Training](https://mlsanity.com/paper/2003.09005/) (2020)
- [Meta Pseudo Labels](https://mlsanity.com/paper/2003.10580/) (2020)
- [Semi-supervised Medical Image Segmentation through Dual-task Consistency](https://mlsanity.com/paper/2009.04448/) (2020)
- [Shape-aware Semi-supervised 3D Semantic Segmentation for Medical Images](https://mlsanity.com/paper/2007.10732/) (2020)
- [Transformation Consistent Self-ensembling Model for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/1903.00348/) (2019)
- [Semi-Supervised Semantic Segmentation with Pixel-Level Contrastive Learning from a Class-wise Memory Bank](https://mlsanity.com/paper/2104.13415/) (2021)
- [An Overview of Deep Semi-Supervised Learning](https://mlsanity.com/paper/2006.05278/) (2020)
- [Semi-supervised Semantic Segmentation with Directional Context-aware Consistency](https://mlsanity.com/paper/2106.14133/) (2021)
- [Mutual Consistency Learning for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2109.09960/) (2021)
- [Semi-supervised Left Atrium Segmentation with Mutual Consistency Training](https://mlsanity.com/paper/2103.02911/) (2021)
- [Efficient Semi-Supervised Gross Target Volume of Nasopharyngeal Carcinoma Segmentation via Uncertainty Rectified Pyramid Consistency](https://mlsanity.com/paper/2012.07042/) (2020)
- [3D Semi-Supervised Learning with Uncertainty-Aware Multi-View Co-Training](https://mlsanity.com/paper/1811.12506/) (2018)
- [Learning Meta-class Memory for Few-Shot Semantic Segmentation](https://mlsanity.com/paper/2108.02958/) (2021)
- [All-Around Real Label Supervision: Cyclic Prototype Consistency Learning for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2109.13930/) (2021)
- [Few-Shot Segmentation with Global and Local Contrastive Learning](https://mlsanity.com/paper/2108.05293/) (2021)
- [Keypoint Based Weakly Supervised Human Parsing](https://mlsanity.com/paper/1809.05285/) (2018)

## Built on by (most cited first, 30 of 93)

- [Bidirectional Copy-Paste for Semi-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2305.00673/) (2023)
- [Unleashing the Potential of SAM for Medical Adaptation via Hierarchical Decoding](https://mlsanity.com/paper/2403.18271/) (2024)
- [Rethinking Semi-Supervised Medical Image Segmentation: A Variance-Reduction Perspective](https://mlsanity.com/paper/2302.01735/) (2023)
- [Towards Generic Semi-Supervised Framework for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/2310.11320/) (2023)
- [Mine yOur owN Anatomy: Revisiting Medical Image Segmentation with Extremely Limited Labels](https://mlsanity.com/paper/2209.13476/) (2022)
- [Correlation-Aware Mutual Learning for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2307.06312/) (2023)
- [Adaptive Bidirectional Displacement for Semi-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2405.00378/) (2024)
- [DHC: Dual-debiased Heterogeneous Co-training Framework for Class-imbalanced Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2307.11960/) (2023)
- [MagicNet: Semi-Supervised Multi-Organ Segmentation via Magic-Cube Partition and Recovery](https://mlsanity.com/paper/2212.14310/) (2022)
- [Alternate Diverse Teaching for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2311.17325/) (2023)
- [Self-aware and Cross-sample Prototypical Learning for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2305.16214/) (2023)
- [Dual Adaptive Transformations for Weakly Supervised Point Cloud Segmentation](https://mlsanity.com/paper/2207.09084/) (2022)
- [Constructing and Exploring Intermediate Domains in Mixed Domain Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2404.08951/) (2024)
- [Translation Consistent Semi-supervised Segmentation for 3D Medical Images](https://mlsanity.com/paper/2203.14523/) (2022)
- [Segment Together: A Versatile Paradigm for Semi-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2311.11686/) (2023)
- [ACTION++: Improving Semi-supervised Medical Image Segmentation with Adaptive Anatomical Contrast](https://mlsanity.com/paper/2304.02689/) (2023)
- [CoactSeg: Learning from Heterogeneous Data for New Multiple Sclerosis Lesion Segmentation](https://mlsanity.com/paper/2307.04513/) (2023)
- [SDCL: Students Discrepancy-Informed Correction Learning for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2409.16728/) (2024)
- [Steady Progress Beats Stagnation: Mutual Aid of Foundation and Conventional Models in Mixed Domain Semi-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2503.16997/) (2025)
- [Diffuse-UDA: Addressing Unsupervised Domain Adaptation in Medical Image Segmentation with Appearance and Structure Aligned Diffusion Models](https://mlsanity.com/paper/2408.05985/) (2024)
- [Reliability-Adaptive Consistency Regularization for Weakly-Supervised Point Cloud Segmentation](https://mlsanity.com/paper/2303.05164/) (2023)
- [The Devil is in the Statistics: Mitigating and Exploiting Statistics Difference for Generalizable Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2407.11356/) (2024)
- [Consistency-guided Meta-Learning for Bootstrapping Semi-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2307.11604/) (2023)
- [EPL: Evidential Prototype Learning for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2404.06181/) (2024)
- [CrossMatch: Enhance Semi-Supervised Medical Image Segmentation with Perturbation Strategies and Knowledge Distillation](https://mlsanity.com/paper/2405.00354/) (2024)
- [Leveraging Task-Specific Knowledge from LLM for Semi-Supervised 3D Medical Image Segmentation](https://mlsanity.com/paper/2407.05088/) (2024)
- [SemiDAViL: Semi-supervised Domain Adaptation with Vision-Language Guidance for Semantic Segmentation](https://mlsanity.com/paper/2504.06389/) (2025)
- [Dual Cross-image Semantic Consistency with Self-aware Pseudo Labeling for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2507.21440/) (2025)
- [Striving for Simplicity: Simple Yet Effective Prior-Aware Pseudo-Labeling for Semi-Supervised Ultrasound Image Segmentation](https://mlsanity.com/paper/2503.13987/) (2025)
- [Balancing Multi-Target Semi-Supervised Medical Image Segmentation with Collaborative Generalist and Specialists](https://mlsanity.com/paper/2504.00862/) (2025)

## Abstract (arXiv)

Semi-supervised segmentation remains challenging in medical imaging since the amount of annotated medical data is often scarce and there are many blurred pixels near the adhesive edges or in the low-contrast regions. To address the issues, we advocate to firstly constrain the consistency of pixels with and without strong perturbations to apply a sufficient smoothness constraint and further encourage the class-level separation to exploit the low-entropy regularization for the model training. Particularly, in this paper, we propose the SS-Net for semi-supervised medical image segmentation tasks, via exploring the pixel-level smoothness and inter-class separation at the same time. The pixel-level smoothness forces the model to generate invariant results under adversarial perturbations. Meanwhile, the inter-class separation encourages individual class features should approach their corresponding high-quality prototypes, in order to make each class distribution compact and separate different classes. We evaluated our SS-Net against five recent methods on the public LA and ACDC datasets. Extensive experimental results under two semi-supervised settings demonstrate the superiority of our proposed SS-Net model, achieving new state-of-the-art (SOTA) performance on both datasets. The code is available at https://github.com/ycwu1997/SS-Net.
