# The Devil is in the Statistics: Mitigating and Exploiting Statistics Difference for Generalizable Semi-supervised Medical Image Segmentation

arXiv: https://arxiv.org/abs/2407.11356 · HTML: https://mlsanity.com/paper/2407.11356/

## Key facts

- Cited by 5 papers in the map (data through 14 Oct 2026).
- Builds on 35 of its 45 references that are in the map.
- First posted on arXiv 16 Jul 2024.

## Builds on (most cited first, 30 of 35)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Batch Normalization: Accelerating Deep Network Training by Reducing Internal Covariate Shift](https://mlsanity.com/paper/1502.03167/) (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)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [Generalizing to Unseen Domains: A Survey on Domain Generalization](https://mlsanity.com/paper/2103.03097/) (2021)
- [Learning to Generalize: Meta-Learning for Domain Generalization](https://mlsanity.com/paper/1710.03463/) (2017)
- [Semi-Supervised Semantic Segmentation with Cross Pseudo Supervision](https://mlsanity.com/paper/2106.01226/) (2021)
- [Domain Generalization via Model-Agnostic Learning of Semantic Features](https://mlsanity.com/paper/1910.13580/) (2019)
- [Uncertainty-aware Self-ensembling Model for Semi-supervised 3D Left Atrium Segmentation](https://mlsanity.com/paper/1907.07034/) (2019)
- [FedDG: Federated Domain Generalization on Medical Image Segmentation via Episodic Learning in Continuous Frequency Space](https://mlsanity.com/paper/2103.06030/) (2021)
- [Embracing Imperfect Datasets: A Review of Deep Learning Solutions for Medical Image Segmentation](https://mlsanity.com/paper/1908.10454/) (2019)
- [Semi-supervised Medical Image Segmentation through Dual-task Consistency](https://mlsanity.com/paper/2009.04448/) (2020)
- [Not-so-supervised: a survey of semi-supervised, multi-instance, and transfer learning in medical image analysis](https://mlsanity.com/paper/1804.06353/) (2018)
- [Revisiting Weak-to-Strong Consistency in Semi-Supervised Semantic Segmentation](https://mlsanity.com/paper/2208.09910/) (2022)
- [Learning to Optimize Domain Specific Normalization for Domain Generalization](https://mlsanity.com/paper/1907.04275/) (2019)
- [Transformation Consistent Self-ensembling Model for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/1903.00348/) (2019)
- [Shape-aware Meta-learning for Generalizing Prostate MRI Segmentation to Unseen Domains](https://mlsanity.com/paper/2007.02035/) (2020)
- [Bidirectional Copy-Paste for Semi-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2305.00673/) (2023)
- [Semi-supervised Left Atrium Segmentation with Mutual Consistency Training](https://mlsanity.com/paper/2103.02911/) (2021)
- [Exploring Smoothness and Class-Separation for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2203.01324/) (2022)
- [A Simple Baseline for Semi-supervised Semantic Segmentation with Strong Data Augmentation](https://mlsanity.com/paper/2104.07256/) (2021)
- [Batch-Instance Normalization for Adaptively Style-Invariant Neural Networks](https://mlsanity.com/paper/1805.07925/) (2018)
- [DoFE: Domain-oriented Feature Embedding for Generalizable Fundus Image Segmentation on Unseen Datasets](https://mlsanity.com/paper/2010.06208/) (2020)
- [Inconsistency-aware Uncertainty Estimation for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2110.08762/) (2021)
- [Enhancing Pseudo Label Quality for Semi-Supervised Domain-Generalized Medical Image Segmentation](https://mlsanity.com/paper/2201.08657/) (2022)
- [Rethinking Data Augmentation for Single-source Domain Generalization in Medical Image Segmentation](https://mlsanity.com/paper/2211.14805/) (2022)
- [Semi-Supervised Domain Generalization with Stochastic StyleMatch](https://mlsanity.com/paper/2106.00592/) (2021)
- [Semi-supervised Meta-learning with Disentanglement for Domain-generalised Medical Image Segmentation](https://mlsanity.com/paper/2106.13292/) (2021)
- [Domain and Content Adaptive Convolution based Multi-Source Domain Generalization for Medical Image Segmentation](https://mlsanity.com/paper/2109.05676/) (2021)

## Built on by (most cited first, 5 of 5)

- [WeakMedSAM: Weakly-Supervised Medical Image Segmentation via SAM with Sub-Class Exploration and Prompt Affinity Mining](https://mlsanity.com/paper/2503.04106/) (2025)
- [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)
- [Balanced Direction from Multifarious Choices: Arithmetic Meta-Learning for Domain Generalization](https://mlsanity.com/paper/2503.18987/) (2025)
- [Bridging the Inter-Domain Gap through Low-Level Features for Cross-Modal Medical Image Segmentation](https://mlsanity.com/paper/2505.11909/) (2025)
- [Style-Aware Blending and Prototype-Based Cross-Contrast Consistency for Semi-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2507.20729/) (2025)

## Abstract (arXiv)

Despite the recent success of domain generalization in medical image segmentation, voxel-wise annotation for all source domains remains a huge burden. Semi-supervised domain generalization has been proposed very recently to combat this challenge by leveraging limited labeled data along with abundant unlabeled data collected from multiple medical institutions, depending on precisely harnessing unlabeled data while improving generalization simultaneously. In this work, we observe that domain shifts between medical institutions cause disparate feature statistics, which significantly deteriorates pseudo-label quality due to an unexpected normalization process. Nevertheless, this phenomenon could be exploited to facilitate unseen domain generalization. Therefore, we propose 1) multiple statistics-individual branches to mitigate the impact of domain shifts for reliable pseudo-labels and 2) one statistics-aggregated branch for domain-invariant feature learning. Furthermore, to simulate unseen domains with statistics difference, we approach this from two aspects, i.e., a perturbation with histogram matching at image level and a random batch normalization selection strategy at feature level, producing diverse statistics to expand the training distribution. Evaluation results on three medical image datasets demonstrate the effectiveness of our method compared with recent SOTA methods. The code is available at https://github.com/qiumuyang/SIAB.