# ProCNS: Progressive Prototype Calibration and Noise Suppression for Weakly-Supervised Medical Image Segmentation

arXiv: https://arxiv.org/abs/2401.14074 · HTML: https://mlsanity.com/paper/2401.14074/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 48 of its 72 references that are in the map.
- First posted on arXiv 25 Jan 2024.

## Builds on (most cited first, 30 of 48)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Temporal Ensembling for Semi-Supervised Learning](https://mlsanity.com/paper/1610.02242/) (2016)
- [Kvasir-SEG: A Segmented Polyp Dataset](https://mlsanity.com/paper/1911.07069/) (2019)
- [Identifying the Best Machine Learning Algorithms for Brain Tumor Segmentation, Progression Assessment, and Overall Survival Prediction in the BRATS Challenge](https://mlsanity.com/paper/1811.02629/) (2018)
- [Learning Pixel-level Semantic Affinity with Image-level Supervision for Weakly Supervised Semantic Segmentation](https://mlsanity.com/paper/1803.10464/) (2018)
- [clDice -- A Novel Topology-Preserving Loss Function for Tubular Structure Segmentation](https://mlsanity.com/paper/2003.07311/) (2020)
- [Prototypical Pseudo Label Denoising and Target Structure Learning for Domain Adaptive Semantic Segmentation](https://mlsanity.com/paper/2101.10979/) (2021)
- [Adaptive Prototype Learning and Allocation for Few-Shot Segmentation](https://mlsanity.com/paper/2104.01893/) (2021)
- [Prototype Mixture Models for Few-shot Semantic Segmentation](https://mlsanity.com/paper/2008.03898/) (2020)
- [Weakly-Supervised Semantic Segmentation via Sub-category Exploration](https://mlsanity.com/paper/2008.01183/) (2020)
- [SAM-Med2D](https://mlsanity.com/paper/2308.16184/) (2023)
- [Normalized Cut Loss for Weakly-supervised CNN Segmentation](https://mlsanity.com/paper/1804.01346/) (2018)
- [AdvCLIP: Downstream-agnostic Adversarial Examples in Multimodal Contrastive Learning](https://mlsanity.com/paper/2308.07026/) (2023)
- [Leveraging Auxiliary Tasks with Affinity Learning for Weakly Supervised Semantic Segmentation](https://mlsanity.com/paper/2107.11787/) (2021)
- [CycleMix: A Holistic Strategy for Medical Image Segmentation from Scribble Supervision](https://mlsanity.com/paper/2203.01475/) (2022)
- [Scribble-Supervised Medical Image Segmentation via Dual-Branch Network and Dynamically Mixed Pseudo Labels Supervision](https://mlsanity.com/paper/2203.02106/) (2022)
- [Adaptive Early-Learning Correction for Segmentation from Noisy Annotations](https://mlsanity.com/paper/2110.03740/) (2021)
- [PRIOR: Prototype Representation Joint Learning from Medical Images and Reports](https://mlsanity.com/paper/2307.12577/) (2023)
- [Scribble2Label: Scribble-Supervised Cell Segmentation via Self-Generating Pseudo-Labels with Consistency](https://mlsanity.com/paper/2006.12890/) (2020)
- [Semi-supervised Semantic Segmentation with Prototype-based Consistency Regularization](https://mlsanity.com/paper/2210.04388/) (2022)
- [Few-shot Medical Image Segmentation using a Global Correlation Network with Discriminative Embedding](https://mlsanity.com/paper/2012.05440/) (2020)
- [Tree Energy Loss: Towards Sparsely Annotated Semantic Segmentation](https://mlsanity.com/paper/2203.10739/) (2022)
- [Universal Weakly Supervised Segmentation by Pixel-to-Segment Contrastive Learning](https://mlsanity.com/paper/2105.00957/) (2021)
- [ACSeg: Adaptive Conceptualization for Unsupervised Semantic Segmentation](https://mlsanity.com/paper/2210.05944/) (2022)
- [Gated CRF Loss for Weakly Supervised Semantic Image Segmentation](https://mlsanity.com/paper/1906.04651/) (2019)
- [Few-shot Medical Image Segmentation with Cycle-resemblance Attention](https://mlsanity.com/paper/2212.03967/) (2022)
- [Foundation Model Assisted Weakly Supervised Semantic Segmentation](https://mlsanity.com/paper/2312.03585/) (2023)
- [BoxTeacher: Exploring High-Quality Pseudo Labels for Weakly Supervised Instance Segmentation](https://mlsanity.com/paper/2210.05174/) (2022)
- [Transductive Few-shot Learning with Prototype-based Label Propagation by Iterative Graph Refinement](https://mlsanity.com/paper/2304.11598/) (2023)

## Built on by (most cited first, 3 of 3)

- [FedLPPA: Learning Personalized Prompt and Aggregation for Federated Weakly-supervised Medical Image Segmentation](https://mlsanity.com/paper/2402.17502/) (2024)
- [MAMBO-NET: Multi-Causal Aware Modeling Backdoor-Intervention Optimization for Medical Image Segmentation Network](https://mlsanity.com/paper/2505.21874/) (2025)
- [Weakly Supervised Segmentation Framework for Thyroid Nodule Based on High-confidence Labels and High-rationality Losses](https://mlsanity.com/paper/2502.19707/) (2025)

## Abstract (arXiv)

Weakly-supervised segmentation (WSS) has emerged as a solution to mitigate the conflict between annotation cost and model performance by adopting sparse annotation formats (e.g., point, scribble, block, etc.). Typical approaches attempt to exploit anatomy and topology priors to directly expand sparse annotations into pseudo-labels. However, due to a lack of attention to the ambiguous edges in medical images and insufficient exploration of sparse supervision, existing approaches tend to generate erroneous and overconfident pseudo proposals in noisy regions, leading to cumulative model error and performance degradation. In this work, we propose a novel WSS approach, named ProCNS, encompassing two synergistic modules devised with the principles of progressive prototype calibration and noise suppression. Specifically, we design a Prototype-based Regional Spatial Affinity (PRSA) loss to maximize the pair-wise affinities between spatial and semantic elements, providing our model of interest with more reliable guidance. The affinities are derived from the input images and the prototype-refined predictions. Meanwhile, we propose an Adaptive Noise Perception and Masking (ANPM) module to obtain more enriched and representative prototype representations, which adaptively identifies and masks noisy regions within the pseudo proposals, reducing potential erroneous interference during prototype computation. Furthermore, we generate specialized soft pseudo-labels for the noisy regions identified by ANPM, providing supplementary supervision. Extensive experiments on six medical image segmentation tasks involving different modalities demonstrate that the proposed framework significantly outperforms representative state-of-the-art methods.