# Rethink Domain Generalization in Heterogeneous Sequence MRI Segmentation

arXiv: https://arxiv.org/abs/2507.23110 · HTML: https://mlsanity.com/paper/2507.23110/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 28 of its 38 references that are in the map.
- First posted on arXiv 30 Jul 2025.

## Builds on (most cited first, 28 of 28)

- [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)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Distributionally Robust Neural Networks for Group Shifts: On the Importance of Regularization for Worst-Case Generalization](https://mlsanity.com/paper/1911.08731/) (2019)
- [In Search of Lost Domain Generalization](https://mlsanity.com/paper/2007.01434/) (2020)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Generalizing to Unseen Domains: A Survey on Domain Generalization](https://mlsanity.com/paper/2103.03097/) (2021)
- [Out-of-Distribution Generalization via Risk Extrapolation (REx)](https://mlsanity.com/paper/2003.00688/) (2020)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [Domain Generalization with MixStyle](https://mlsanity.com/paper/2104.02008/) (2021)
- [MONAI: An open-source framework for deep learning in healthcare](https://mlsanity.com/paper/2211.02701/) (2022)
- [AMOS: A Large-Scale Abdominal Multi-Organ Benchmark for Versatile Medical Image Segmentation](https://mlsanity.com/paper/2206.08023/) (2022)
- [FedDG: Federated Domain Generalization on Medical Image Segmentation via Episodic Learning in Continuous Frequency Space](https://mlsanity.com/paper/2103.06030/) (2021)
- [Gradient Starvation: A Learning Proclivity in Neural Networks](https://mlsanity.com/paper/2011.09468/) (2020)
- [Invariance Principle Meets Information Bottleneck for Out-of-Distribution Generalization](https://mlsanity.com/paper/2106.06607/) (2021)
- [Robust and Generalizable Visual Representation Learning via Random Convolutions](https://mlsanity.com/paper/2007.13003/) (2020)
- [Shape-aware Meta-learning for Generalizing Prostate MRI Segmentation to Unseen Domains](https://mlsanity.com/paper/2007.02035/) (2020)
- [MS-Net: Multi-Site Network for Improving Prostate Segmentation with Heterogeneous MRI Data](https://mlsanity.com/paper/2002.03366/) (2020)
- [SAM-Med3D: Towards General-purpose Segmentation Models for Volumetric Medical Images](https://mlsanity.com/paper/2310.15161/) (2023)
- [STU-Net: Scalable and Transferable Medical Image Segmentation Models Empowered by Large-Scale Supervised Pre-training](https://mlsanity.com/paper/2304.06716/) (2023)
- [SegVol: Universal and Interactive Volumetric Medical Image Segmentation](https://mlsanity.com/paper/2311.13385/) (2023)
- [Probable Domain Generalization via Quantile Risk Minimization](https://mlsanity.com/paper/2207.09944/) (2022)
- [SAM Fails to Segment Anything? -- SAM-Adapter: Adapting SAM in Underperformed Scenes: Camouflage, Shadow, Medical Image Segmentation, and More](https://mlsanity.com/paper/2304.09148/) (2023)
- [Realistic Adversarial Data Augmentation for MR Image Segmentation](https://mlsanity.com/paper/2006.13322/) (2020)
- [Touchstone Benchmark: Are We on the Right Way for Evaluating AI Algorithms for Medical Segmentation?](https://mlsanity.com/paper/2411.03670/) (2024)
- [Domain Generalizer: A Few-shot Meta Learning Framework for Domain Generalization in Medical Imaging](https://mlsanity.com/paper/2008.07724/) (2020)
- [Large Scale MRI Collection and Segmentation of Cirrhotic Liver](https://mlsanity.com/paper/2410.16296/) (2024)
- [Domain Generalization with Adversarial Intensity Attack for Medical Image Segmentation](https://mlsanity.com/paper/2304.02720/) (2023)

## Built on by (most cited first, 1 of 1)

- [Why Invariance is Not Enough for Biomedical Domain Generalization and How to Fix It](https://mlsanity.com/paper/2604.02564/) (2026)

## Abstract (arXiv)

Clinical magnetic-resonance (MR) protocols generate many T1 and T2 sequences whose appearance differs more than the acquisition sites that produce them. Existing domain-generalization benchmarks focus almost on cross-center shifts and overlook this dominant source of variability. Pancreas segmentation remains a major challenge in abdominal imaging: the gland is small, irregularly, surrounded by organs and fat, and often suffers from low T1 contrast. State-of-the-art deep networks that already achieve >90% Dice on the liver or kidneys still miss 20-30% of the pancreas. The organ is also systematically under-represented in public cross-domain benchmarks, despite its clinical importance in early cancer detection, surgery, and diabetes research. To close this gap, we present PancreasDG, a large-scale multi-center 3D MRI pancreas segmentation dataset for investigating domain generalization in medical imaging. The dataset comprises 563 MRI scans from six institutions, spanning both venous phase and out-of-phase sequences, enabling study of both cross-center and cross-sequence variations with pixel-accurate pancreas masks created by a double-blind, two-pass protocol. Through comprehensive analysis, we reveal three insights: (i) limited sampling introduces significant variance that may be mistaken for distribution shifts, (ii) cross-center performance correlates with source domain performance for identical sequences, and (iii) cross-sequence shifts require specialized solutions. We also propose a semi-supervised approach that leverages anatomical invariances, significantly outperforming state-of-the-art domain generalization techniques with 61.63% Dice score improvements and 87.00% on two test centers for cross-sequence segmentation. PancreasDG sets a new benchmark for domain generalization in medical imaging. Dataset, code, and models will be available at https://pancreasdg.netlify.app.