# Prototypical Few-Shot Medical Image Semantic Segmentation with Background Fusion

arXiv: https://arxiv.org/abs/2412.02983 · HTML: https://mlsanity.com/paper/2412.02983/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 22 of its 40 references that are in the map.
- First posted on arXiv 4 Dec 2024.

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

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Non-local Neural Networks](https://mlsanity.com/paper/1711.07971/) (2017)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [SegNet: A Deep Convolutional Encoder-Decoder Architecture for Image Segmentation](https://mlsanity.com/paper/1511.00561/) (2015)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [CCNet: Criss-Cross Attention for Semantic Segmentation](https://mlsanity.com/paper/1811.11721/) (2018)
- [PANet: Few-Shot Image Semantic Segmentation with Prototype Alignment](https://mlsanity.com/paper/1908.06391/) (2019)
- [Learning Deconvolution Network for Semantic Segmentation](https://mlsanity.com/paper/1505.04366/) (2015)
- [One-Shot Learning for Semantic Segmentation](https://mlsanity.com/paper/1709.03410/) (2017)
- [CHAOS Challenge -- Combined (CT-MR) Healthy Abdominal Organ Segmentation](https://mlsanity.com/paper/2001.06535/) (2020)
- [Multivariate mixture model for myocardium segmentation combining multi-source images](https://mlsanity.com/paper/1612.08820/) (2016)
- [Self-Supervision with Superpixels: Training Few-shot Medical Image Segmentation without Annotation](https://mlsanity.com/paper/2007.09886/) (2020)
- ['Squeeze & Excite' Guided Few-Shot Segmentation of Volumetric Images](https://mlsanity.com/paper/1902.01314/) (2019)
- [Few-shot Medical Image Segmentation using a Global Correlation Network with Discriminative Embedding](https://mlsanity.com/paper/2012.05440/) (2020)
- [Y-Net: Joint Segmentation and Classification for Diagnosis of Breast Biopsy Images](https://mlsanity.com/paper/1806.01313/) (2018)
- [Anomaly Detection-Inspired Few-Shot Medical Image Segmentation Through Self-Supervision With Supervoxels](https://mlsanity.com/paper/2203.02048/) (2022)
- [Few-shot Medical Image Segmentation with Cycle-resemblance Attention](https://mlsanity.com/paper/2212.03967/) (2022)
- [Few-Shot Medical Image Segmentation via a Region-enhanced Prototypical Transformer](https://mlsanity.com/paper/2309.04825/) (2023)
- [Q-Net: Query-Informed Few-Shot Medical Image Segmentation](https://mlsanity.com/paper/2208.11451/) (2022)
- [Prototype Correlation Matching and Class-Relation Reasoning for Few-Shot Medical Image Segmentation](https://mlsanity.com/paper/2406.05054/) (2024)
- [Few-Shot Medical Image Segmentation with Large Kernel Attention](https://mlsanity.com/paper/2407.19148/) (2024)

## Abstract (arXiv)

Few-shot Semantic Segmentation (FSS) aims to adapt a pre-trained model to new classes with as few as a single labeled training sample per class. The existing prototypical work used in natural image scenarios biasedly focus on capturing foreground's discrimination while employing a simplistic representation for background, grounded on the inherent observation separation between foreground and background. However, a frequency spectrum entropy analysis suggests that this paradigm is not applicable to medical images where the foreground and background share numerous visual features, necessitating a more detailed description for the background. In this paper, we present a new Background-fused prototype (Bro) approach for FSS in medical images. Instead of identifying a commonality of background subjects in the support image, Bro fuses this background to discriminative prototypes, with two pivot designs. Specifically, Feature Similarity Calibration (FeaC) initially reduces noise in the support image by employing feature cross-attention with the query image. Subsequently, Hierarchical Channel-Adversarial Attention (HiCA) merges the background into comprehensive prototypes. We achieve this by a channel groups-based attention mechanism, where an adversarial Mean-Offset structure encourages a coarse-to-fine fusion. Designed as a generic plug-in, our Bro can be seamlessly integrated with existing FSS models. Extensive experiments validate the specificity of the background in medical images and the efficacy of Bro in enhancing the performance of previous FSS models on standard benchmarks.