# Navigating Distribution Shifts in Medical Image Analysis: A Survey

arXiv: https://arxiv.org/abs/2411.05824 · HTML: https://mlsanity.com/paper/2411.05824/

## Key facts

- Cited by 5 papers in the map (data through 14 Oct 2026).
- Builds on 158 of its 321 references that are in the map.
- First posted on arXiv 5 Nov 2024.

## Builds on (most cited first, 30 of 158)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Semi-Supervised Classification with Graph Convolutional Networks](https://mlsanity.com/paper/1609.02907/) (2016)
- [Graph Attention Networks](https://mlsanity.com/paper/1710.10903/) (2017)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Communication-Efficient Learning of Deep Networks from Decentralized Data](https://mlsanity.com/paper/1602.05629/) (2016)
- [Federated Optimization in Heterogeneous Networks](https://mlsanity.com/paper/1812.06127/) (2018)
- [Improved Regularization of Convolutional Neural Networks with Cutout](https://mlsanity.com/paper/1708.04552/) (2017)
- [CyCADA: Cycle-Consistent Adversarial Domain Adaptation](https://mlsanity.com/paper/1711.03213/) (2017)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [Meta-Learning in Neural Networks: A Survey](https://mlsanity.com/paper/2004.05439/) (2020)
- [FedBN: Federated Learning on Non-IID Features via Local Batch Normalization](https://mlsanity.com/paper/2102.07623/) (2021)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [Domain Generalization with MixStyle](https://mlsanity.com/paper/2104.02008/) (2021)
- [Exploiting Shared Representations for Personalized Federated Learning](https://mlsanity.com/paper/2102.07078/) (2021)
- [Self-Challenging Improves Cross-Domain Generalization](https://mlsanity.com/paper/2007.02454/) (2020)
- [Domain Generalization via Model-Agnostic Learning of Semantic Features](https://mlsanity.com/paper/1910.13580/) (2019)
- [Deep Learning for Medical Image Analysis](https://mlsanity.com/paper/1708.08987/) (2017)
- [Domain Adaptation for Medical Image Analysis: A Survey](https://mlsanity.com/paper/2102.09508/) (2021)
- [FedProto: Federated Prototype Learning across Heterogeneous Clients](https://mlsanity.com/paper/2105.00243/) (2021)
- [Unsupervised Domain Adaptation with Residual Transfer Networks](https://mlsanity.com/paper/1602.04433/) (2016)
- [CHAOS Challenge -- Combined (CT-MR) Healthy Abdominal Organ Segmentation](https://mlsanity.com/paper/2001.06535/) (2020)
- [Med3D: Transfer Learning for 3D Medical Image Analysis](https://mlsanity.com/paper/1904.00625/) (2019)
- [FedDG: Federated Domain Generalization on Medical Image Segmentation via Episodic Learning in Continuous Frequency Space](https://mlsanity.com/paper/2103.06030/) (2021)
- [REFUGE Challenge: A Unified Framework for Evaluating Automated Methods for Glaucoma Assessment from Fundus Photographs](https://mlsanity.com/paper/1910.03667/) (2019)
- [Federated Learning for Smart Healthcare: A Survey](https://mlsanity.com/paper/2111.08834/) (2021)
- [Multi-Institutional Deep Learning Modeling Without Sharing Patient Data: A Feasibility Study on Brain Tumor Segmentation](https://mlsanity.com/paper/1810.04304/) (2018)
- [Generalized Federated Learning via Sharpness Aware Minimization](https://mlsanity.com/paper/2206.02618/) (2022)
- [Robust and Generalizable Visual Representation Learning via Random Convolutions](https://mlsanity.com/paper/2007.13003/) (2020)

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

- [Un-mixing Test-time Adaptation under Heterogeneous Data Streams](https://mlsanity.com/paper/2411.15173/) (2024)
- [An autonomous agent for auditing and improving the reliability of clinical AI models](https://mlsanity.com/paper/2507.05755/) (2025)
- [Unsupervised Susceptibility Distortion Correction of EPI without Calibration Scans via Image Translation-Based Registration](https://mlsanity.com/paper/2606.21588/) (2026)
- [Fully Automated High-Precision Segmentation of Retinal Atrophy and Ellipsoid Zone Thickness in OCT: A Reliable Tool for Real-World GA Monitoring](https://mlsanity.com/paper/2606.31502/) (2026)
- [How Far from Clinical Deployment? Evaluating the Complete Unsupervised Domain Adaptation Pipeline in Medical Imaging](https://mlsanity.com/paper/2608.12035/) (2026)

## Abstract (arXiv)

Medical Image Analysis (MedIA) has become indispensable in modern healthcare, enhancing clinical diagnostics and personalized treatment. Despite the remarkable advancements supported by deep learning (DL) technologies, their practical deployment faces challenges posed by distribution shifts, where models trained on specific datasets underperform on others from varying hospitals, or patient populations. To address this issue, researchers have been actively developing strategies to increase the adaptability of DL models, enabling their effective use in unfamiliar environments. This paper systematically reviews approaches that apply DL techniques to MedIA systems affected by distribution shifts. Rather than organizing existing methods by technical characteristics, we explicitly bridge real-world clinical constraints -- such as limited data accessibility, strict privacy requirements, and heterogeneous collaboration protocols -- with the technical paradigms able to address them. By establishing this connection between operational constraints and methodological evolution, we categorize existing works into Joint Training, Federated Learning, Fine-tuning, and Domain Generalization, each aligned with specific healthcare scenarios. Beyond this taxonomy, our empirical analysis suggests that, as domain information becomes progressively less accessible across these paradigms, performance improvements become increasingly constrained, and further uncovers a gradual shift in methodological focus from explicit distribution alignment toward uncertainty-aware modeling, ultimately pointing to the need for more deployability-aware design in real-world MedIA.